{"reporting_entity_name": "GIIC_TPA","reporting_entity_type": "GIIC_Geisinger Indemnity Insurance Company","last_updated_on": "2026-10-07","version": "2.0","provider_references": [                                                                                                                                                    
{"provider_group_id":541545860,"network_name":[],"provider_groups":[{"npi":[1003088295,1326060492,1497814040,1609112036,1699798942],"tin":{"type":"ein","value":"231352222","business_name":"York Hospital"}}]}
], "in_network" : [
{"negotiation_arrangement":"ffs","name":"Room & board - semi-private two bed - pediatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0123","description":"Room & board - semi-private two bed - pediatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board ward - other","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0159","description":"Room & board ward - other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private (deluxe) - ob","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0142","description":"Private (deluxe) - ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-private - three & four beds - detoxification","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0136","description":"Semi-private - three & four beds - detoxification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board ward","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0150","description":"Room & board ward","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursery - newborn level 1","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0171","description":"Nursery - newborn level 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive care - trauma","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0208","description":"Intensive care - trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subacute care - level iii (complex care)","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0193","description":"Subacute care - level iii (complex care)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"per diem","negotiated_rate":420.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - private - oncology","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0117","description":"Room & board - private - oncology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private (deluxe) - oncology","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0147","description":"Private (deluxe) - oncology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursery","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0170","description":"Nursery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-private - three & four beds","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0130","description":"Semi-private - three & four beds","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive care - other intensive care","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0209","description":"Intensive care - other intensive care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private (deluxe) - pediatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0143","description":"Private (deluxe) - pediatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursery - newborn level 3","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0173","description":"Nursery - newborn level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board ward - psychiatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0154","description":"Room & board ward - psychiatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-private - three & four beds - ob","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0132","description":"Semi-private - three & four beds - ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private (deluxe) - psychiatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0144","description":"Private (deluxe) - psychiatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-private - three & four beds - oncology","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0137","description":"Semi-private - three & four beds - oncology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - private - pediatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0113","description":"Room & board - private - pediatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"All - inclusive room and board plus ancillary","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0100","description":"All - inclusive room and board plus ancillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other room & board - self care","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0167","description":"Other room & board - self care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subacute care - level i (skilled care)","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0191","description":"Subacute care - level i (skilled care)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"per diem","negotiated_rate":420.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private (deluxe)","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0140","description":"Private (deluxe)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subacute care - level ii (comprehensive care)","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0192","description":"Subacute care - level ii (comprehensive care)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"per diem","negotiated_rate":420.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board ward - pediatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0153","description":"Room & board ward - pediatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive care - burn care","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0207","description":"Intensive care - burn care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive care","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0200","description":"Intensive care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive care - psychiatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0204","description":"Intensive care - psychiatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - private","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0110","description":"Room & board - private","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board ward - ob","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0152","description":"Room & board ward - ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-private - three & four beds - psychiatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0134","description":"Semi-private - three & four beds - psychiatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive care - icu","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0206","description":"Intensive care - icu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-private - three & four beds - rehabilitation","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0138","description":"Semi-private - three & four beds - rehabilitation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board ward - rehabilitation","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0158","description":"Room & board ward - rehabilitation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive care - pediatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0203","description":"Intensive care - pediatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board ward - detoxification","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0156","description":"Room & board ward - detoxification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursery - newborn level 4","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0174","description":"Nursery - newborn level 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other room & board - other","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0169","description":"Other room & board - other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-private - three & four beds - pediatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0133","description":"Semi-private - three & four beds - pediatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board ward - medical/surgical/gyn","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0151","description":"Room & board ward - medical/surgical/gyn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private (deluxe) - hospice","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0145","description":"Private (deluxe) - hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private (deluxe) - other","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0149","description":"Private (deluxe) - other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursery - other","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0179","description":"Nursery - other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursery - newborn level 2","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0172","description":"Nursery - newborn level 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive care - surgical","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0201","description":"Intensive care - surgical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private (deluxe) - medical/surgical/gyn","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0141","description":"Private (deluxe) - medical/surgical/gyn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - semi-private two bed - psychiatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0124","description":"Room & board - semi-private two bed - psychiatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private (deluxe) - rehabilitation","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0148","description":"Private (deluxe) - rehabilitation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - semi-private two bed - rehabilitation","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0128","description":"Room & board - semi-private two bed - rehabilitation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-private - three & four beds - other","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0139","description":"Semi-private - three & four beds - other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - semi-private two bed","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0120","description":"Room & board - semi-private two bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - private - psychiatric","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0114","description":"Room & board - private - psychiatric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - private - rehabilitation","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0118","description":"Room & board - private - rehabilitation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - semi-private two bed - medical/surgical/gyn","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0121","description":"Room & board - semi-private two bed - medical/surgical/gyn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - semi-private two bed - other","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0129","description":"Room & board - semi-private two bed - other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - semi-private two bed - hospice","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0125","description":"Room & board - semi-private two bed - hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board ward - oncology","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0157","description":"Room & board ward - oncology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary care - heart transplant","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0213","description":"Coronary care - heart transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive care - medical","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0202","description":"Intensive care - medical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - semi-private two bed - ob","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0122","description":"Room & board - semi-private two bed - ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - semi-private two bed - detoxification","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0126","description":"Room & board - semi-private two bed - detoxification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - private - medical/surgical/gyn","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0111","description":"Room & board - private - medical/surgical/gyn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - private - other","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0119","description":"Room & board - private - other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-private - three & four beds - medical/surgical/gyn","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0131","description":"Semi-private - three & four beds - medical/surgical/gyn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - private - ob","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0112","description":"Room & board - private - ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - private - detoxification","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0116","description":"Room & board - private - detoxification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-private - three & four beds - hospice","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0135","description":"Semi-private - three & four beds - hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - semi-private two bed - oncology","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0127","description":"Room & board - semi-private two bed - oncology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private (deluxe) - detoxification","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0146","description":"Private (deluxe) - detoxification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary care - myocardial infarction","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0211","description":"Coronary care - myocardial infarction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary care - other coronary care","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0219","description":"Coronary care - other coronary care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other room & board - sterile environment","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0164","description":"Other room & board - sterile environment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other room & board","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0160","description":"Other room & board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary care - ccu","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0214","description":"Coronary care - ccu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary care","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0210","description":"Coronary care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary care - pulmonary care","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0212","description":"Coronary care - pulmonary care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board - private - hospice","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0115","description":"Room & board - private - hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room & board ward - hospice","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0155","description":"Room & board ward - hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"All - inclusive room and board","billing_code_type":"RC","billing_code_type_version":"2024","billing_code":"0101","description":"All - inclusive room and board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"inpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOF1","description":"ICD-HIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth kidney transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86851","description":"Anesth kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQB1","description":"ICD-OLQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVB0","description":"ICD-FHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","description":"HCPCS-J7173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ciliary transsleral therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66710","description":"Ciliary transsleral therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJE1","description":"ICD-OHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCC0","description":"ICD-IDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERA0","description":"ICD-KERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl devital tis 20 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97597","description":"Rmvl devital tis 20 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29836","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGC0","description":"ICD-OBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXE1","description":"ICD-CBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISA0","description":"ICD-CISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUF0","description":"ICD-CCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLC0","description":"ICD-MKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correct rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45540","description":"Correct rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJA1","description":"ICD-GGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHE1","description":"ICD-KFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEE1","description":"ICD-IFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93622","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rev_ comm_ track_ doc biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8883","description":"Rev_ comm_ track_ doc biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prp i/hern init block >5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49507","description":"Prp i/hern init block >5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treponema pallidum ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87285","description":"Treponema pallidum ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28E","description":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJD1","description":"ICD-KAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph bx rprt w/dyspl info","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3126F","description":"Esoph bx rprt w/dyspl info","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smear complex stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87209","description":"Smear complex stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE135","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","description":"HCPCS-M1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bso omentectomy w/tah","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58956","description":"Bso omentectomy w/tah","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOD0","description":"ICD-HGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVB1","description":"ICD-CEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB236","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEE0","description":"ICD-AFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gr 34 nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2358","description":"Gr 34 nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAB0","description":"ICD-EFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAB1","description":"ICD-FAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKB0","description":"ICD-NBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOA1","description":"ICD-LBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOC0","description":"ICD-DIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8D","description":"High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHF1","description":"ICD-KDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKB0","description":"ICD-CEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastroesophageal reflux exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78262","description":"Gastroesophageal reflux exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trans elec jt stim dev sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0762","description":"Trans elec jt stim dev sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKE0","description":"ICD-NIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEE1","description":"ICD-KFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKA0","description":"ICD-NDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1076T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1076T","description":"CPT-1076T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21A","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ bivalent spike protein_ preservative free_ 3 mcg/0.2 mL dosage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91317","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ bivalent spike protein_ preservative free_ 3 mcg/0.2 mL dosage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0749T","description":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44121","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Matristem micromatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4118","description":"Matristem micromatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occlusal guard - hard appliance_ partial arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9946","description":"Occlusal guard - hard appliance_ partial arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIC1","description":"ICD-NDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJA1","description":"ICD-KGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC210","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain image w/flow < 4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78601","description":"Brain image w/flow < 4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise excessive skin leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15833","description":"Excise excessive skin leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAF1","description":"ICD-MGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extrnl bleaching per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9973","description":"Extrnl bleaching per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEF0","description":"ICD-GCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam drg >16<=48 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6210","description":"Foam drg >16<=48 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ear microscopy examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92504","description":"Ear microscopy examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ Cardiac Contractility Modulation (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1824","description":"Generator_ Cardiac Contractility Modulation (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUE1","description":"ICD-FBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFB0","description":"ICD-GAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIA0","description":"ICD-EEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDC0","description":"ICD-KFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFA1","description":"ICD-FBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLF1","description":"ICD-CGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIE0","description":"ICD-JAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBC0","description":"ICD-IFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCD0","description":"ICD-KDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEB1","description":"ICD-OFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMA1","description":"ICD-MDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1404","description":"HCPCS-C1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLD1","description":"ICD-OJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Approp anticonvuls tstng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4191F","description":"Approp anticonvuls tstng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscop mucosal resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43211","description":"Esophagoscop mucosal resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemolysins/agglutinins auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86940","description":"Hemolysins/agglutinins auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0494U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","description":"CPT-0494U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ft prosth multiaxial ankl/ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5978","description":"Ft prosth multiaxial ankl/ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOD1","description":"ICD-DCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0669","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0669","description":"HCPCS-G0669","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0565","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0565","description":"HCPCS-G0565","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sotalol hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9482","description":"Injection_ sotalol hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRE1","description":"ICD-LCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKC0","description":"ICD-KAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJA0","description":"ICD-FBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who screened positive for at least 1 of the 5 hrsns","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1320","description":"Patients who screened positive for at least 1 of the 5 hrsns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Free myo/skin flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15756","description":"Free myo/skin flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0903","description":"HCPCS-A0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJA0","description":"ICD-KIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0017","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9632","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6519","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","description":"HCPCS-A6519","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL33","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace thrc unit hrt syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052T","description":"Replace thrc unit hrt syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33478","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDB1","description":"ICD-JIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoluminal bx biliary tree","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47543","description":"Endoluminal bx biliary tree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJC0","description":"ICD-GCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGF0","description":"ICD-BCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC21","description":"ICD-3LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAC0","description":"ICD-NHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUE0","description":"ICD-NFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rehab thxpy options w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4400F","description":"Rehab thxpy options w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ sacral_ with integrated neurostimulator_ including imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0786T","description":"Insertion or replacement of percutaneous electrode array_ sacral_ with integrated neurostimulator_ including imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient  compression arm sleeve and glove combination_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6575","description":"Gradient  compression arm sleeve and glove combination_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQE0","description":"ICD-KFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFE0","description":"ICD-OLFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAE1","description":"ICD-IAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWD0","description":"ICD-PJWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5275","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2865","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","description":"HCPCS-J2865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3C","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic mens shoes oxford","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3219","description":"Orthopedic mens shoes oxford","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDD1","description":"ICD-GEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB201","description":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNE1","description":"ICD-NJNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anes spine transthor w/vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62659","description":"Anes spine transthor w/vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACE0","description":"ICD-IACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg artery-vein four","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33521","description":"Cabg artery-vein four","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQA0","description":"ICD-OGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCB0","description":"ICD-FDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVE1","description":"ICD-OBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJA0","description":"ICD-CHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of patient-activated cardiac event recorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33282","description":"Implantation of patient-activated cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUC1","description":"ICD-IIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTF0","description":"ICD-JBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFF0","description":"ICD-OHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEF0","description":"ICD-ICEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1139","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ho flex pavlik harns pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1620","description":"Ho flex pavlik harns pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA31","description":"ICD-1GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQC1","description":"ICD-LAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density_ tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0508T","description":"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density_ tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMD1","description":"ICD-JFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALE1","description":"ICD-CALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foscarnet sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1455","description":"Foscarnet sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC106","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise max/zygoma mal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21034","description":"Excise max/zygoma mal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neutron beam tx simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77422","description":"Neutron beam tx simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28X","description":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVA1","description":"ICD-JBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53430","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASC0","description":"ICD-GASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect recur gyn mal w/lym","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58958","description":"Resect recur gyn mal w/lym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1902","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1902","description":"CDT-D1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUA0","description":"ICD-NIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","description":"HCPCS-E1033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGB1","description":"ICD-BCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJA1","description":"ICD-NKJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rx corneoscleral cntact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92317","description":"Rx corneoscleral cntact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLA1","description":"ICD-ACLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20D","description":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINA1","description":"ICD-NINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILA0","description":"ICD-GILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78264","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7030","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLD1","description":"ICD-JFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA201","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O shoe convert to sof counte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3590","description":"O shoe convert to sof counte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable endoscope sheath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4270","description":"Disposable endoscope sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMA1","description":"ICD-AIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ gadopiclenol_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9573","description":"Injection_ gadopiclenol_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL45","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADA1","description":"ICD-CADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23465","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEF1","description":"ICD-EDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Work hardening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97545","description":"Work hardening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXF0","description":"ICD-CHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC245","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCB0","description":"ICD-ICCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0802","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0802","description":"CDT-D0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33860","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15200","description":"Skin full graft trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC231","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML03","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRE0","description":"ICD-GIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHE1","description":"ICD-MEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38530","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98985","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","description":"CPT-98985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antithrombin recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7196","description":"Antithrombin recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEE0","description":"ICD-GBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIME1","description":"ICD-KIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC135","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62304","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMA0","description":"ICD-CEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWA0","description":"ICD-KAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCC1","description":"ICD-NFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAC1","description":"ICD-JCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ENTAMOEBA HISTOLYTICA GRP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87337","description":"IAAD IA ENTAMOEBA HISTOLYTICA GRP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glycosylated hemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83036","description":"Glycosylated hemoglobin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 4mod sacro-scap pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0464","description":"Tlso 4mod sacro-scap pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBD1","description":"ICD-EEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25335","description":"Realignment of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Disease Other Than Dissection (Eg_ Aneurysm)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33859","description":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Disease Other Than Dissection (Eg_ Aneurysm)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJA1","description":"ICD-NHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx multi myeloma stage i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9128","description":"Onc dx multi myeloma stage i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIB1","description":"ICD-IHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMA0","description":"ICD-AFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA31","description":"ICD-3BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBC1","description":"ICD-JDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUD1","description":"ICD-MKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX44","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29824","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD135","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYE0","description":"ICD-DEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPC0","description":"ICD-FHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy for bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44391","description":"Colonoscopy for bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Augmentation cheek bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21270","description":"Augmentation cheek bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hgb lvl >/= 13 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3279F","description":"Hgb lvl >/= 13 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDE0","description":"ICD-EGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hfo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3913","description":"Hfo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive ear canal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69150","description":"Extensive ear canal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE236","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIE0","description":"ICD-NKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8A","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93976","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVB0","description":"ICD-JFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASC0","description":"ICD-HASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSD1","description":"ICD-CBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL51","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTE0","description":"ICD-BFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACA0","description":"ICD-KACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not screening for TB or interpreting results (i.e._ patient positive for TB and documentati","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1004","description":"Documentation of medical reason for not screening for TB or interpreting results (i.e._ patient positive for TB and documentati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCC0","description":"ICD-NDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCA1","description":"ICD-NLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54200","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2047","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2047","description":"HCPCS-A2047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGED0","description":"ICD-GGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXD0","description":"ICD-FGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech lang goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9175","description":"Speech lang goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens hydrophil bifocl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2522","description":"Cntct lens hydrophil bifocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of angiotensin ii","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82163","description":"Assay of angiotensin ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phq-scr >9 doc in 12m time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9572","description":"Phq-scr >9 doc in 12m time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB256","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKD1","description":"ICD-BGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Co-morbid condition assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1026F","description":"Co-morbid condition assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNC1","description":"ICD-GHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFA1","description":"ICD-CHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29200","description":"Strapping of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA21","description":"ICD-3LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYD0","description":"ICD-OLYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMF0","description":"ICD-BEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electro connect btw 2 sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2311","description":"Electro connect btw 2 sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ naxitamab-gqgk_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9348","description":"Injection_ naxitamab-gqgk_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg monitoring/computer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95953","description":"Eeg monitoring/computer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATC0","description":"ICD-JATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHF1","description":"ICD-OBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasty_ one vertebral body_ unilateral or bilateral injection; cervical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2360","description":"Percutaneous vertebroplasty_ one vertebral body_ unilateral or bilateral injection; cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLF0","description":"ICD-MKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARD1","description":"ICD-LARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lap enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83670","description":"Assay of lap enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHF1","description":"ICD-NDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSA1","description":"ICD-GFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPA1","description":"ICD-FIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEC0","description":"ICD-CIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDD0","description":"ICD-AHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXB1","description":"ICD-OEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUD1","description":"ICD-MIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDA1","description":"ICD-FFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPF0","description":"ICD-JBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUF1","description":"ICD-FDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraop kinetic balnce sensr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0396T","description":"Intraop kinetic balnce sensr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O2 flow reg pos inspir press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1352","description":"O2 flow reg pos inspir press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24B","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEE1","description":"ICD-CBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSD1","description":"ICD-PJSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit cath repair kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5518","description":"Hit cath repair kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Htlv-ii antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86688","description":"Htlv-ii antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCE1","description":"ICD-NFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJE1","description":"ICD-JIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOF0","description":"ICD-OKOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSB0","description":"ICD-LBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0585T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMA1","description":"ICD-OJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETD1","description":"ICD-KETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAE0","description":"ICD-FBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMF1","description":"ICD-FBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIE1","description":"ICD-FFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient has a reactive hcv antibody test_ and has a follow up hcv viral test that does not detect hcv viremia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1234","description":"Patient has a reactive hcv antibody test_ and has a follow up hcv viral test that does not detect hcv viremia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXA0","description":"ICD-KBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYD0","description":"ICD-HEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bio mtrls to aid soft/os reg","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4265","description":"Bio mtrls to aid soft/os reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefepime hydrochloride (b braun)_ not therapeutically equivalent to maxipime_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0703","description":"Injection_ cefepime hydrochloride (b braun)_ not therapeutically equivalent to maxipime_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNB0","description":"ICD-BBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUC1","description":"ICD-BDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOA1","description":"ICD-PLOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBD1","description":"ICD-KBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscpy inj agent for incont","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0377T","description":"Anoscpy inj agent for incont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (Baxter)_ not therapeutically equivalent to J0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0874","description":"Injection_ daptomycin (Baxter)_ not therapeutically equivalent to J0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSB0","description":"ICD-GCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15999","description":"Removal of pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc lymphatic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38589","description":"Laparoscope proc lymphatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise spine cord vsl thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63252","description":"Revise spine cord vsl thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aminocaproic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0017","description":"Injection_ aminocaproic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL14","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA06","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including MR guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10011","description":"Fine needle aspiration biopsy_ including MR guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject for spine disk x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62291","description":"Inject for spine disk x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRF1","description":"ICD-OFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERC0","description":"ICD-KERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB21","description":"ICD-4JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0750","description":"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aqueous shunt eye w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66179","description":"Aqueous shunt eye w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCA0","description":"ICD-MBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLA1","description":"ICD-FFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50574","description":"Kidney endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSE0","description":"ICD-DFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML46","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOC0","description":"ICD-OKOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYE0","description":"ICD-KIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27228","description":"Treat hip fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Car seat/bed test 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94780","description":"Car seat/bed test 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCC0","description":"ICD-BHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDB1","description":"ICD-NJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAC1","description":"ICD-OKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","description":"CPT-76014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tap block bi injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64488","description":"Tap block bi injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYD1","description":"ICD-KFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6067","description":"Implant supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGD0","description":"ICD-CDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUA1","description":"ICD-EIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt info into recall system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7010F","description":"Pt info into recall system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optical endomicroscpy interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88375","description":"Optical endomicroscpy interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVE1","description":"ICD-KEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEE1","description":"ICD-CEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD226","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLC0","description":"ICD-IBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDF0","description":"ICD-KEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKC1","description":"ICD-GFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-op service lvrs 1-9 dos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0304","description":"Pre-op service lvrs 1-9 dos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSD0","description":"ICD-OGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTB1","description":"ICD-IBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1243","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAA1","description":"ICD-IDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31070","description":"Exploration of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC44","description":"Medium Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-waterproof tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4450","description":"Non-waterproof tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA214","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retain crown resin w hi nble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6720","description":"Retain crown resin w hi nble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy vent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4366","description":"Ostomy vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKA1","description":"ICD-BEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photochemotherapy uv-a or b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96913","description":"Photochemotherapy uv-a or b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRF0","description":"ICD-OHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound filler dry form / gram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6262","description":"Wound filler dry form / gram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFD0","description":"ICD-OGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADF1","description":"ICD-IADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGED1","description":"ICD-AGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair nose to lip fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42260","description":"Repair nose to lip fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Torsion straight knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2380","description":"Torsion straight knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB155","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARA0","description":"ICD-PARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNC0","description":"ICD-BDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artacent AC_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4189","description":"Artacent AC_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLB1","description":"ICD-OFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag-coronal panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0638","description":"Lso sag-coronal panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lrh hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83727","description":"Assay of lrh hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAB0","description":"ICD-MIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apomorphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0364","description":"Apomorphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32100","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUA0","description":"ICD-BGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILC1","description":"ICD-FILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8B","description":"Low Rehab_ ADL Index 0-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ASPERGILLUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87305","description":"IAAD IA ASPERGILLUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revitalon 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4157","description":"Revitalon 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUC0","description":"ICD-IHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTD0","description":"ICD-ICTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEE0","description":"ICD-EDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open tx post pelvic fxcture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0415","description":"Open tx post pelvic fxcture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Services provided as part of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9990","description":"Services provided as part of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKF0","description":"ICD-BDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBF1","description":"ICD-OLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEID0","description":"ICD-JEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDED0","description":"ICD-FDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQC0","description":"ICD-LHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGB0","description":"ICD-CFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Employment Benefits Counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1740","description":"Employment Benefits Counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJB1","description":"ICD-CIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prefab glove for term device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6890","description":"Prefab glove for term device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1705","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1705","description":"CDT-D1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFA1","description":"ICD-ODFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0061","description":"Anesthesiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc forearm tum deep < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25076","description":"Exc forearm tum deep < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth kidney stone destruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87251","description":"Anesth kidney stone destruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninterest escort in non er","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0080","description":"Noninterest escort in non er","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12C","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 1)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1713","description":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 1)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3A","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCE0","description":"ICD-OLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRA1","description":"ICD-LBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPE0","description":"ICD-FIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBA0","description":"ICD-MHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTF1","description":"ICD-GGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDB1","description":"ICD-KGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8H","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Sandwich","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1761","description":"Home Delivered Meals-Sandwich","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVB0","description":"ICD-GDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clear eyelid gland w/heat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0207T","description":"Clear eyelid gland w/heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCD0","description":"ICD-OFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFE0","description":"ICD-GIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVE1","description":"ICD-GFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETB0","description":"ICD-EETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mobile arm supports reclinin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2628","description":"Mobile arm supports reclinin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15A","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOD1","description":"ICD-OIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGB1","description":"ICD-JDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"R&l hrt art/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93461","description":"R&l hrt art/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIB0","description":"ICD-IGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHB1","description":"ICD-GEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCC0","description":"ICD-EHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Latex leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5113","description":"Latex leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icg angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92240","description":"Icg angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHB0","description":"ICD-NBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCF0","description":"ICD-JGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPB1","description":"ICD-OBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBF0","description":"ICD-MJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAD0","description":"ICD-IIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28615","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap gastr bypass incl smll i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43645","description":"Lap gastr bypass incl smll i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHE0","description":"ICD-IFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ c-131","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2642","description":"Brachytx_ stranded_ c-131","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wash harvest stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38209","description":"Wash harvest stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIE1","description":"ICD-CHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIE1","description":"ICD-AIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace cover w/c seat cush","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2619","description":"Replace cover w/c seat cush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC32","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sperm washing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58323","description":"Sperm washing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD145","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Split flat caliper stirr & p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2230","description":"Split flat caliper stirr & p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sperm isolation simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89260","description":"Sperm isolation simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2205","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko w adj flex/ext rotat mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1846","description":"Ko w adj flex/ext rotat mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gad-base mr contrast nos_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9579","description":"Gad-base mr contrast nos_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52265","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHD0","description":"ICD-KIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1074","description":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAB0","description":"ICD-KAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28606","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBB0","description":"ICD-JIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of midfoot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28304","description":"Incision of midfoot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sitz type bath or equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0160","description":"Sitz type bath or equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTC1","description":"ICD-NCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES214","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHA0","description":"ICD-CGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNA0","description":"ICD-GDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFE0","description":"ICD-GBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBE1","description":"ICD-EDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWE0","description":"ICD-LDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAF1","description":"ICD-GCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Demonstrate use home inr mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0248","description":"Demonstrate use home inr mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPE1","description":"ICD-FIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRC1","description":"ICD-ODRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAA1","description":"ICD-BIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHND0","description":"ICD-NHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No 30 day f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9404","description":"No 30 day f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMA0","description":"ICD-MJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9164","description":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE112","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA31","description":"ICD-1CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWF1","description":"ICD-OEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25444","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4043","description":"Cast sup lng leg splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Preparation And Transmission","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0711T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Preparation And Transmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEB1","description":"ICD-ICEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1285","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATA1","description":"ICD-CATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clin depression screen not d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8432","description":"Clin depression screen not d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Posterior gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8000","description":"Posterior gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEC0","description":"ICD-OJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACF1","description":"ICD-CACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGB0","description":"ICD-NLGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36800","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58210","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary colon cancer disorders (eg_ Lynch syndrome_ <i>PTEN</i> hamartoma syndrome_ Cowden syndrome_ familial adenomatosis polyposis)_ genomic sequence analysis panel utili","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0101U","description":"Hereditary colon cancer disorders (eg_ Lynch syndrome_ <i>PTEN</i> hamartoma syndrome_ Cowden syndrome_ familial adenomatosis polyposis)_ genomic sequence analysis panel utili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFE0","description":"ICD-NFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00524","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","description":"CPT-00524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVE0","description":"ICD-CCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIC1","description":"ICD-EEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43117","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQC1","description":"ICD-OBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJF0","description":"ICD-CDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled breath condensate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83987","description":"Exhaled breath condensate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDC0","description":"ICD-IBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGA0","description":"ICD-OFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99334","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0594","description":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUC0","description":"ICD-FBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVE0","description":"ICD-NFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNB1","description":"ICD-CHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21B","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUC0","description":"ICD-OKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8B","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETC1","description":"ICD-NETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48551","description":"Prep donor pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab-arrx_ biosimilar_ (riabni)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5123","description":"Injection_ rituximab-arrx_ biosimilar_ (riabni)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64640","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBE1","description":"ICD-KEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24362","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/clin ascvd dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9674","description":"Pt w/clin ascvd dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tcran magn stim redetemine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90869","description":"Tcran magn stim redetemine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51585","description":"Removal of bladder & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBME0","description":"ICD-CBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained With Diagnostic Ultrasound Examination Of The Same Anatomy (","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0690T","description":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained With Diagnostic Ultrasound Examination Of The Same Anatomy (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cosyntropin_ not otherwise specified_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0833","description":"Injection_ cosyntropin_ not otherwise specified_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBE1","description":"ICD-MKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUA0","description":"ICD-MFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA211","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOE0","description":"ICD-PAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of diaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39545","description":"Revision of diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHC1","description":"ICD-JFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENF1","description":"ICD-BENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX53","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKE0","description":"ICD-FGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gadoxetate disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9581","description":"Gadoxetate disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADC1","description":"ICD-MADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLD0","description":"ICD-GFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARB1","description":"ICD-DARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLC0","description":"ICD-NGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKC1","description":"ICD-NLKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","description":"HCPCS-J9601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethro w/addl implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52442","description":"Cystourethro w/addl implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ genital region_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6570","description":"Gradient compression garment_ genital region_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUF0","description":"ICD-MJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHME1","description":"ICD-IHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMA1","description":"ICD-CHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMC0","description":"ICD-BCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOC1","description":"ICD-PCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXA0","description":"ICD-NGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exsufflation belt_ includes all supplies and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1021","description":"Exsufflation belt_ includes all supplies and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration Not Followed By Surgical Repair_ Artery; Lower Extremity (Eg_ Common Femoral_ Deep Femoral_ Superficial Femoral_ Popliteal_ Tibial_ Peroneal)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35703","description":"Exploration Not Followed By Surgical Repair_ Artery; Lower Extremity (Eg_ Common Femoral_ Deep Femoral_ Superficial Femoral_ Popliteal_ Tibial_ Peroneal)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELE0","description":"ICD-EELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAB0","description":"ICD-EGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heat quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0109T","description":"Heat quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTA1","description":"ICD-OLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt lithium 4.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0605","description":"Repl batt lithium 4.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGD1","description":"ICD-BEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB214","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICC1","description":"ICD-FICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0092A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Advancing Care For Heart Disease Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0055","description":"Advancing Care For Heart Disease Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWA0","description":"ICD-GEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMD1","description":"ICD-MGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMF0","description":"ICD-IAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDC0","description":"ICD-FDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental inlay metl 3/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2530","description":"Dental inlay metl 3/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFE1","description":"ICD-KIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDD0","description":"ICD-BBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70481","description":"Ct orbit/ear/fossa w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX13","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX43","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKB1","description":"ICD-OLKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGE0","description":"ICD-FAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAE1","description":"ICD-CIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36906","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; known familial sequence variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81337","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; known familial sequence variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQD1","description":"ICD-HDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKB0","description":"ICD-KEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOD0","description":"ICD-PFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRA1","description":"ICD-OJRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUC1","description":"ICD-NDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glucagon tolerance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82946","description":"Glucagon tolerance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVA1","description":"ICD-KEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHB1","description":"ICD-OJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFD0","description":"ICD-KHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR MoAb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9840","description":"RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR MoAb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD206","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGE1","description":"ICD-NHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBE1","description":"ICD-JIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of mercury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83825","description":"Assay of mercury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBD1","description":"ICD-GCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt & graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33764","description":"Major vessel shunt & graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride_ (Belrapzo)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9036","description":"Injection_ bendamustine hydrochloride_ (Belrapzo)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of finger/thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26951","description":"Amputation of finger/thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assessment by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9001","description":"Assessment by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor ix complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7194","description":"Factor ix complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMF0","description":"ICD-KCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMD1","description":"ICD-BCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJB0","description":"ICD-BBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKA1","description":"ICD-JEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ intradiscal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1754","description":"Catheter_ intradiscal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLE1","description":"ICD-NBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92642","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","description":"CPT-92642","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBE0","description":"ICD-ADBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGB0","description":"ICD-JHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXA1","description":"ICD-FAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXE0","description":"ICD-KGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCF1","description":"ICD-CHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam pituitary saddle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70240","description":"X-ray exam pituitary saddle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap vent/abd hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49652","description":"Lap vent/abd hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24125","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj hi_ initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9003","description":"Mccd_ risk adj hi_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTD0","description":"ICD-GCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59120","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pozelimab-bbfg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9376","description":"Injection_ pozelimab-bbfg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXD1","description":"ICD-NGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAB1","description":"ICD-JBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth amputation of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93251","description":"Anesth amputation of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonrandomized_ nonblinded procedure for NYHA Class II_ III_ IV heart failure; transcatheter implantation of interatrial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9760","description":"Nonrandomized_ nonblinded procedure for NYHA Class II_ III_ IV heart failure; transcatheter implantation of interatrial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corneal trnspl endothelial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65756","description":"Corneal trnspl endothelial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27500","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4296","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","description":"HCPCS-A4296","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTD1","description":"ICD-CFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTD1","description":"ICD-CGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Probe_ perc lumb disc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2614","description":"Probe_ perc lumb disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAD0","description":"ICD-GIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHD1","description":"ICD-FIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44146","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA31","description":"ICD-2FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97530","description":"Therapeutic activities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Create passage to kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52334","description":"Create passage to kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-htn/htn_ no f/u_ not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8952","description":"Pre-htn/htn_ no f/u_ not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00802","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","description":"CPT-00802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCF1","description":"ICD-MKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methacholine chloride_ neb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7674","description":"Methacholine chloride_ neb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUF0","description":"ICD-KBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTF1","description":"ICD-FHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDC0","description":"ICD-AGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAA1","description":"ICD-FGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0D","description":"Low Rehab_ ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPC1","description":"ICD-BIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXD0","description":"ICD-NGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10C","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retrieval of oocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58970","description":"Retrieval of oocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMA1","description":"ICD-KAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Restrata minimatrix_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2026","description":"Restrata minimatrix_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFF0","description":"ICD-FFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CaregraFT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4322","description":"CaregraFT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBC1","description":"ICD-OEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMA1","description":"ICD-NHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEB1","description":"ICD-CDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICB0","description":"ICD-GICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTE0","description":"ICD-FFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c shoulder harness/straps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0960","description":"W/c shoulder harness/straps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISB1","description":"ICD-PISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIME1","description":"ICD-JIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1014","description":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEA1","description":"ICD-BIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect enlarged toe tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28340","description":"Resect enlarged toe tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57530","description":"Removal of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRF0","description":"ICD-DFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ acute myeloid leukemia_ myelodysplastic syndrome_ and myeloproliferative neoplasms_ DNA analysis_ 23 genes_ interrogation for sequenc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171U","description":"Targeted genomic sequence analysis panel_ acute myeloid leukemia_ myelodysplastic syndrome_ and myeloproliferative neoplasms_ DNA analysis_ 23 genes_ interrogation for sequenc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGE1","description":"ICD-OCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHC0","description":"ICD-EGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHA1","description":"ICD-KBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam infant hips static","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76886","description":"Us exam infant hips static","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADE1","description":"ICD-GADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES160","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1504","description":"HCPCS-A1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-osseointegrated snd proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8692","description":"Non-osseointegrated snd proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin protect wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2604","description":"Skin protect wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dry pressure pad for mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0199","description":"Dry pressure pad for mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHC1","description":"ICD-MIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKF1","description":"ICD-OBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove&replace pm gen singl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33227","description":"Remove&replace pm gen singl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLB0","description":"ICD-GGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr fem hernia init blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49553","description":"Rpr fem hernia init blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28C","description":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj tst 5-6 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95909","description":"Nrv cndj tst 5-6 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2216","description":"Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLD1","description":"ICD-MGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNE0","description":"ICD-CCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g._ prior anaphylaxis due to the pneumococcal vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1178","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g._ prior anaphylaxis due to the pneumococcal vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPA1","description":"ICD-NCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDA0","description":"ICD-KDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33975","description":"Implant ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection_ and post administration monitoring in the home or residence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0241","description":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection_ and post administration monitoring in the home or residence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0218T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLC0","description":"ICD-KFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESC0","description":"ICD-LESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKD1","description":"ICD-CCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMD0","description":"ICD-NLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWD1","description":"ICD-DFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMB0","description":"ICD-JEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44369","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc taa repr w/o subcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33881","description":"Endovasc taa repr w/o subcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTA1","description":"ICD-BCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1C","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Permanent tear duct plug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4263","description":"Permanent tear duct plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKA0","description":"ICD-KFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB11","description":"ICD-1AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4421","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","description":"HCPCS-Q4421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Facial moulage complete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5912","description":"Facial moulage complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93641","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMD0","description":"ICD-OJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJA0","description":"ICD-NEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lovotibeglogene autotemcel_ per treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3394","description":"Injection_ lovotibeglogene autotemcel_ per treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERA0","description":"ICD-LERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVA1","description":"ICD-KAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/stent plcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44402","description":"Colonoscopy w/stent plcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNA1","description":"ICD-FBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (panzyga)_ intravenous_ non-lyophilized (e.g._ liquid)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1576","description":"Injection_ immune globulin (panzyga)_ intravenous_ non-lyophilized (e.g._ liquid)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXC0","description":"ICD-OJXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFC0","description":"ICD-OBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv4 vaccine 3 yrs plus im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90688","description":"Iiv4 vaccine 3 yrs plus im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLC1","description":"ICD-BCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC116","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of iron","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83540","description":"Assay of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE241","description":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNA0","description":"ICD-FHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARE1","description":"ICD-DARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFC0","description":"ICD-GEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWA0","description":"ICD-LIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYD0","description":"ICD-OIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVA1","description":"ICD-FAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryo-Cord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4237","description":"Cryo-Cord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTC0","description":"ICD-ACTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fx rad extra-articul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25607","description":"Treat fx rad extra-articul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8B","description":"Very High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPD1","description":"ICD-BAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISE0","description":"ICD-LISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC07","description":"Very High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23530","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQB1","description":"ICD-PAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTF1","description":"ICD-MCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPD1","description":"ICD-NCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYB0","description":"ICD-ODYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNA1","description":"ICD-BGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0678","description":"Non-pneumatic sequential compression garment_ full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0696U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696U","description":"CPT-0696U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multiple family group psytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90849","description":"Multiple family group psytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES224","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixed wing air transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0430","description":"Fixed wing air transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEB0","description":"ICD-JFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIE1","description":"ICD-ACIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLA1","description":"ICD-GDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic Examination_ Esophagus_ Including Scout Chest Radiograph(S) And Delayed Image(S)_ When Performed; Double-Contrast (Eg_ High-Density Barium And Effervescent Agent) S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74221","description":"Radiologic Examination_ Esophagus_ Including Scout Chest Radiograph(S) And Delayed Image(S)_ When Performed; Double-Contrast (Eg_ High-Density Barium And Effervescent Agent) S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEE1","description":"ICD-OLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXF1","description":"ICD-JAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL41","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive testis surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54535","description":"Extensive testis surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88373","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBA0","description":"ICD-IBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo tibial fracture rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2116","description":"Afo tibial fracture rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Paraffin bath unit portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0235","description":"Paraffin bath unit portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQD1","description":"ICD-DCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQC1","description":"ICD-GIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHD0","description":"ICD-MFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"corticotomy - one to three teeth or tooth spaces_ per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7296","description":"corticotomy - one to three teeth or tooth spaces_ per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ voriconazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3465","description":"Injection_ voriconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDA0","description":"ICD-NCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENC0","description":"ICD-FENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51500","description":"Removal of bladder cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0535U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","description":"CPT-0535U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vessel mapping hemo access","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0365","description":"Vessel mapping hemo access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCD0","description":"ICD-ADCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc order cefazolin/cefurox","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4041F","description":"Doc order cefazolin/cefurox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHB1","description":"ICD-MAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trluml perip athrc iliac art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0238T","description":"Trluml perip athrc iliac art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC111","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ hexaminolevulinate HCl_ 100 mg_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9275","description":"Injection_ hexaminolevulinate HCl_ 100 mg_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNB1","description":"ICD-KDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHE0","description":"ICD-FIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5141","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","description":"HCPCS-Q5141","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABC0","description":"ICD-OABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ deoxycholic acid_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0591","description":"Injection_ deoxycholic acid_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIE1","description":"ICD-FCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lepirudin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1945","description":"Lepirudin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMA0","description":"ICD-JCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGID1","description":"ICD-MGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5157","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","description":"HCPCS-Q5157","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6197","description":"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00936","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","description":"CPT-00936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDD1","description":"ICD-KEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTC0","description":"ICD-BHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam l-s spine 2/3 vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72100","description":"X-ray exam l-s spine 2/3 vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43289","description":"Laparoscope proc esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compatibility test antiglob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86922","description":"Compatibility test antiglob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryoablate prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55873","description":"Cryoablate prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHE1","description":"ICD-OFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILE1","description":"ICD-IILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I&d p-spine c/t/cerv-thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22010","description":"I&d p-spine c/t/cerv-thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic Positional Obstructive Sleep Apnea Treatment_ With Sensor_ Includes All Components And Accessories_ Any Type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1001","description":"Electronic Positional Obstructive Sleep Apnea Treatment_ With Sensor_ Includes All Components And Accessories_ Any Type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLA0","description":"ICD-GCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genital surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55899","description":"Genital surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof_ or 1% of body surface area of infants and childre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0479T","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof_ or 1% of body surface area of infants and childre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB105","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDB1","description":"ICD-NGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPB1","description":"ICD-NHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAC1","description":"ICD-ICAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAA1","description":"ICD-OEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22D","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUD1","description":"ICD-CIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEE0","description":"ICD-FCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMD0","description":"ICD-FGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fxnl status assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1170F","description":"Fxnl status assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tongue jaw & neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41155","description":"Tongue jaw & neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDID1","description":"ICD-KDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Miniature knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5826","description":"Miniature knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFA1","description":"ICD-OKFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUA1","description":"ICD-CEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59850","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transport chair pt wt >300lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1039","description":"Transport chair pt wt >300lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIB1","description":"ICD-NLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFE0","description":"ICD-FBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI_ Rorschach_ WAIS)_ per hour of t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96101","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI_ Rorschach_ WAIS)_ per hour of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLB1","description":"ICD-NBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTC1","description":"ICD-CGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIC0","description":"ICD-AFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWA1","description":"ICD-PIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fos c chld non-ther per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0041","description":"Fos c chld non-ther per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBE0","description":"ICD-FFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIF0","description":"ICD-MIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXB1","description":"ICD-JDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVF1","description":"ICD-NEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acylcarnitines qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82016","description":"Acylcarnitines qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRB0","description":"ICD-LBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB11","description":"ICD-1FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATF1","description":"ICD-OATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD141","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20D","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2070","description":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVF1","description":"ICD-OKVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISE1","description":"ICD-HISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXF1","description":"ICD-FHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHC0","description":"ICD-CEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBA0","description":"ICD-CEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBD1","description":"ICD-FIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEE0","description":"ICD-NLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXF1","description":"ICD-OAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIC0","description":"ICD-JAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKD0","description":"ICD-OAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWF1","description":"ICD-OGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of cervix radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57531","description":"Removal of cervix radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47540","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGA0","description":"ICD-JBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML01","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","description":"HCPCS-J2601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13D","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo new ureter/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50948","description":"Laparo new ureter/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBD1","description":"ICD-JCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0175","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","description":"HCPCS-J0175","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQE0","description":"ICD-CEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_hemodialysis_short-term","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1752","description":"Cath_hemodialysis_short-term","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMF1","description":"ICD-AGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct abd & pelvis w/o contrast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74176","description":"Ct abd & pelvis w/o contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93642","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICE1","description":"ICD-EICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC21","description":"ICD-2LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calcitonin salmon injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0630","description":"Calcitonin salmon injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES220","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB42","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEE0","description":"ICD-FIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red cell survival kinetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78135","description":"Red cell survival kinetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSA0","description":"ICD-OFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6012","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25A","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lpn home care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1031","description":"Lpn home care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"7 field photo interp doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2024F","description":"7 field photo interp doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam abdom complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76700","description":"Us exam abdom complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFF1","description":"ICD-BHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0499U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","description":"CPT-0499U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAE1","description":"ICD-IEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surv score no improv w/tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9605","description":"Surv score no improv w/tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA105","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01810","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","description":"CPT-01810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0303","description":"HCPCS-C0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","description":"CPT-00635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of support implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20670","description":"Removal of support implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx esophageal t4 no prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9097","description":"Onc dx esophageal t4 no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Death occurring during the index acute care hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9814","description":"Death occurring during the index acute care hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOC0","description":"ICD-KHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDE1","description":"ICD-OGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFC1","description":"ICD-FCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYA1","description":"ICD-DEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDC0","description":"ICD-NDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulpal regeneration initial","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3355","description":"Pulpal regeneration initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABC1","description":"ICD-KABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEC0","description":"ICD-NAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nhl trans to lg bcell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9136","description":"Onc dx nhl trans to lg bcell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEF0","description":"ICD-NBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSB0","description":"ICD-KBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOE1","description":"ICD-GCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMC1","description":"ICD-NKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTB1","description":"ICD-MDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKD0","description":"ICD-BEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81545","description":"Oncology thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6076","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLF0","description":"ICD-NHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXB0","description":"ICD-OLXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0228T","description":"Njx tfrml eprl w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEB1","description":"ICD-CIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption studies combined_ with and without intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78272","description":"Vitamin B-12 absorption studies combined_ with and without intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray of mammary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77053","description":"X-ray of mammary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer care checklist used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0583F","description":"Transfer care checklist used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser surgery eye strands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67031","description":"Laser surgery eye strands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFF0","description":"ICD-FHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLE0","description":"ICD-BDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTC0","description":"ICD-NDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITA0","description":"ICD-GITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Service Coordination**","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1011","description":"Service Coordination**","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQD1","description":"ICD-OHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ GELSYN-3_ for intra-articular injection_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7328","description":"Hyaluronan or derivative_ GELSYN-3_ for intra-articular injection_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam filled caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2217","description":"Foam filled caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDE1","description":"ICD-JFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAB0","description":"ICD-KCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0601","description":"HCPCS-B0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures mandibl part metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5214","description":"Dentures mandibl part metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHC1","description":"ICD-BEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWA1","description":"ICD-GEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECE0","description":"ICD-OECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens gas permbl bifocl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2512","description":"Cntct lens gas permbl bifocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFID0","description":"ICD-IFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPE0","description":"ICD-OIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted case mgmt per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2023","description":"Targeted case mgmt per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFC0","description":"ICD-FDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD216","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","description":"CPT-98016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self-mgmt educ & train 1 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98960","description":"Self-mgmt educ & train 1 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; up to 7 vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22836","description":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; up to 7 vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARB1","description":"ICD-PARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAB0","description":"ICD-GBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADE1","description":"ICD-FADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGE0","description":"ICD-NFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5147","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","description":"HCPCS-Q5147","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove mandible cyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21046","description":"Remove mandible cyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFD0","description":"ICD-CFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPA1","description":"ICD-GBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of fascia for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20922","description":"Removal of fascia for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA213","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cog&behav imprmnt scrng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3755F","description":"Cog&behav imprmnt scrng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alprostadil urethral suppos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0275","description":"Alprostadil urethral suppos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCD0","description":"ICD-GBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPF1","description":"ICD-NGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUE0","description":"ICD-GDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cnslng epi spec sfty issues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4330F","description":"Cnslng epi spec sfty issues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Provision of COVID-19 test_ nonprescription self-administered and self-collected use_ FDA approved_ authorized or cleared_ one test count","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1034","description":"Provision of COVID-19 test_ nonprescription self-administered and self-collected use_ FDA approved_ authorized or cleared_ one test count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB11","description":"ICD-2BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92945","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","description":"CPT-92945","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMC1","description":"ICD-CEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMA0","description":"ICD-BDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATB1","description":"ICD-MATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCC0","description":"ICD-IHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVE1","description":"ICD-FHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMB0","description":"ICD-IDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"D5w infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7070","description":"D5w infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29825","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOE0","description":"ICD-GDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj menotropins 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0122","description":"Inj menotropins 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAF0","description":"ICD-BDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDED1","description":"ICD-JDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADF0","description":"ICD-KADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth collar bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45451","description":"Anesth collar bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hg a1c level lt 7.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3044F","description":"Hg a1c level lt 7.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change of gastrostomy tube_ percutaneous_ without imaging or endoscopic guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43760","description":"Change of gastrostomy tube_ percutaneous_ without imaging or endoscopic guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block lumbar/thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64520","description":"N block lumbar/thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1026T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1026T","description":"CPT-1026T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24D","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYE0","description":"ICD-DDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surrogate viral neutralization test (sVNT)_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ ELISA_ plasma_ serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0226U","description":"Surrogate viral neutralization test (sVNT)_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ ELISA_ plasma_ serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Split blood or products","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86985","description":"Split blood or products","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36581","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supported employment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6106","description":"Supported employment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g. virtual check-in_ by a qualified health care professional who cannot report evaluation and management services_ provided to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2251","description":"Brief communication technology-based service_ e.g. virtual check-in_ by a qualified health care professional who cannot report evaluation and management services_ provided to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radium/radioisotope therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77799","description":"Radium/radioisotope therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ho bi thighcuffs w sprdr bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1652","description":"Ho bi thighcuffs w sprdr bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFE0","description":"ICD-KDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conductive garment for tens/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0731","description":"Conductive garment for tens/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTB0","description":"ICD-GDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALC1","description":"ICD-CALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including CT guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10009","description":"Fine needle aspiration biopsy_ including CT guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLE0","description":"ICD-OLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31080","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBA0","description":"ICD-MGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBA0","description":"ICD-KIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Axolotl DualGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4332","description":"Axolotl DualGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTB0","description":"ICD-AFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnio Wound_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4181","description":"Amnio Wound_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPB0","description":"ICD-BGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCE1","description":"ICD-MKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose and 0.45% saline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5010","description":"5% dextrose and 0.45% saline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0534","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","description":"HCPCS-G0534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARF0","description":"ICD-PARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFB0","description":"ICD-CBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLA1","description":"ICD-OFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJC1","description":"ICD-KGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental skin graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7920","description":"Dental skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0519T","description":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABC0","description":"ICD-GABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA21","description":"ICD-2CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIC0","description":"ICD-MCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red cell sequestration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78140","description":"Red cell sequestration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit hydra 1 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9374","description":"Hit hydra 1 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCC1","description":"ICD-OKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens extended wear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2513","description":"Contact lens extended wear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESB0","description":"ICD-PESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKD1","description":"ICD-NCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp comm supp svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2016","description":"Comp comm supp svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of anorectal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45108","description":"Removal of anorectal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Placement And Subsequent Removal Of Cerebral Embolic Protection Device(S)_ Including Arterial Access_ Catheterization_ Imaging_ And Radiological Supervision And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33370","description":"Transcatheter Placement And Subsequent Removal Of Cerebral Embolic Protection Device(S)_ Including Arterial Access_ Catheterization_ Imaging_ And Radiological Supervision And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUF0","description":"ICD-AFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deluxe lens feature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2702","description":"Deluxe lens feature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81165","description":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54105","description":"Biopsy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abx reg prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9498","description":"Abx reg prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWC1","description":"ICD-OIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIF1","description":"ICD-EFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAD1","description":"ICD-EGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCB0","description":"ICD-BFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDC1","description":"ICD-OBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVF1","description":"ICD-CFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJD1","description":"ICD-JGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWC0","description":"ICD-OHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL53","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMA0","description":"ICD-KAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bitewings - three films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0273","description":"Bitewings - three films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84078","description":"Assay alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPB1","description":"ICD-CEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOC0","description":"ICD-LIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELC0","description":"ICD-GELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHED0","description":"ICD-NHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISD0","description":"ICD-OISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQF1","description":"ICD-DEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPB1","description":"ICD-BCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEC1","description":"ICD-JEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNE1","description":"ICD-NHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39000","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQA1","description":"ICD-GDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACB1","description":"ICD-CACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx gastric no recurrence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9100","description":"Onc dx gastric no recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVD1","description":"ICD-NDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spec gene test hyp cardiomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3866","description":"Spec gene test hyp cardiomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBID0","description":"ICD-BBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXB1","description":"ICD-BEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15C","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2046","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2046","description":"HCPCS-A2046","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External recharg sys extern","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8695","description":"External recharg sys extern","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop ea cast chg & realign","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6386","description":"Postop ea cast chg & realign","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0541T","description":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHC0","description":"ICD-NCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20D","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHE1","description":"ICD-EIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of heart lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93505","description":"Biopsy of heart lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision_ unilateral (List separately in addition to cod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34715","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision_ unilateral (List separately in addition to cod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXD0","description":"ICD-NFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not on a statin (e.g._ pregnancy_ in vitro fertilization_ clomiphene Rx_ ESRD_ cirrhosis_ muscular pain and disease during the measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9940","description":"Documentation of medical reason(s) for not on a statin (e.g._ pregnancy_ in vitro fertilization_ clomiphene Rx_ ESRD_ cirrhosis_ muscular pain and disease during the measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD141","description":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHD0","description":"ICD-GEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTB1","description":"ICD-KGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSB1","description":"ICD-PLSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQD1","description":"ICD-GIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis for chromosomal abnormalities_ copy number variants_ duplications/deletions_ inversions_ unb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0469U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis for chromosomal abnormalities_ copy number variants_ duplications/deletions_ inversions_ unb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4363","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","description":"HCPCS-Q4363","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0524","description":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hib prp-omp vacc 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90647","description":"Hib prp-omp vacc 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX22","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUB0","description":"ICD-FCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLD0","description":"ICD-BHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6563","description":"Gradient compression stocking_ waist length_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXC0","description":"ICD-FCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47000","description":"Needle biopsy of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBA0","description":"ICD-JIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneum compressor segmental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0651","description":"Pneum compressor segmental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mucus trap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8210","description":"Mucus trap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOE1","description":"ICD-PLOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Instillation_ hexaminolevulinate hydrochloride_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9589","description":"Instillation_ hexaminolevulinate hydrochloride_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPE0","description":"ICD-NAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove groin lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38760","description":"Remove groin lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOE0","description":"ICD-KBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDE0","description":"ICD-IBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Polysom 6/> yrs 4/> param","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95810","description":"Polysom 6/> yrs 4/> param","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKB1","description":"ICD-NIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAA1","description":"ICD-FIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of wrist bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25210","description":"Removal of wrist bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYE1","description":"ICD-LDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of psa total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84153","description":"Assay of psa total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with dementia at any time prior to or during the month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1271","description":"Patients with dementia at any time prior to or during the month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig bmi calculation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8422","description":"Pt inelig bmi calculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIC1","description":"ICD-IIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01490","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","description":"CPT-01490","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBND0","description":"ICD-NBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0150","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0150","description":"HCPCS-E0150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITC/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5215","description":"Hearing aid_ contralateral routing system_ binaural_ ITC/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOE1","description":"ICD-PIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens lenticular trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2315","description":"Lens lenticular trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13D","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDC1","description":"ICD-CIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27215","description":"Treat pelvic fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIC1","description":"ICD-GAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90484","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","description":"CPT-90484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA21","description":"ICD-3IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","description":"HCPCS-J3374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMB0","description":"ICD-BGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUF1","description":"ICD-IIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQD1","description":"ICD-KDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANF0","description":"ICD-GANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00872","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","description":"CPT-00872","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plt_ pher_ l/r cmv-neg_ irr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9053","description":"Plt_ pher_ l/r cmv-neg_ irr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise kidney blood vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50100","description":"Revise kidney blood vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Soft Tissue_ Other_ Harvested By Direct Excision (Eg_ Fat_ Dermis_ Fascia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15769","description":"Grafting Of Autologous Soft Tissue_ Other_ Harvested By Direct Excision (Eg_ Fat_ Dermis_ Fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA235","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEA1","description":"ICD-IDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam stability fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83662","description":"Foam stability fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE135","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid imaging w/blood flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78014","description":"Thyroid imaging w/blood flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microslide consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88323","description":"Microslide consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISC0","description":"ICD-CISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABB0","description":"ICD-OABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAD1","description":"ICD-IDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test presump opt inst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0478","description":"Drug test presump opt inst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26540","description":"Repair hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE234","description":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCF1","description":"ICD-MBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDID0","description":"ICD-GDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12001","description":"Rpr s/n/ax/gen/trnk 2.5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immntx 1 sting insect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95130","description":"Immntx 1 sting insect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0535","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","description":"HCPCS-G0535","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITB1","description":"ICD-FITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Choline C 11_ diagnostic_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9461","description":"Choline C 11_ diagnostic_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC45","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sewhfo airplane w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3978","description":"Sewhfo airplane w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGF0","description":"ICD-NEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFF0","description":"ICD-KIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Testosterone; bioavailable_ direct measurement (eg_ differential precipitation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84410","description":"Testosterone; bioavailable_ direct measurement (eg_ differential precipitation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWC1","description":"ICD-KGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAD0","description":"ICD-OIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFF1","description":"ICD-NIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACED0","description":"ICD-ACED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel new leather standa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3455","description":"Shoe heel new leather standa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOB0","description":"ICD-LIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSB1","description":"ICD-OLSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDD0","description":"ICD-EHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINE0","description":"ICD-GINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAA1","description":"ICD-OIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emergent Cases","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1142","description":"Emergent Cases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIB1","description":"ICD-KDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00406","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","description":"CPT-00406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-speech device service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92606","description":"Non-speech device service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJC1","description":"ICD-BHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB31","description":"ICD-4KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB11","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPB0","description":"ICD-CFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAF1","description":"ICD-OEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOE1","description":"ICD-PEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJA1","description":"ICD-OBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical trays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4550","description":"Surgical trays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brca2 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81216","description":"Brca2 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGB1","description":"ICD-BEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWD0","description":"ICD-PAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43652","description":"Laparoscopy vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aortic hemiarch graft including isolation and control of the arch vessels_ beveled open distal aortic anastomosis extending under one or more of the arch vessels_ and total ci","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33866","description":"Aortic hemiarch graft including isolation and control of the arch vessels_ beveled open distal aortic anastomosis extending under one or more of the arch vessels_ and total ci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01925","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","description":"CPT-01925","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Fixed Retainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8699","description":"Re-Cement Or Re-Bond Fixed Retainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder blade lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23182","description":"Remove shoulder blade lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKA1","description":"ICD-KAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTB0","description":"ICD-KFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBB1","description":"ICD-FBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWE1","description":"ICD-PJWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cochlear device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8614","description":"Cochlear device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No sleep apnea assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8841","description":"No sleep apnea assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB21","description":"ICD-1FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKB0","description":"ICD-JBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human Papillomavirus vaccine types 6_ 11_ 16_ 18_ 31_ 33_ 45_ 52_ 58_ nonavalent (9vHPV)_ 2 or 3 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90651","description":"Human Papillomavirus vaccine types 6_ 11_ 16_ 18_ 31_ 33_ 45_ 52_ 58_ nonavalent (9vHPV)_ 2 or 3 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDC1","description":"ICD-GIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC150","description":"Clinically Complex _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56631","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Separate eyelid adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68340","description":"Separate eyelid adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQB1","description":"ICD-CFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral counseling for diabetes prevention_ distance learning_ 60 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9887","description":"Behavioral counseling for diabetes prevention_ distance learning_ 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGD0","description":"ICD-OJGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser surg penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54057","description":"Laser surg penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGND0","description":"ICD-NGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bio-connekt per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4161","description":"Bio-connekt per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (anxiety disorders)_ mRNA_ gene expression profiling by RNA sequencing of 15 biomarkers_ whole blood_ algorithm reported as predictive risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0437U","description":"Psychiatry (anxiety disorders)_ mRNA_ gene expression profiling by RNA sequencing of 15 biomarkers_ whole blood_ algorithm reported as predictive risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFB0","description":"ICD-BIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icm device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93290","description":"Icm device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1459","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","description":"HCPCS-M1459","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBF0","description":"ICD-GHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2_ or each additional 1% of body surface area of infants a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0480T","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2_ or each additional 1% of body surface area of infants a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC24","description":"Very High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIB1","description":"ICD-OCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17276","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUF1","description":"ICD-NIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Battery elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0496","description":"Battery elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1225","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD140","description":"Clinically Complex _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ ocriplasmin_ 0.125 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7316","description":"Inj_ ocriplasmin_ 0.125 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETF1","description":"ICD-GETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQE1","description":"ICD-OEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJB1","description":"ICD-BDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transport portable x-ray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0070","description":"Transport portable x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22C","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reposition venous catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36597","description":"Reposition venous catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL26","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEF0","description":"ICD-AGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTD0","description":"ICD-JDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJF1","description":"ICD-BEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D6180","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6180","description":"CDT-D6180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMD0","description":"ICD-NEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supply allowance for therapeutic continuous glucose monitor (CGM)_ includes all supples and accessories_ 1 unit = 1 mo. supply","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0553","description":"Supply allowance for therapeutic continuous glucose monitor (CGM)_ includes all supples and accessories_ 1 unit = 1 mo. supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst hgh nbl mtl >=3srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6611","description":"Onlay cst hgh nbl mtl >=3srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Placement of a custom removable clear plastic temporary aesthetic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9939","description":"Placement of a custom removable clear plastic temporary aesthetic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelets_ pheresis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9034","description":"Platelets_ pheresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBE1","description":"ICD-JBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIA0","description":"ICD-OLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption study (eg_ Schilling test); with intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78271","description":"Vitamin B-12 absorption study (eg_ Schilling test); with intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 85 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0147U","description":"Drug assay_ definitive_ 85 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRD1","description":"ICD-OHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 cast based metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6781","description":"Crown 3/4 cast based metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risperidone_ (Uzedy)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9158","description":"Injection_ risperidone_ (Uzedy)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office emergency care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99058","description":"Office emergency care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise lumbar artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22862","description":"Revise lumbar artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFC0","description":"ICD-CDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5362","description":"Speech screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERE1","description":"ICD-OERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEE1","description":"ICD-CDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRE0","description":"ICD-PCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13D","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHF0","description":"ICD-MCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c dpth 20-21 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2342","description":"W/c dpth 20-21 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCD1","description":"ICD-KBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","description":"HCPCS-M1374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetone assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82010","description":"Acetone assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVD1","description":"ICD-BIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meals when receive services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1010","description":"Meals when receive services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESF1","description":"ICD-OESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1088T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1088T","description":"CPT-1088T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLD1","description":"ICD-JCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76978","description":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral con def mod palat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5959","description":"Intraoral con def mod palat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD154","description":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (eg_ Parkinson disease_ dementia with Lewy bodies)_ cerebrospinal fluid (CSF)_ detection of misfolded a-synuclein protein by seed amplification assay_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0393U","description":"Neurology (eg_ Parkinson disease_ dementia with Lewy bodies)_ cerebrospinal fluid (CSF)_ detection of misfolded a-synuclein protein by seed amplification assay_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Outside state ambulance serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0021","description":"Outside state ambulance serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB35","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKE0","description":"ICD-CDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAED0","description":"ICD-IAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLE1","description":"ICD-JDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12B","description":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCD1","description":"ICD-GCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIB1","description":"ICD-CIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDF0","description":"ICD-KDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC32","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAB0","description":"ICD-BCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIE1","description":"ICD-ADIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYD1","description":"ICD-CHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj unspecified therapy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7899","description":"Tmj unspecified therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFF0","description":"ICD-OAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42425","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe dennis browne splint bo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3640","description":"Shoe dennis browne splint bo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX24","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWE0","description":"ICD-GGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFA0","description":"ICD-KCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIB1","description":"ICD-OAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDA1","description":"ICD-IBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOC0","description":"ICD-HDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADB0","description":"ICD-FADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Papaverin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2440","description":"Papaverin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYA1","description":"ICD-LBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCB0","description":"ICD-EFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXB0","description":"ICD-GBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB01","description":"Medium Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 1 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34841","description":"Endovasc visc aorta 1 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIF0","description":"ICD-EFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputate lower leg at knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27598","description":"Amputate lower leg at knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom grad glove med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8425","description":"Custom grad glove med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGB1","description":"ICD-KBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBA0","description":"ICD-MLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gel cap app device for trach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8515","description":"Gel cap app device for trach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; requiring revision of gastrostomy tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43763","description":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; requiring revision of gastrostomy tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shorten radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25390","description":"Shorten radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUF1","description":"ICD-MCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc of non tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9275","description":"Doc of non tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXD1","description":"ICD-BCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBE1","description":"ICD-ODBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBB0","description":"ICD-JFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC244","description":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJB1","description":"ICD-OBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95975","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albuterol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7611","description":"Albuterol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAC0","description":"ICD-NCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHA0","description":"ICD-MFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC40","description":"High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration/repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45563","description":"Exploration/repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUE0","description":"ICD-OIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEID0","description":"ICD-GEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCD0","description":"ICD-MLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low extemity neur exam docum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8404","description":"Low extemity neur exam docum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 10 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91319","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 10 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQD0","description":"ICD-GBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collect & prep saliva sample","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0417","description":"Collect & prep saliva sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFD0","description":"ICD-NKFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sperm identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89257","description":"Sperm identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCF1","description":"ICD-KDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYF0","description":"ICD-PFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATD1","description":"ICD-CATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFC1","description":"ICD-KGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart tmr w/other procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33141","description":"Heart tmr w/other procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0656U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0656U","description":"CPT-0656U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUD1","description":"ICD-KIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENA0","description":"ICD-JENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWB1","description":"ICD-LAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIA1","description":"ICD-ECIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVD0","description":"ICD-FAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); set-up and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0811T","description":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); set-up and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3405","description":"HCPCS-J3405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and/or with contrast material(s); unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77058","description":"Magnetic resonance imaging_ breast_ without and/or with contrast material(s); unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABB0","description":"ICD-IABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCID0","description":"ICD-CCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"64 lead ecg w/i&r only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0180T","description":"64 lead ecg w/i&r only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKE1","description":"ICD-NIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCD0","description":"ICD-FFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEC1","description":"ICD-IHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADE0","description":"ICD-FADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHND0","description":"ICD-BHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33412","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWA1","description":"ICD-DDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of nasal valve collapse with low energy_ temperature-controlled (ie_ radiofrequency) subcutaneous/submucosal remodeling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30469","description":"Repair of nasal valve collapse with low energy_ temperature-controlled (ie_ radiofrequency) subcutaneous/submucosal remodeling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15854","description":"Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGD1","description":"ICD-NAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal vaccine inhalation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3530","description":"Nasal vaccine inhalation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOD1","description":"ICD-GCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFF0","description":"ICD-GEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of phosphorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84100","description":"Assay of phosphorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVE1","description":"ICD-OEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRD0","description":"ICD-LCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vitolarsen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1427","description":"Injection_ vitolarsen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJA0","description":"ICD-BGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLF0","description":"ICD-OJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10B","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANC0","description":"ICD-FANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWB1","description":"ICD-CDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Beta amyloid_ AB42/40 ratio_ immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific prot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0412U","description":"Beta amyloid_ AB42/40 ratio_ immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific prot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bupivacaine (posimir)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9144","description":"Injection_ bupivacaine (posimir)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXB0","description":"ICD-JBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gallium ga-68 psma-11_ diagnostic_ (ucla)_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9594","description":"Gallium ga-68 psma-11_ diagnostic_ (ucla)_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWC0","description":"ICD-HGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35021","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEE1","description":"ICD-NFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ other than for screening for peripheral arteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0859T","description":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ other than for screening for peripheral arteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Detach non-adjus hght armrst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0015","description":"Detach non-adjus hght armrst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHA1","description":"ICD-OAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQE1","description":"ICD-CEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Air polymer-type A intrauterine foam_ 0.1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9574","description":"Air polymer-type A intrauterine foam_ 0.1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHF0","description":"ICD-IBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRE1","description":"ICD-KGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary peripheral neuropathies (eg_ Charcot-Marie-Tooth_ spastic paraplegia)_ genomic sequence analysis panel_ must include sequencing of at least 5 peripheral neuropathy-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81448","description":"Hereditary peripheral neuropathies (eg_ Charcot-Marie-Tooth_ spastic paraplegia)_ genomic sequence analysis panel_ must include sequencing of at least 5 peripheral neuropathy-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trnsprnl Impl Prm Adj Balln Cnt Dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9746","description":"Trnsprnl Impl Prm Adj Balln Cnt Dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDB0","description":"ICD-FGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kerecis omega3 marigen shield_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2019","description":"Kerecis omega3 marigen shield_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGB0","description":"ICD-GCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHB0","description":"ICD-JDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOA0","description":"ICD-OKOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid met imaging/studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78016","description":"Thyroid met imaging/studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer - Porcelain Fused To Predominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6098","description":"Implant Supported Retainer - Porcelain Fused To Predominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHD1","description":"ICD-EIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig neg scrn depres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8510","description":"Pt inelig neg scrn depres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Receiver/transmitter_ neuro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1816","description":"Receiver/transmitter_ neuro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychophysiological therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90875","description":"Psychophysiological therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIND0","description":"ICD-KIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically node negative (T1N0N0 or T2N0N0) invasive breast cancer before or after neoadjuvant systemic therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9911","description":"Clinically node negative (T1N0N0 or T2N0N0) invasive breast cancer before or after neoadjuvant systemic therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1107T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1107T","description":"CPT-1107T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay rbc glutathione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82979","description":"Assay rbc glutathione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHC0","description":"ICD-OIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIB1","description":"ICD-JIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLB0","description":"ICD-MHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Job Coaching 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1733","description":"Employment - Job Coaching 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVD1","description":"ICD-NEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLA0","description":"ICD-OGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgimend_ fetal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9358","description":"Surgimend_ fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scan proc cranial intra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61781","description":"Scan proc cranial intra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKD1","description":"ICD-CEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1002","description":"Custom item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","description":"HCPCS-E1807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLED0","description":"ICD-MLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay technique_ (eg_ enzyme immunoassay [EIA]_ enzyme-linked immunosorbent assay [ELISA]_ fluorescence immunoassay [FIA]_ immunoch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87467","description":"Infectious agent antigen detection by immunoassay technique_ (eg_ enzyme immunoassay [EIA]_ enzyme-linked immunosorbent assay [ELISA]_ fluorescence immunoassay [FIA]_ immunoch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOE0","description":"ICD-KDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAID1","description":"ICD-OAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSA0","description":"ICD-CHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplt allo hct/donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38240","description":"Transplt allo hct/donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIA1","description":"ICD-IBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRF1","description":"ICD-PBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0970T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","description":"CPT-0970T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33900","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDB1","description":"ICD-JBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJA1","description":"ICD-NIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAA0","description":"ICD-JGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heinz bodies direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85441","description":"Heinz bodies direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54115","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8F","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology tissue of origin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81504","description":"Oncology tissue of origin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kne-shin exo sng axi mnl loc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5710","description":"Kne-shin exo sng axi mnl loc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24587","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDD0","description":"ICD-MGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70210","description":"X-ray exam of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacy comp/disp serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9430","description":"Pharmacy comp/disp serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43123","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECA0","description":"ICD-OECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary suspensory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5105","description":"Urinary suspensory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIE1","description":"ICD-EBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrafiltration monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9007","description":"Ultrafiltration monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSF0","description":"ICD-CFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Map tachycardia add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93609","description":"Map tachycardia add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNC1","description":"ICD-NHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin sub graft f/n/hf/g addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15276","description":"Skin sub graft f/n/hf/g addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWC0","description":"ICD-PDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Init pm e/m new pat 1-4 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99382","description":"Init pm e/m new pat 1-4 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21089","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPE0","description":"ICD-FGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAB0","description":"ICD-JGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTF0","description":"ICD-MBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum deep <5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27619","description":"Exc leg/ankle tum deep <5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEB1","description":"ICD-MDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDE0","description":"ICD-OKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWB1","description":"ICD-PIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair mouth/nose fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30600","description":"Repair mouth/nose fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Regional block anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9211","description":"Regional block anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient not eligible due to active diagnosis of hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9744","description":"Patient not eligible due to active diagnosis of hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMD1","description":"ICD-CHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC141","description":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTA0","description":"ICD-OHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC31","description":"ICD-1EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NEURO ALZHEIMER CELL AGGREGJ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0206U","description":"NEURO ALZHEIMER CELL AGGREGJ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPC0","description":"ICD-GIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQF0","description":"ICD-OGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0407","description":"HCPCS-A0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCC0","description":"ICD-NLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSF0","description":"ICD-ODSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPD0","description":"ICD-KFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSB1","description":"ICD-HGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJD0","description":"ICD-OBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40700","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMD1","description":"ICD-FCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMA1","description":"ICD-NLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBC1","description":"ICD-KIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prefab steel crown primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2934","description":"Prefab steel crown primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTF1","description":"ICD-KCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUA1","description":"ICD-OCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX11","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0616","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","description":"HCPCS-J0616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unspecified oral anti-emetic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0181","description":"Unspecified oral anti-emetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair fibula nonunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27726","description":"Repair fibula nonunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLC1","description":"ICD-IHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Joint survey single view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77077","description":"Joint survey single view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKD0","description":"ICD-KDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77263","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pten gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81321","description":"Pten gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEE0","description":"ICD-MAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAF0","description":"ICD-MHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXF0","description":"ICD-JEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITA1","description":"ICD-OITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWF1","description":"ICD-PFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supply_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T5999","description":"Supply_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHB0","description":"ICD-JEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELC0","description":"ICD-CELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27252","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18B","description":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAF1","description":"ICD-EHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB31","description":"ICD-2DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDB1","description":"ICD-CCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBC1","description":"ICD-MDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGF0","description":"ICD-JBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHB0","description":"ICD-NJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99427","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAC0","description":"ICD-MEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTD0","description":"ICD-FGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24D","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88028","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHB1","description":"ICD-NFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92993","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBE0","description":"ICD-CIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNC1","description":"ICD-KFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-elec oscillatory pep dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0484","description":"Non-elec oscillatory pep dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ biochemical assays of 7 proteins (follicle stimulating hormone_ human epididymis protein 4_ apolipoprotein A-1_ transferrin_ beta-2 macroglobulin_ prealbum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0375U","description":"Oncology (ovarian)_ biochemical assays of 7 proteins (follicle stimulating hormone_ human epididymis protein 4_ apolipoprotein A-1_ transferrin_ beta-2 macroglobulin_ prealbum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEA1","description":"ICD-OCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUE1","description":"ICD-AEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUF1","description":"ICD-ACUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERC0","description":"ICD-GERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng arm splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4020","description":"Cast sup lng arm splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBE0","description":"ICD-NBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMA1","description":"ICD-OIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTD0","description":"ICD-IBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUD1","description":"ICD-FAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMB0","description":"ICD-IIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVE1","description":"ICD-NKVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown lengthen hard tissue","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4249","description":"Crown lengthen hard tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXD0","description":"ICD-OCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVF0","description":"ICD-KEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHA1","description":"ICD-IBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRB1","description":"ICD-ODRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of somatomedin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84305","description":"Assay of somatomedin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0575U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","description":"CPT-0575U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1403","description":"HCPCS-A1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients With A Catheter That Have Limited Life Expectancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0050","description":"Patients With A Catheter That Have Limited Life Expectancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKE1","description":"ICD-NLKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXA1","description":"ICD-KAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethral lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57230","description":"Repair of urethral lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB205","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDF0","description":"ICD-OIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLC0","description":"ICD-GDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFD0","description":"ICD-JBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTF0","description":"ICD-CDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0767","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0767","description":"HCPCS-E0767","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVB0","description":"ICD-KDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBC0","description":"ICD-AEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23665","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPA0","description":"ICD-KGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/o implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21406","description":"Opn tx orbit fx w/o implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Lefamulin (Xenleta)_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9054","description":"Injection_ Lefamulin (Xenleta)_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Punch biopsy of skin (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11105","description":"Punch biopsy of skin (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTC1","description":"ICD-FFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCF0","description":"ICD-MBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart image (pet) multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78492","description":"Heart image (pet) multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9612","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","description":"HCPCS-A9612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHA0","description":"ICD-FEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINA0","description":"ICD-OINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prothrombin complex concentrate (human)_ kcentra_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7168","description":"Prothrombin complex concentrate (human)_ kcentra_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGD1","description":"ICD-GAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25028","description":"Drainage of forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJA1","description":"ICD-KIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCE1","description":"ICD-OHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50728","description":"Revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vascular biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75970","description":"Vascular biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATD0","description":"ICD-EATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWE0","description":"ICD-GCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Symp aaa urgent repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9600","description":"Symp aaa urgent repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBD1","description":"ICD-BIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVC1","description":"ICD-OFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos pain assess no f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8509","description":"Pos pain assess no f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transab esoph hiat hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43332","description":"Transab esoph hiat hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92632","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","description":"CPT-92632","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14C","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAF0","description":"ICD-BBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA10","description":"High Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDD1","description":"ICD-GDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWB1","description":"ICD-GCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGA1","description":"ICD-CFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVD1","description":"ICD-CGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLD0","description":"ICD-ICLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYD1","description":"ICD-KCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMB0","description":"ICD-JBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDA1","description":"ICD-OJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBB0","description":"ICD-MKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1702","description":"HCPCS-A1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXD1","description":"ICD-NCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ekg interpret & report preve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0405","description":"Ekg interpret & report preve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD155","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC230","description":"Clinically Complex _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14A","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTC1","description":"ICD-EDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhc slp ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0161","description":"Hhc slp ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYA0","description":"ICD-CBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWC0","description":"ICD-KCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81182","description":"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAC1","description":"ICD-CAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTA1","description":"ICD-OJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln cmplt mand lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5751","description":"Denture reln cmplt mand lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9063","description":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGE0","description":"ICD-GIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentur repr broken compl bas","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5510","description":"Dentur repr broken compl bas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFED1","description":"ICD-BFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0520U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","description":"CPT-0520U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pm device progr eval sngl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93279","description":"Pm device progr eval sngl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No rh-immunoglobulin order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8811","description":"No rh-immunoglobulin order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23C","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDD1","description":"ICD-NLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQD0","description":"ICD-GAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAID0","description":"ICD-CAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATC1","description":"ICD-GATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAA1","description":"ICD-CHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWD1","description":"ICD-LCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCD1","description":"ICD-EHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0350U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant nerve end","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64787","description":"Implant nerve end","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTB0","description":"ICD-ADTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Interpretation And Report By Physician Or Other Qualified Health Care Professional_ Per Calendar Month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0706T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Interpretation And Report By Physician Or Other Qualified Health Care Professional_ Per Calendar Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTC1","description":"ICD-KCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTF1","description":"ICD-CFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKA1","description":"ICD-KEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQC1","description":"ICD-CGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA12","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In-home respite care_ 4-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0529","description":"In-home respite care_ 4-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diphtheria_ tetanus toxoids_ and whole cell pertussis vaccine and hemophilus influenza b vaccine (dtp-hib)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90720","description":"Diphtheria_ tetanus toxoids_ and whole cell pertussis vaccine and hemophilus influenza b vaccine (dtp-hib)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical_ with frontal sinus exploration_ including removal of tissue from frontal sinus_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31276","description":"Nasal/sinus endoscopy_ surgical_ with frontal sinus exploration_ including removal of tissue from frontal sinus_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUC0","description":"ICD-MIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOB0","description":"ICD-PEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFME0","description":"ICD-IFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pne scrn done doc not ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9281","description":"Pne scrn done doc not ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQD0","description":"ICD-HGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQE0","description":"ICD-HCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion/graft of hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26844","description":"Fusion/graft of hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vascular graft_ synthetic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8670","description":"Vascular graft_ synthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDE0","description":"ICD-GHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXF0","description":"ICD-OCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAD0","description":"ICD-NGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIF0","description":"ICD-OAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cyto/molecular report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88291","description":"Cyto/molecular report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26434","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients With Moderate Or Severe Mitral Stenosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0044","description":"Patients With Moderate Or Severe Mitral Stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYF1","description":"ICD-DCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYF1","description":"ICD-PIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQF1","description":"ICD-GDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYD1","description":"ICD-CCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPB0","description":"ICD-OFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKB0","description":"ICD-KHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTB0","description":"ICD-MLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFC0","description":"ICD-OCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abdomen surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49999","description":"Abdomen surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHE0","description":"ICD-BCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLC1","description":"ICD-KHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ho frejka cov only pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1610","description":"Ho frejka cov only pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDE0","description":"ICD-FEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC31","description":"ICD-2JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLA1","description":"ICD-CCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0989T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","description":"CPT-0989T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUF0","description":"ICD-OBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplant/graft palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26489","description":"Transplant/graft palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy br/wa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44380","description":"Small bowel endoscopy br/wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIA0","description":"ICD-OGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJF0","description":"ICD-JFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSA0","description":"ICD-PHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Overdenture partial mandib","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5866","description":"Overdenture partial mandib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor fletcher fact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85292","description":"Clot factor fletcher fact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1160","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26373","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC31","description":"ICD-3BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYE0","description":"ICD-GGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1454","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","description":"HCPCS-M1454","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No satisfy with care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0918","description":"No satisfy with care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPD0","description":"ICD-FBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAE0","description":"ICD-IFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQD1","description":"ICD-DHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lanadelumab-flyo_ 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician_ not for use when drug is self-administered)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0593","description":"Injection_ lanadelumab-flyo_ 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician_ not for use when drug is self-administered)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAA0","description":"ICD-CGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLC1","description":"ICD-JFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ de","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81164","description":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv rna plan care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0575F","description":"Hiv rna plan care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder & vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57289","description":"Repair bladder & vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1454","description":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fit spectacles single system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92354","description":"Fit spectacles single system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doppler color flow add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93325","description":"Doppler color flow add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7683","description":"Triamcinolone comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTA0","description":"ICD-MCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18B","description":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELE1","description":"ICD-CELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0556","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","description":"HCPCS-G0556","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep ak ischial laminated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5590","description":"Prep ak ischial laminated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOB0","description":"ICD-LEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMA1","description":"ICD-GBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUA0","description":"ICD-NGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 30 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90637","description":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 30 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYB0","description":"ICD-HAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMB0","description":"ICD-OAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHF1","description":"ICD-BBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVB1","description":"ICD-FFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB224","description":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEB1","description":"ICD-OBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKC1","description":"ICD-CEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36584","description":"Replace picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPB0","description":"ICD-GFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTD1","description":"ICD-MGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBF1","description":"ICD-MHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor viii multimetric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85247","description":"Clot factor viii multimetric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYA0","description":"ICD-LEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA02","description":"Very High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFE0","description":"ICD-FDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBB0","description":"ICD-IEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFA1","description":"ICD-NFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCE1","description":"ICD-OFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL34","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine eltrd perq aray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63661","description":"Remove spine eltrd perq aray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Theraskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4121","description":"Theraskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Volun service at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9476","description":"Volun service at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEE1","description":"ICD-JGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKD0","description":"ICD-CIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAF1","description":"ICD-CIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pm generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33233","description":"Removal of pm generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIED0","description":"ICD-AIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDE0","description":"ICD-JBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home ventilator_ dual-function respiratory device_ also performs additional function of cough stimulation_ includes all accessories_ components and supplies for all functions","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0468","description":"Home ventilator_ dual-function respiratory device_ also performs additional function of cough stimulation_ includes all accessories_ components and supplies for all functions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35082","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYF0","description":"ICD-KIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGC0","description":"ICD-JCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ed svc ckd grp per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0421","description":"Ed svc ckd grp per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACE1","description":"ICD-MACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQA0","description":"ICD-PAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDB1","description":"ICD-EIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWB1","description":"ICD-DFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEA1","description":"ICD-EEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACA0","description":"ICD-EACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1137","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUE1","description":"ICD-JGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of rectal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45150","description":"Excision of rectal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOE1","description":"ICD-OCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ concentration technique_ smears_ and interpretation (eg_ Saccomanno technique) (List separately in addition to code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0829T","description":"Digitization of glass microscope slides for cytopathology_ concentration technique_ smears_ and interpretation (eg_ Saccomanno technique) (List separately in addition to code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm system binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5282","description":"Ald fm/dm system binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIF0","description":"ICD-CEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30020","description":"Drainage of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASA0","description":"ICD-CASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA241","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBF0","description":"ICD-MLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICE0","description":"ICD-JICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gtt-added samples","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82952","description":"Gtt-added samples","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA GIARDIA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87329","description":"IAAD IA GIARDIA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAD0","description":"ICD-JAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMD1","description":"ICD-IBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE146","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65781","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLC0","description":"ICD-EFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flulaval vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2036","description":"Flulaval vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High strength ltwt whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0004","description":"High strength ltwt whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMD1","description":"ICD-OAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tick-borne encephalitis virus vaccine_ inactivated; 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90627","description":"Tick-borne encephalitis virus vaccine_ inactivated; 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ravulizumab-cwvz_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9052","description":"Injection_ ravulizumab-cwvz_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61580","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHA1","description":"ICD-KFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMF0","description":"ICD-EAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8G","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIF0","description":"ICD-KDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst t/o & repair compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58292","description":"Vag hyst t/o & repair compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIC1","description":"ICD-ECIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVA1","description":"ICD-JIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSF0","description":"ICD-PDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUE1","description":"ICD-GFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1402","description":"HCPCS-B1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIB1","description":"ICD-IGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDC0","description":"ICD-EBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB05","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext ecg recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0296T","description":"Ext ecg recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9172","description":"HCPCS-C9172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFD0","description":"ICD-NIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultralightweight wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0005","description":"Ultralightweight wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYC1","description":"ICD-OBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA34","description":"Medium Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smear special stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87207","description":"Smear special stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITF1","description":"ICD-JITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATB0","description":"ICD-AATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Promazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2950","description":"Promazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11B","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPA0","description":"ICD-OBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKC1","description":"ICD-BFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12A","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 1 genotyping (HPA-1)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81105","description":"Human Platelet Antigen 1 genotyping (HPA-1)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKC1","description":"ICD-BBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSB1","description":"ICD-DDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBD1","description":"ICD-FHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVC0","description":"ICD-OIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUA1","description":"ICD-BIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDF0","description":"ICD-MDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRD0","description":"ICD-DGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRA1","description":"ICD-DCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"History of mole changes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1050F","description":"History of mole changes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow socket ins use w/o lck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6695","description":"Elbow socket ins use w/o lck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place duod/jej tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49441","description":"Place duod/jej tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23C","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICA0","description":"ICD-AICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGID1","description":"ICD-BGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGA0","description":"ICD-NCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB13","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWE0","description":"ICD-GBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACF1","description":"ICD-NACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEB0","description":"ICD-KHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21422","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMD1","description":"ICD-OJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC11","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLC1","description":"ICD-FCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRA1","description":"ICD-PLRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGME0","description":"ICD-FGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUE0","description":"ICD-GGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (WG Critical Care)_ not therapeutically equivalent to J0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0687","description":"Injection_ cefazolin sodium (WG Critical Care)_ not therapeutically equivalent to J0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNC1","description":"ICD-GBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of nasal bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70160","description":"X-ray exam of nasal bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIB1","description":"ICD-BEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB34","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWC0","description":"ICD-KAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUB1","description":"ICD-JDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med rsn no stat tx/presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9667","description":"Doc med rsn no stat tx/presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNC0","description":"ICD-NCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ sculptra_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2028","description":"Inj_ sculptra_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDE0","description":"ICD-OGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4344","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","description":"HCPCS-Q4344","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPF1","description":"ICD-GIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSB1","description":"ICD-DCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0452T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL07","description":"High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55605","description":"Incise sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of sex hormone globul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84270","description":"Assay of sex hormone globul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVC0","description":"ICD-OFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTC0","description":"ICD-ABTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maxillary part denture flex","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5225","description":"Maxillary part denture flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent repair of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64872","description":"Subsequent repair of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKE1","description":"ICD-JAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis auto w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81003","description":"Urinalysis auto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAF0","description":"ICD-NHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFF0","description":"ICD-BIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIE1","description":"ICD-ICIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAB1","description":"ICD-JAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALF0","description":"ICD-GALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10B","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPB1","description":"ICD-GIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","description":"HCPCS-J3387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0823T","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA11","description":"ICD-4JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dacarbazine 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9130","description":"Dacarbazine 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES254","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYE1","description":"ICD-KBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHA0","description":"ICD-ECHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHA1","description":"ICD-NCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0044U","description":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYB0","description":"ICD-KHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom power whlchr base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0013","description":"Custom power whlchr base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDD0","description":"ICD-OLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDC0","description":"ICD-MKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of prolactin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84146","description":"Assay of prolactin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ viltolarsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9071","description":"Injection_ viltolarsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBE1","description":"ICD-BDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr e/n/e/l 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14060","description":"Tis trnfr e/n/e/l 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37256","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","description":"CPT-37256","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAA1","description":"ICD-OGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20206","description":"Needle biopsy muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEC1","description":"ICD-ICEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOF1","description":"ICD-HGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Polatuzumab Vedotin-Piiq_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9309","description":"Injection_ Polatuzumab Vedotin-Piiq_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFID1","description":"ICD-BFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUA0","description":"ICD-FGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOE1","description":"ICD-OKOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCC1","description":"ICD-FBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJF1","description":"ICD-JBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMC0","description":"ICD-FHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGB1","description":"ICD-BFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ bandage liner_ lower extremity_ any size or length_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6594","description":"Gradient compression bandaging supply_ bandage liner_ lower extremity_ any size or length_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMF1","description":"ICD-EEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADC0","description":"ICD-IADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGF0","description":"ICD-KIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0138U","description":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autonomic nrv parasym inervj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95921","description":"Autonomic nrv parasym inervj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0102","description":"HCPCS-B0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDC1","description":"ICD-BEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEB1","description":"ICD-IBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITD1","description":"ICD-JITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWC0","description":"ICD-OIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAD0","description":"ICD-ADAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHB1","description":"ICD-OFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLF0","description":"ICD-BBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1036T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1036T","description":"CPT-1036T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion during 3-dimensn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0241T","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion during 3-dimensn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67950","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ustekinumab_ for intravenous injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3358","description":"Ustekinumab_ for intravenous injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg_ drug metabolism)_ gene analysis_ common variant(s) (eg_ *2_ *22)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81230","description":"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg_ drug metabolism)_ gene analysis_ common variant(s) (eg_ *2_ *22)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55715","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","description":"CPT-55715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX50","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of troponin quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84484","description":"Assay of troponin quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA221","description":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28060","description":"Partial removal foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release spinal cord lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63200","description":"Release spinal cord lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNF0","description":"ICD-BCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFB1","description":"ICD-GEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJC0","description":"ICD-CFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00102","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","description":"CPT-00102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVE1","description":"ICD-BGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMC0","description":"ICD-BHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of hip socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27122","description":"Reconstruction of hip socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wc van mileage per mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0209","description":"Wc van mileage per mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWB0","description":"ICD-OEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNE0","description":"ICD-GFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYD0","description":"ICD-KBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDC0","description":"ICD-IHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB10","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq lumbosacral injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22511","description":"Perq lumbosacral injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYB0","description":"ICD-GFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOD0","description":"ICD-PLOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUD0","description":"ICD-BDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVB1","description":"ICD-KBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis via av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4052F","description":"Hemodialysis via av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIC0","description":"ICD-ODIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status performed once in the last 12 months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9916","description":"Functional status performed once in the last 12 months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Development Of The Treatment Plan_ Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2086","description":"Office-Based Treatment For Opioid Use Disorder_ Including Development Of The Treatment Plan_ Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSF1","description":"ICD-HBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVA1","description":"ICD-BFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDE1","description":"ICD-NKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFB0","description":"ICD-FEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKB0","description":"ICD-FBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal application device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7034","description":"Nasal application device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXA0","description":"ICD-BCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSF1","description":"ICD-HCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAA1","description":"ICD-ADAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUD0","description":"ICD-KBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXC1","description":"ICD-NLXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHF0","description":"ICD-NDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53210","description":"Removal of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUB0","description":"ICD-ACUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBB1","description":"ICD-GEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUA0","description":"ICD-BBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIC0","description":"ICD-KCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLB1","description":"ICD-MJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28A","description":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMF0","description":"ICD-NEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Long qt synd gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81280","description":"Long qt synd gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDND1","description":"ICD-GDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE220","description":"Special Care Low _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion 25-28 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2265","description":"Induced abortion 25-28 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0682T","description":"Removal Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDB0","description":"ICD-JCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPD0","description":"ICD-JDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18F","description":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUC1","description":"ICD-MJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of neck vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37565","description":"Ligation of neck vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNB0","description":"ICD-NFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBB0","description":"ICD-NHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHED1","description":"ICD-GHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx dental pain minor proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9110","description":"Tx dental pain minor proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJE0","description":"ICD-KFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUE1","description":"ICD-CEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWC1","description":"ICD-HFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56605","description":"Biopsy of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKA1","description":"ICD-OBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIND1","description":"ICD-KIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVC0","description":"ICD-FGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87636","description":"IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB125","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUF1","description":"ICD-JDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRA1","description":"ICD-DBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISB1","description":"ICD-HISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTE1","description":"ICD-JFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemotx Adm Iv Inf Tech; Ini Inf Office/Clin Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0498","description":"Chemotx Adm Iv Inf Tech; Ini Inf Office/Clin Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAF1","description":"ICD-MCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove intrvas foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37197","description":"Remove intrvas foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antiemetic rectal/supp nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8498","description":"Antiemetic rectal/supp nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOF1","description":"ICD-OEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDE0","description":"ICD-FGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPB1","description":"ICD-NBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCC1","description":"ICD-NLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXE0","description":"ICD-NLXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0B","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flexion/extension wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6620","description":"Flexion/extension wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0698U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698U","description":"CPT-0698U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQB0","description":"ICD-HGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLD0","description":"ICD-OKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBB0","description":"ICD-EHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQE0","description":"ICD-GFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18B","description":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear matrix protein 22","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86386","description":"Nuclear matrix protein 22","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOC1","description":"ICD-KCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nicotine patch nonlegend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4991","description":"Nicotine patch nonlegend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRE1","description":"ICD-OKRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCB1","description":"ICD-KDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE155","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECF1","description":"ICD-IECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pantoprazole (Hikma)_ not therapeutically equivalent to J2470_ 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2471","description":"Injection_ pantoprazole (Hikma)_ not therapeutically equivalent to J2470_ 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEE1","description":"ICD-NKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9900","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKF0","description":"ICD-BCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBC1","description":"ICD-JHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDA0","description":"ICD-OEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMB0","description":"ICD-ICMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDB0","description":"ICD-OIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMB1","description":"ICD-FBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYE0","description":"ICD-LCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKE0","description":"ICD-CCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHD1","description":"ICD-GAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIA0","description":"ICD-KFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast add mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19288","description":"Perq dev breast add mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit enzyme replace diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9357","description":"Hit enzyme replace diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or n","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2210","description":"Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert pelv fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22848","description":"Insert pelv fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bl exchange/transfuse nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36450","description":"Bl exchange/transfuse nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRD1","description":"ICD-LDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit20.1-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12046","description":"Intmd rpr n-hf/genit20.1-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOB1","description":"ICD-DFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xray endovasc thor ao repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75956","description":"Xray endovasc thor ao repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIC0","description":"ICD-EIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teplizumab-mzwv_ 5 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9381","description":"Injection_ teplizumab-mzwv_ 5 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace socket below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5700","description":"Replace socket below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSE0","description":"ICD-KDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stereotactic biopsy_ aspiration_ or excision of lesion_ spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63615","description":"Stereotactic biopsy_ aspiration_ or excision of lesion_ spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4367","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","description":"HCPCS-Q4367","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0998T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","description":"CPT-0998T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYC1","description":"ICD-LGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy chemodenervation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52287","description":"Cystoscopy chemodenervation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Progenamatrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4222","description":"Progenamatrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJD0","description":"ICD-NLJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHC1","description":"ICD-NDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQE0","description":"ICD-OEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFC0","description":"ICD-KIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHC1","description":"ICD-NKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthotic(s)/prosthetic(s) management and/or training_ upper extremity(ies)_ lower extremity(ies)_ and/or trunk_ subsequent orthotic(s)/prosthetic(s) encounter_ each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97763","description":"Orthotic(s)/prosthetic(s) management and/or training_ upper extremity(ies)_ lower extremity(ies)_ and/or trunk_ subsequent orthotic(s)/prosthetic(s) encounter_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA43","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5939","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5939","description":"CDT-D5939","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMD0","description":"ICD-IEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNE0","description":"ICD-FBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBC0","description":"ICD-FGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCD0","description":"ICD-EBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radxps in end rprt4fluro pxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6045F","description":"Radxps in end rprt4fluro pxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAE0","description":"ICD-BGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tricyclic & cyclicals 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80337","description":"Tricyclic & cyclicals 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NuDYN DL or NuDYN DL MESH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4285","description":"NuDYN DL or NuDYN DL MESH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKA1","description":"ICD-GIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45317","description":"Proctosigmoidoscopy bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDD1","description":"ICD-FBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect face/scalp tum < 2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21015","description":"Resect face/scalp tum < 2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ decitabine (sun pharma) not therapeutically equivalent to j0894_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0893","description":"Injection_ decitabine (sun pharma) not therapeutically equivalent to j0894_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31225","description":"Removal of upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUB0","description":"ICD-BFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYE1","description":"ICD-CBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGE1","description":"ICD-BFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy flex dx brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43197","description":"Esophagoscopy flex dx brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic(s) training_ upper and/or lower extremity(ies)_ initial prosthetic(s) encounter_ each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97761","description":"Prosthetic(s) training_ upper and/or lower extremity(ies)_ initial prosthetic(s) encounter_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko elastic with joints","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1810","description":"Ko elastic with joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45300","description":"Proctosigmoidoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physical Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4025","description":"Physical Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUE0","description":"ICD-JCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAE1","description":"ICD-ACAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise spermatic cord veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55535","description":"Revise spermatic cord veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAE0","description":"ICD-AHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; supply and technical support_ per 30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0733T","description":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; supply and technical support_ per 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDID1","description":"ICD-MDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGE0","description":"ICD-FHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86701","description":"Hiv-1antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPE0","description":"ICD-KCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVD1","description":"ICD-OEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8544","description":"Cabg measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHF0","description":"ICD-OLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMA0","description":"ICD-CFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC11","description":"ICD-1IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNE1","description":"ICD-CBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMB0","description":"ICD-NEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24D","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXE0","description":"ICD-GBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty rest","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4212","description":"Gingivectomy/plasty rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFND0","description":"ICD-GFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect heart sac lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33050","description":"Resect heart sac lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBD1","description":"ICD-CBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36590","description":"Removal tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFD1","description":"ICD-NKFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYE0","description":"ICD-CDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSC0","description":"ICD-OKSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightweight det a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1088","description":"Wheelchair lightweight det a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIF1","description":"ICD-EIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGB0","description":"ICD-CEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Of Drug-Eluting Implant_ Including Punctal Dilation When Performed_ Into Lacrimal Canaliculus_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68841","description":"Insertion Of Drug-Eluting Implant_ Including Punctal Dilation When Performed_ Into Lacrimal Canaliculus_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATE1","description":"ICD-KATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPD1","description":"ICD-NBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUB1","description":"ICD-CAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/implant finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26536","description":"Revise/implant finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUF0","description":"ICD-JAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANF0","description":"ICD-JANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA52","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decalcification procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0475","description":"Decalcification procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0082","description":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOC0","description":"ICD-PJOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSF0","description":"ICD-DGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML50","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia)_ genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0237U","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia)_ genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCE0","description":"ICD-MLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0750T","description":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQE0","description":"ICD-PKQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNB0","description":"ICD-KGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20C","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Modify speech aid prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5960","description":"Modify speech aid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE226","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epsd bk pain for 12 wks/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1136F","description":"Epsd bk pain for 12 wks/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOF0","description":"ICD-GEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA231","description":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/us guide bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45342","description":"Sigmoidoscopy w/us guide bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brief (20 minutes) in-home visit for a new patient post-discharge.  For use only in a Medicare-appro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2001","description":"Brief (20 minutes) in-home visit for a new patient post-discharge.  For use only in a Medicare-appro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTE0","description":"ICD-JFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYF0","description":"ICD-OGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATE0","description":"ICD-EATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFF1","description":"ICD-BIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVE0","description":"ICD-OKVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQE0","description":"ICD-LIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47350","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLD0","description":"ICD-FGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQB1","description":"ICD-GIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFD0","description":"ICD-BIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMC1","description":"ICD-JCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENE0","description":"ICD-GENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18E","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap vent/abd hern proc comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49653","description":"Lap vent/abd hern proc comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHD1","description":"ICD-ADHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXA1","description":"ICD-NKXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGD0","description":"ICD-JAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0269T","description":"Rev/remvl crtd sns dev total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDA0","description":"ICD-GIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calcium gluconate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0610","description":"Calcium gluconate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIC0","description":"ICD-BHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for bladder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51600","description":"Injection for bladder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8909","description":"Mra w/cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDD1","description":"ICD-JFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home hospice case 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0271","description":"Home hospice case 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDD0","description":"ICD-GDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRC0","description":"ICD-ODRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Create tear sac drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68720","description":"Create tear sac drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spinal orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1499","description":"Spinal orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUE0","description":"ICD-JHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25900","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBD0","description":"ICD-NLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUE0","description":"ICD-AHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKF1","description":"ICD-FAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1497","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","description":"HCPCS-M1497","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJD1","description":"ICD-CDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optokinetic nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92544","description":"Optokinetic nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 45","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88263","description":"Chromosome analysis 45","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBB1","description":"ICD-AEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOA0","description":"ICD-PBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAED0","description":"ICD-NAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHF0","description":"ICD-AIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJD1","description":"ICD-NHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Injection/Nerve Block Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0620","description":"Hospital Special Treatment Room Support Component (Hstrsc) Injection/Nerve Block Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0666","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","description":"HCPCS-J0666","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUE1","description":"ICD-ADUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDE0","description":"ICD-ODDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12D","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAF0","description":"ICD-OCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVE1","description":"ICD-KCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIF1","description":"ICD-KBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVE0","description":"ICD-NJVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTC1","description":"ICD-NHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBC1","description":"ICD-EEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl& replc pulse gen 1 lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33262","description":"Rmvl& replc pulse gen 1 lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFED0","description":"ICD-AFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOD1","description":"ICD-GHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDB1","description":"ICD-AEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31587","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardioversion electric ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92960","description":"Cardioversion electric ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0A","description":"Low Rehab_ ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMF1","description":"ICD-NJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUC0","description":"ICD-ICUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBA1","description":"ICD-GIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVD1","description":"ICD-OJVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estrogens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82671","description":"Assay of estrogens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBF1","description":"ICD-KHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject/aspirate liver cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47015","description":"Inject/aspirate liver cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA21","description":"ICD-4IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2B","description":"High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFB1","description":"ICD-OKFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pros sock multi ply upper lm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8435","description":"Pros sock multi ply upper lm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bed accessory brd/tbl/supprt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0315","description":"Bed accessory brd/tbl/supprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNE1","description":"ICD-KHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phlebotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99195","description":"Phlebotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIF1","description":"ICD-NGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22C","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFA0","description":"ICD-FFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAF0","description":"ICD-IAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC130","description":"Clinically Complex _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fqhc visit new patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0466","description":"Fqhc visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Voltage-Gated Calcium Channel Antibody_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86596","description":"Voltage-Gated Calcium Channel Antibody_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFD0","description":"ICD-CGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites_ liquid chromatography with tandem mass spectrom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0322U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites_ liquid chromatography with tandem mass spectrom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAC0","description":"ICD-CCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx complx malar fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21365","description":"Opn tx complx malar fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAB0","description":"ICD-GFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISA0","description":"ICD-KISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENB1","description":"ICD-JENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRC0","description":"ICD-LDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTD1","description":"ICD-KCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVC1","description":"ICD-BDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43820","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSF0","description":"ICD-DDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8G","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture tiss condtin mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5851","description":"Denture tiss condtin mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Core build-up incl any pins","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2950","description":"Core build-up incl any pins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Hyperbaric Oxygen Treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X2061","description":"Hospital Special Treatment Room Support Component (Hstrsc) Hyperbaric Oxygen Treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJF1","description":"ICD-KHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0537U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","description":"CPT-0537U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASA1","description":"ICD-DASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHC0","description":"ICD-KAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOE1","description":"ICD-GAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1036","description":"Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gsc >15 & hd ct by ed md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9594","description":"Gsc >15 & hd ct by ed md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEE0","description":"ICD-FEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No neuropsych symptoms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8948","description":"No neuropsych symptoms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3291","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","description":"HCPCS-J3291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAC1","description":"ICD-KHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pros sock single ply upper l","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8485","description":"Pros sock single ply upper l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had only urgent care visits during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1021","description":"Patient had only urgent care visits during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dna/rna sequencing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87153","description":"Dna/rna sequencing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACF0","description":"ICD-KACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1037T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1037T","description":"CPT-1037T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMC0","description":"ICD-BIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90624","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","description":"CPT-90624","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE106","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2048","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2048","description":"HCPCS-A2048","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort iii w/ lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21155","description":"Lefort iii w/ lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAE0","description":"ICD-ADAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLC0","description":"ICD-OFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIC0","description":"ICD-FDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00813","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","description":"CPT-00813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIC1","description":"ICD-IAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited ankle motion ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2200","description":"Limited ankle motion ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp common ipsi carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35601","description":"Art byp common ipsi carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTE1","description":"ICD-BCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGF0","description":"ICD-NIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLB0","description":"ICD-MLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRB1","description":"ICD-PHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOE0","description":"ICD-OJOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1B","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEA0","description":"ICD-IGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA21","description":"ICD-2GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harvest art for cabg add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35600","description":"Harvest art for cabg add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWA0","description":"ICD-CHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTB1","description":"ICD-EBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSE0","description":"ICD-KCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of spermatic ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54900","description":"Fusion of spermatic ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICA1","description":"ICD-GICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRD1","description":"ICD-GHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFC0","description":"ICD-KGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELF1","description":"ICD-OELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOD0","description":"ICD-OGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATD1","description":"ICD-NATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intermittent asthma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1039F","description":"Intermittent asthma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJE1","description":"ICD-FBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22A","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHE1","description":"ICD-BCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIE1","description":"ICD-IAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEE0","description":"ICD-GFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transvaginal us non-ob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76830","description":"Transvaginal us non-ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX05","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKC1","description":"ICD-JEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow inter loc elbow forarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6250","description":"Elbow inter loc elbow forarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVB1","description":"ICD-JDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc face les sbq 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21012","description":"Exc face les sbq 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEF0","description":"ICD-JGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70380","description":"X-ray exam of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add pwr leg elevation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1010","description":"Add pwr leg elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1332","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA21","description":"ICD-4AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11402","description":"Exc tr-ext b9+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGE1","description":"ICD-KHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMB1","description":"ICD-BDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGA0","description":"ICD-FGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dynamic standing frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0642","description":"Dynamic standing frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTD0","description":"ICD-OGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMA0","description":"ICD-ABMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX31","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0603","description":"HCPCS-C0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQA0","description":"ICD-LFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIF1","description":"ICD-OAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYC1","description":"ICD-PDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18G","description":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSF1","description":"ICD-KBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zoster (shingles) vaccine (HZV)_ recombinant_ sub-unit_ adjuvanted_ for intramuscular injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90750","description":"Zoster (shingles) vaccine (HZV)_ recombinant_ sub-unit_ adjuvanted_ for intramuscular injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQA0","description":"ICD-OCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBC0","description":"ICD-NIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQA1","description":"ICD-CHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMF1","description":"ICD-ODMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8C","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD117","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec alys vagus nrv pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0317T","description":"Elec alys vagus nrv pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMF0","description":"ICD-OKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bed safety enclosure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0316","description":"Bed safety enclosure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCA0","description":"ICD-EBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBF0","description":"ICD-MFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICE0","description":"ICD-BICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEA1","description":"ICD-MDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01444","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","description":"CPT-01444","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Uv lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2755","description":"Uv lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drive belt power wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0098","description":"Drive belt power wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk thigh lacer non-molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5680","description":"Bk thigh lacer non-molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCE0","description":"ICD-MGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITC0","description":"ICD-BITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Splice spleen/kidney veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37181","description":"Splice spleen/kidney veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHB1","description":"ICD-CIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUF1","description":"ICD-MAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJD1","description":"ICD-CCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lip surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40799","description":"Lip surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA120","description":"Reduced Physical Function _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo sing upright w/ adjust s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1920","description":"Afo sing upright w/ adjust s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Section recurrent laryngeal nerve_ therapeutic (separate procedure)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31595","description":"Section recurrent laryngeal nerve_ therapeutic (separate procedure)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSC0","description":"ICD-GHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt surv results not avail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9604","description":"Pt surv results not avail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWC1","description":"ICD-CGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWE1","description":"ICD-CIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10D","description":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70190","description":"X-ray exam of eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd control bleeding any","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43255","description":"Egd control bleeding any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVB0","description":"ICD-GFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ atezolizumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9022","description":"Injection_ atezolizumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBB1","description":"ICD-GFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUC0","description":"ICD-CCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28H","description":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQB1","description":"ICD-CHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pm device progr eval multi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93281","description":"Pm device progr eval multi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fit spectacles bifocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92341","description":"Fit spectacles bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHD1","description":"ICD-BAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXA1","description":"ICD-NIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJF0","description":"ICD-NAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEB0","description":"ICD-EAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","description":"HCPCS-J7601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSC1","description":"ICD-HFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMB1","description":"ICD-EIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIB0","description":"ICD-OGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEB1","description":"ICD-GHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Morphine 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0093","description":"Morphine 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHA0","description":"ICD-OAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA16","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWA1","description":"ICD-HAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB124","description":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1123","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSC1","description":"ICD-CDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWD1","description":"ICD-OLWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWF1","description":"ICD-HGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC11","description":"ICD-2BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compre dental tx transition","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8070","description":"Compre dental tx transition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93224","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEE1","description":"ICD-NDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g._ patients with dementia or tracheostomy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1215","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g._ patients with dementia or tracheostomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXE0","description":"ICD-BBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99425","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert abdomen-venous drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49425","description":"Insert abdomen-venous drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1901","description":"HCPCS-B1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRA0","description":"ICD-HFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADD0","description":"ICD-NADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18X","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUA0","description":"ICD-GCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ Chemotherapeutic Drug Cytotoxicity Assay Of Cancer Stem Cells (Cscs)_ From Cultured Cscs And Primary Tumor Cells_ Categorical Drug Response Reported Based On Percent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0564T","description":"Oncology_ Chemotherapeutic Drug Cytotoxicity Assay Of Cancer Stem Cells (Cscs)_ From Cultured Cscs And Primary Tumor Cells_ Categorical Drug Response Reported Based On Percent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen quant tiagabine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80199","description":"Drug screen quant tiagabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFD1","description":"ICD-GGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2312","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","description":"HCPCS-J2312","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analys placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88267","description":"Chromosome analys placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0601U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","description":"CPT-0601U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology gynecologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81536","description":"Oncology gynecologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4210","description":"Gingivectomy/plasty per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDE0","description":"ICD-OHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iv oct for proc init vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0291T","description":"Iv oct for proc init vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0935T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","description":"CPT-0935T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHF1","description":"ICD-JBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDC0","description":"ICD-ADDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Portable oxygen concentrator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1392","description":"Portable oxygen concentrator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHED1","description":"ICD-FHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Single visn sphere 4.12-7.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2101","description":"Single visn sphere 4.12-7.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of aqueous shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66184","description":"Revision of aqueous shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRF1","description":"ICD-PFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq coronary mech thrombect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92973","description":"Prq coronary mech thrombect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55868","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","description":"CPT-55868","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKC1","description":"ICD-OGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUD1","description":"ICD-JAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXA0","description":"ICD-CCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCC0","description":"ICD-OKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYA1","description":"ICD-PDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBB0","description":"ICD-NBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shortening of hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26479","description":"Shortening of hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVD1","description":"ICD-CDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEED1","description":"ICD-OEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BMI is documented as being outside of normal limits_ follow-up plan is not completed for documented reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9716","description":"BMI is documented as being outside of normal limits_ follow-up plan is not completed for documented reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMD0","description":"ICD-IBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9775","description":"Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMD1","description":"ICD-BDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMF0","description":"ICD-OHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIF1","description":"ICD-BIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABE0","description":"ICD-GABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza b ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87275","description":"Influenza b ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKID0","description":"ICD-MKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28C","description":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMC1","description":"ICD-FHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJF0","description":"ICD-BAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEE0","description":"ICD-IGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVD1","description":"ICD-KFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1035T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1035T","description":"CPT-1035T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ peramivir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2547","description":"Injection_ peramivir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADA1","description":"ICD-BADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXA0","description":"ICD-NDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA15","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHC1","description":"ICD-BIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27499","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUF0","description":"ICD-GAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45130","description":"Excision of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXB0","description":"ICD-NHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24D","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGE1","description":"ICD-OBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUE0","description":"ICD-IGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9392","description":"Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA56","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLB1","description":"ICD-AHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNC0","description":"ICD-NGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBC1","description":"ICD-MCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 2 vhd 451-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0808","description":"Pov group 2 vhd 451-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICC1","description":"ICD-AICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXC1","description":"ICD-BBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPA1","description":"ICD-GCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytherapy radioelements","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3001","description":"Brachytherapy radioelements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCA0","description":"ICD-NHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBF1","description":"ICD-KGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES101","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTA0","description":"ICD-NGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKC0","description":"ICD-GGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPB1","description":"ICD-OJPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDE0","description":"ICD-MJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAD1","description":"ICD-GGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPF0","description":"ICD-NEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo prolong infuse w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96416","description":"Chemo prolong infuse w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor liver/arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47147","description":"Prep donor liver/arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAB0","description":"ICD-OLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDF0","description":"ICD-BCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cvd risk assessment performed_ have a documented calculated risk score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1258","description":"Cvd risk assessment performed_ have a documented calculated risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKA0","description":"ICD-FAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow mold doub splt soc ste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6120","description":"Elbow mold doub splt soc ste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSD0","description":"ICD-PFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGF1","description":"ICD-FHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lincomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2010","description":"Lincomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat eyelid by injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68200","description":"Treat eyelid by injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01916","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","description":"CPT-01916","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMD1","description":"ICD-BGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp grade elec breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0604","description":"Hosp grade elec breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation hemorrhoid w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0249T","description":"Ligation hemorrhoid w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tb intradermal test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86580","description":"Tb intradermal test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABF1","description":"ICD-AABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMA0","description":"ICD-FEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo ak ultra-light material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5950","description":"Endo ak ultra-light material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frozen blood freeze/thaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86932","description":"Frozen blood freeze/thaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99285","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncotype MAP Pan-Cancer Tissue Test_ Paradigm Diagnostics_ Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0244U","description":"Oncotype MAP Pan-Cancer Tissue Test_ Paradigm Diagnostics_ Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1007","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1007","description":"HCPCS-L1007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLC1","description":"ICD-FHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSD1","description":"ICD-OJSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00404","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","description":"CPT-00404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76019","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","description":"CPT-76019","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0902","description":"HCPCS-C0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"C-reactive protein hs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86141","description":"C-reactive protein hs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB150","description":"Clinically Complex _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1091T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1091T","description":"CPT-1091T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWB0","description":"ICD-OHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJA0","description":"ICD-OAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peri-Procedural Device Evaluation (In-Person) And Programming Of Device System Parameters Before Or After A Surgery_ Procedure_ Or Test With Analysis_ Review_ And Report By A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0684T","description":"Peri-Procedural Device Evaluation (In-Person) And Programming Of Device System Parameters Before Or After A Surgery_ Procedure_ Or Test With Analysis_ Review_ And Report By A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC217","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGF1","description":"ICD-CGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGF0","description":"ICD-OEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ 14 or more classes of drugs and substances_ definitive tandem mass spectrometry with chromatography_ capillary blood_ quantitative report with th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054U","description":"Prescription drug monitoring_ 14 or more classes of drugs and substances_ definitive tandem mass spectrometry with chromatography_ capillary blood_ quantitative report with th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11C","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Each Additional 15 Minutes Of One-On-One Physician Or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90913","description":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Each Additional 15 Minutes Of One-On-One Physician Or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAB1","description":"ICD-ICAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBF0","description":"ICD-OFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVC0","description":"ICD-FIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIA1","description":"ICD-JGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27685","description":"Revision of lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTD1","description":"ICD-JCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMF1","description":"ICD-GIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep ak ischial plast molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5560","description":"Prep ak ischial plast molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid frame pre subclav","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0470","description":"Tlso rigid frame pre subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILC1","description":"ICD-OILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDE1","description":"ICD-BDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKA1","description":"ICD-CAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUD0","description":"ICD-FHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA33","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVC1","description":"ICD-KCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETC1","description":"ICD-BETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVC1","description":"ICD-KIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Matristem wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4119","description":"Matristem wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD201","description":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA126","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMF0","description":"ICD-BIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ blinatumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9039","description":"Injection_ blinatumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (eg_ pharmacogenomics) genomic sequence analysis panel_ must include testing of at least 6 genes_ including CYP2C19_ CYP2D6_ and CYP2D6 duplication/deletion an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81418","description":"Drug metabolism (eg_ pharmacogenomics) genomic sequence analysis panel_ must include testing of at least 6 genes_ including CYP2C19_ CYP2D6_ and CYP2D6 duplication/deletion an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii recombinant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7192","description":"Factor viii recombinant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27816","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCC1","description":"ICD-OHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNE1","description":"ICD-OJNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMC1","description":"ICD-OLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCE0","description":"ICD-MHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays lungs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75743","description":"Artery x-rays lungs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder blade lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23172","description":"Remove shoulder blade lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24D","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laronidase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1931","description":"Laronidase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5136","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","description":"HCPCS-Q5136","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFB1","description":"ICD-NBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECF0","description":"ICD-AECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB51","description":"Low Rehab_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJE1","description":"ICD-KHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1502","description":"HCPCS-B1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lutetium lu 177_ dotatate_ therapeutic_ 1 millicure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9513","description":"Lutetium lu 177_ dotatate_ therapeutic_ 1 millicure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ amivantamab-vmjw_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9061","description":"Injection_ amivantamab-vmjw_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1110","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo cholecystectomy/explr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47564","description":"Laparo cholecystectomy/explr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Halo cervical into body jack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0820","description":"Halo cervical into body jack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation syringe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4322","description":"Irrigation syringe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTF1","description":"ICD-AGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2A","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICF1","description":"ICD-BICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWC0","description":"ICD-OEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ntsty modul rad tx dlvr smpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77385","description":"Ntsty modul rad tx dlvr smpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Borrelia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86619","description":"Borrelia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC11","description":"ICD-2EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBB1","description":"ICD-FDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Transcatheter Ultrasound Ablation Of Nerves Innervating The Pulmonary Arteries_ Including Right Heart Catheterization_ Pulmonary Artery Angiography_ And All Imagi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0632T","description":"Percutaneous Transcatheter Ultrasound Ablation Of Nerves Innervating The Pulmonary Arteries_ Including Right Heart Catheterization_ Pulmonary Artery Angiography_ And All Imagi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGA1","description":"ICD-FAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYF1","description":"ICD-PAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fqhc visit_ ippe or awv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0468","description":"Fqhc visit_ ippe or awv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB31","description":"ICD-3GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat tail bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27200","description":"Treat tail bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEC1","description":"ICD-OLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not performing functional status (e.g._ patient is severely impaired and caregiver knowledge is limited_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9917","description":"Documentation of medical reason(s) for not performing functional status (e.g._ patient is severely impaired and caregiver knowledge is limited_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2212","description":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQE1","description":"ICD-KGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky =50)_ cardiac c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2207","description":"Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky =50)_ cardiac c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8X","description":"High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open coronary endarterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33572","description":"Open coronary endarterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWE0","description":"ICD-DDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Toxoplasma antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86778","description":"Toxoplasma antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow socket ins use w/lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6694","description":"Elbow socket ins use w/lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6057","description":"Custom abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVE1","description":"ICD-FBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ammonia test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4774","description":"Ammonia test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resp virus 12-25 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87633","description":"Resp virus 12-25 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18E","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus and fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43312","description":"Repair esophagus and fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43605","description":"Biopsy of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ labetalol hydrochloride_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1920","description":"Injection_ labetalol hydrochloride_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Private duty/independent nsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1000","description":"Private duty/independent nsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRC0","description":"ICD-KFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein l3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82107","description":"Alpha-fetoprotein l3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist disart myoelectronic c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6925","description":"Wrist disart myoelectronic c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54430","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOF1","description":"ICD-CDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMB1","description":"ICD-GAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXA0","description":"ICD-BEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTC1","description":"ICD-BBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQB0","description":"ICD-PBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1480","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","description":"HCPCS-M1480","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTB1","description":"ICD-GBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor ix ptc/chrstmas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85250","description":"Clot factor ix ptc/chrstmas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHF1","description":"ICD-AEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBB1","description":"ICD-CCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01274","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","description":"CPT-01274","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWA1","description":"ICD-GGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0583U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","description":"CPT-0583U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYB1","description":"ICD-PGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX60","description":"Medium Rehab plus Extensive_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHE1","description":"ICD-IFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPC0","description":"ICD-FFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACF0","description":"ICD-JACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prim art m-thrmbc sbsq vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37185","description":"Prim art m-thrmbc sbsq vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/singl lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33240","description":"Insrt pulse gen w/singl lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWC0","description":"ICD-CFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERD1","description":"ICD-CERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGE0","description":"ICD-OJGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med reason for no ceph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9196","description":"Med reason for no ceph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.00d/>6.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2106","description":"Spherocylinder 4.00d/>6.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSE0","description":"ICD-LCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRD0","description":"ICD-CHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bebtelovimab_ 175 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0222","description":"Injection_ bebtelovimab_ 175 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDF1","description":"ICD-FFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prostatic rf thermotx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53852","description":"Prostatic rf thermotx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neonate crit care subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99469","description":"Neonate crit care subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phys exam for college","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0622","description":"Phys exam for college","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABD1","description":"ICD-GABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHE0","description":"ICD-KDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23A","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD126","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYF0","description":"ICD-DFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10D","description":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSB0","description":"ICD-GFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDC1","description":"ICD-FHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJD0","description":"ICD-OJJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rezafungin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0349","description":"Injection_ rezafungin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43121","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIE0","description":"ICD-FFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDB1","description":"ICD-NIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXC1","description":"ICD-OBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQC0","description":"ICD-KAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA25","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval self-assess depression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3005","description":"Eval self-assess depression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22A","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXB0","description":"ICD-FAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prostate laser enucleation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52649","description":"Prostate laser enucleation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLF0","description":"ICD-JGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88160","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGA1","description":"ICD-OLGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX46","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB134","description":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB246","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAF0","description":"ICD-ECAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harness figure of 8 sing con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6675","description":"Harness figure of 8 sing con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL30","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMF1","description":"ICD-EDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA156","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA154","description":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTB1","description":"ICD-ABTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHB0","description":"ICD-ADHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hd shck absrber for hd powwc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1018","description":"Hd shck absrber for hd powwc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL13","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPA1","description":"ICD-BIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23A","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCD0","description":"ICD-NJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC31","description":"ICD-4CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXA1","description":"ICD-JBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCB0","description":"ICD-MBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAA0","description":"ICD-KHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJB1","description":"ICD-FCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ac5 advanced wound system (ac5)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2020","description":"Ac5 advanced wound system (ac5)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj enoxaparin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1650","description":"Inj enoxaparin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUD0","description":"ICD-KHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUF1","description":"ICD-NAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEC1","description":"ICD-AHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMB1","description":"ICD-AEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQA0","description":"ICD-PBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVA1","description":"ICD-OJVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alanine amino (alt) (sgpt)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84460","description":"Alanine amino (alt) (sgpt)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pet image full body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78813","description":"Pet image full body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93016","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNC1","description":"ICD-CDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4377","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","description":"HCPCS-Q4377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEF1","description":"ICD-EHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA11","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRC0","description":"ICD-CHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25B","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCE1","description":"ICD-GBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBC0","description":"ICD-FCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26420","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray bend only l-s spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72120","description":"X-ray bend only l-s spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepc mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8549","description":"Hepc mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIC0","description":"ICD-OBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA235","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMD0","description":"ICD-BGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total kt/v greater than or equal to 1. 7 per week (total clearance of urea [kt] / volume [v])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8718","description":"Total kt/v greater than or equal to 1. 7 per week (total clearance of urea [kt] / volume [v])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOE1","description":"ICD-LHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx laryngoscopy w/oper scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31526","description":"Dx laryngoscopy w/oper scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNC1","description":"ICD-JBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAB0","description":"ICD-OCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJB1","description":"ICD-CDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53410","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIA1","description":"ICD-EIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHC1","description":"ICD-FGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAC1","description":"ICD-NEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cabazitaxel (Sandoz)_ not therapeutically equivalent to J9043_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9064","description":"Injection_ cabazitaxel (Sandoz)_ not therapeutically equivalent to J9043_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAD0","description":"ICD-FAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOC0","description":"ICD-HBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECA1","description":"ICD-AECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVB0","description":"ICD-CAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28G","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","description":"HCPCS-M1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWB1","description":"ICD-KDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8500","description":"Hiv meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD113","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOC0","description":"ICD-PFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microbiology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87999","description":"Microbiology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had more than one emergency department visit in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9850","description":"Patient had more than one emergency department visit in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture aerobic identify","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87077","description":"Culture aerobic identify","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine potassium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84133","description":"Assay of urine potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCC0","description":"ICD-NCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNF0","description":"ICD-JFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no abx therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9559","description":"Doc med reas no abx therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD155","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB21","description":"ICD-4AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFED0","description":"ICD-FFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBE1","description":"ICD-AGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stoma plug or seal_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5081","description":"Stoma plug or seal_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preputial stretching","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54450","description":"Preputial stretching","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXD0","description":"ICD-GEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5164","description":"HCPCS-Q5164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0525","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","description":"HCPCS-J0525","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calc bmi abv up param f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8417","description":"Calc bmi abv up param f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27435","description":"Incision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPF1","description":"ICD-OLPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25630","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluciclovine f-18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9588","description":"Fluciclovine f-18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGA1","description":"ICD-ODGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0069","description":"Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe clubfoot wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3380","description":"Shoe clubfoot wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harvest femoropopliteal vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35572","description":"Harvest femoropopliteal vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIF1","description":"ICD-GDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQA0","description":"ICD-KHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEC0","description":"ICD-NBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPE0","description":"ICD-CBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nhl stg unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9138","description":"Onc dx nhl stg unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDA0","description":"ICD-ECDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fit contac lens for managmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92072","description":"Fit contac lens for managmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23455","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOE0","description":"ICD-KHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5D","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEF1","description":"ICD-KIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEID0","description":"ICD-IEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELC1","description":"ICD-IELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUB0","description":"ICD-FHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADD0","description":"ICD-EADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gel pressure mattress pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0185","description":"Gel pressure mattress pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXD1","description":"ICD-FEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELE0","description":"ICD-JELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg cast chg shlder/t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6384","description":"Postop dsg cast chg shlder/t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDC1","description":"ICD-JFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Granisetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1626","description":"Granisetron hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCE0","description":"ICD-BDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g._ intestinal infection_ pertussis_ bacterial infection_ lyme disease_ otitis media_ acute sinu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9712","description":"Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g._ intestinal infection_ pertussis_ bacterial infection_ lyme disease_ otitis media_ acute sinu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rsk fx ref w/n 24 hrs xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5100F","description":"Rsk fx ref w/n 24 hrs xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leukocyte histamine release","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86343","description":"Leukocyte histamine release","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kt/v >/= 1.7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3084F","description":"Kt/v >/= 1.7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEB1","description":"ICD-CEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVC1","description":"ICD-OEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gallium nitrate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1457","description":"Gallium nitrate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDF1","description":"ICD-BBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt trnsfrd from anesth to cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0581F","description":"Pt trnsfrd from anesth to cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXF0","description":"ICD-NCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIF1","description":"ICD-MEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDD0","description":"ICD-ECDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMB0","description":"ICD-NFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Viral culture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0416","description":"Viral culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA16","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assess hlth/behave init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96150","description":"Assess hlth/behave init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCC1","description":"ICD-NBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCC1","description":"ICD-OFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assist living waiver/month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2030","description":"Assist living waiver/month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAF1","description":"ICD-CGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert intrauterine device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58300","description":"Insert intrauterine device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCME0","description":"ICD-FCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGE1","description":"ICD-NKGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echograp trans r pros study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76873","description":"Echograp trans r pros study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEB1","description":"ICD-GEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","description":"HCPCS-A2028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14B","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUF1","description":"ICD-CBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meropenem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2185","description":"Meropenem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANE1","description":"ICD-OANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUD1","description":"ICD-EAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTA0","description":"ICD-BGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEF1","description":"ICD-GAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30420","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFB0","description":"ICD-BHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin suppl 100 caps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0194","description":"Vitamin suppl 100 caps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEND1","description":"ICD-GEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPA0","description":"ICD-NBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQC0","description":"ICD-OLQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telescopic intraocular lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1840","description":"Telescopic intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11106","description":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLB0","description":"ICD-JHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Water pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0187","description":"Water pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGD0","description":"ICD-OIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj pantoprazole sodium_ via","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9113","description":"Inj pantoprazole sodium_ via","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRC1","description":"ICD-OGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLD0","description":"ICD-ECLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ (aponvie)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9145","description":"Injection_ aprepitant_ (aponvie)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33958","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4A","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYB0","description":"ICD-HCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65222","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKF1","description":"ICD-GFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surface mechanomyography (sMMG) with concurrent application of inertial measurement unit (IMU) sensors for measurement of multi-joint range of motion_ posture_ gait_ and muscl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0778T","description":"Surface mechanomyography (sMMG) with concurrent application of inertial measurement unit (IMU) sensors for measurement of multi-joint range of motion_ posture_ gait_ and muscl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD211","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgraft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4209","description":"Surgraft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIE1","description":"ICD-KGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGC0","description":"ICD-KGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86971","description":"Rbc pretx incubatj w/enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair prosthesis per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7520","description":"Repair prosthesis per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1430","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","description":"HCPCS-M1430","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLD0","description":"ICD-AFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8F","description":"Low Rehab_ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0884","description":"Pwc gp4 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Symes type ptb brim design s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5632","description":"Symes type ptb brim design s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Individual_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96159","description":"Health Behavior Intervention_ Individual_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9247","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9247","description":"CDT-D9247","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligate/strip short leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37718","description":"Ligate/strip short leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLC1","description":"ICD-NHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIA1","description":"ICD-GAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELA1","description":"ICD-FELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSE0","description":"ICD-CGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUB1","description":"ICD-CBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fas/dir ldl 70-189mg/dl mst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9666","description":"Fas/dir ldl 70-189mg/dl mst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML20","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMC0","description":"ICD-OEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAB1","description":"ICD-GIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUB1","description":"ICD-AFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 12.6-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12035","description":"Intmd rpr s/a/t/ext 12.6-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDA0","description":"ICD-ACDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE106","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGID1","description":"ICD-CGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96573","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJA0","description":"ICD-KHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent motor threshold re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0892T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent motor threshold re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ibalizumab-uiyk_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1746","description":"Injection_ ibalizumab-uiyk_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25D","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHC1","description":"ICD-CBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHB0","description":"ICD-OLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronch w/balloon occlusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31634","description":"Bronch w/balloon occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Preparation And Transmission Of Data For Analysis To Be Performed Elsewhere","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77090","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Preparation And Transmission Of Data For Analysis To Be Performed Elsewhere","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQB0","description":"ICD-CHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinogen antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85385","description":"Fibrinogen antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEB1","description":"ICD-FGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0642U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0642U","description":"CPT-0642U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unclassified drugs or biolog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9399","description":"Unclassified drugs or biolog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSB1","description":"ICD-GHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20D","description":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No eval activity clin symp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3119F","description":"No eval activity clin symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NUDT15 (nudix hydrolase 15) (eg_ drug metabolism) gene analysis_ common variant(s) (eg_ *2_ *3_ *4_ *5_ *6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81306","description":"NUDT15 (nudix hydrolase 15) (eg_ drug metabolism) gene analysis_ common variant(s) (eg_ *2_ *3_ *4_ *5_ *6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDE0","description":"ICD-EHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1249","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCC1","description":"ICD-KFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWC1","description":"ICD-GBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISC1","description":"ICD-PISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ntrk3 (Neurotrophic Receptor Tyrosine Kinase 3) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81193","description":"Ntrk3 (Neurotrophic Receptor Tyrosine Kinase 3) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth skull drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21251","description":"Anesth skull drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28H","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67110","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0886T","description":"Sigmoidoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other manual wheelchair/base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0009","description":"Other manual wheelchair/base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAE0","description":"ICD-EDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAA1","description":"ICD-EIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE214","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thxp apheresis w/hdl delip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0342T","description":"Thxp apheresis w/hdl delip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXE0","description":"ICD-JAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Splint wrist or ankle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8451","description":"Splint wrist or ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWC0","description":"ICD-PBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14B","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIND0","description":"ICD-CIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29015","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANB1","description":"ICD-JANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHB0","description":"ICD-ECHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cpm device_ other than knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0936","description":"Cpm device_ other than knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft axill-brachial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35522","description":"Art byp grft axill-brachial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWA1","description":"ICD-GIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic image jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70336","description":"Magnetic image jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pouch drainable w barrier at","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5061","description":"Pouch drainable w barrier at","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28B","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0203","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0203","description":"CDT-D0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0639U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0639U","description":"CPT-0639U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB21","description":"ICD-3JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHF0","description":"ICD-KCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIF1","description":"ICD-MLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDA1","description":"ICD-BDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reticulated platelet assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85055","description":"Reticulated platelet assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64790","description":"Removal of nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWE0","description":"ICD-LEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed semi-elect w/ mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0294","description":"Hosp bed semi-elect w/ mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGED1","description":"ICD-FGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC204","description":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bronchus add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32501","description":"Repair bronchus add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEE0","description":"ICD-IIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELA0","description":"ICD-JELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA43","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBB0","description":"ICD-CEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUD0","description":"ICD-JFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost a/e acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7404","description":"Add ue prost a/e acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulpal therapy posterior pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3240","description":"Pulpal therapy posterior pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove tear gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68540","description":"Remove tear gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYC1","description":"ICD-HBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj cutting into joint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7860","description":"Tmj cutting into joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allgrft implnt knee w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29867","description":"Allgrft implnt knee w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAE0","description":"ICD-JDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGF0","description":"ICD-GCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44650","description":"Repair bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWC0","description":"ICD-PHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVD0","description":"ICD-CBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLB1","description":"ICD-FBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXD1","description":"ICD-KHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB53","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC146","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTA1","description":"ICD-CCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; bilateral placement_ including cystoscopy and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0548T","description":"Transperineal periurethral balloon continence device; bilateral placement_ including cystoscopy and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAD0","description":"ICD-JDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko dbl upright w/air pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1847","description":"Ko dbl upright w/air pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0492","description":"Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILB1","description":"ICD-AILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hx injec drug use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9450","description":"Hx injec drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No eval riskk vte card prior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9299","description":"No eval riskk vte card prior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAF1","description":"ICD-MDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67208","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGD0","description":"ICD-CGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJF1","description":"ICD-NFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTD1","description":"ICD-FDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTC1","description":"ICD-OJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHD1","description":"ICD-ACHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knuckle joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26518","description":"Fusion of knuckle joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42426","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAF1","description":"ICD-AHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019]_ rs1333048 [CDKN2B-AS1]_ rs12129789 [KCND3]_ rs942","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0440U","description":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019]_ rs1333048 [CDKN2B-AS1]_ rs12129789 [KCND3]_ rs942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB14","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc no pain comfort 48hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9251","description":"Doc no pain comfort 48hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dstrj extensive retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67227","description":"Dstrj extensive retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXE0","description":"ICD-CBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMF1","description":"ICD-KIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITF0","description":"ICD-AITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11B","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAF1","description":"ICD-ACAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVA1","description":"ICD-OCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFB0","description":"ICD-JDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTF1","description":"ICD-KDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srs cran les complex addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61799","description":"Srs cran les complex addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Saliva test_ hormone level;","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3652","description":"Saliva test_ hormone level;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20D","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMC1","description":"ICD-MEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thumb dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26641","description":"Treat thumb dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMB1","description":"ICD-CGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRF1","description":"ICD-PCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1>=risk or>= mod risk for te","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8972","description":"1>=risk or>= mod risk for te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision secondary cataract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66820","description":"Incision secondary cataract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC220","description":"Clinically Complex _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGB0","description":"ICD-FIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIC0","description":"ICD-BGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWF0","description":"ICD-LFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc comp or mort w in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9268","description":"Doc comp or mort w in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9713","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWD1","description":"ICD-CHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise arm/leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64708","description":"Revise arm/leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24495","description":"Decompression of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost b/e acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7403","description":"Add ue prost b/e acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0168","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","description":"HCPCS-J0168","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL06","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEID1","description":"ICD-EEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert needle bone cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36680","description":"Insert needle bone cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXE0","description":"ICD-OBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA124","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18C","description":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAE1","description":"ICD-EAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB254","description":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABD0","description":"ICD-NABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBF1","description":"ICD-FCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sever cranial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64771","description":"Sever cranial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDE1","description":"ICD-KEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61518","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVD0","description":"ICD-KAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD112","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC55","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA34","description":"Very High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBC1","description":"ICD-NFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMF0","description":"ICD-JAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNB0","description":"ICD-NJNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACC1","description":"ICD-MACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCE1","description":"ICD-BGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGF0","description":"ICD-JEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit periorbtl implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21390","description":"Opn tx orbit periorbtl implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUD0","description":"ICD-FCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51820","description":"Revision of urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Atten d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9167","description":"Atten d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0142A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49659","description":"Laparo proc hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","description":"HCPCS-Q4402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; With Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0634T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; With Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQB0","description":"ICD-CCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of knee ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27405","description":"Repair of knee ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid plastic custom fa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0480","description":"Tlso rigid plastic custom fa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6005","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35241","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trnscth renal symp denrv bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0339T","description":"Trnscth renal symp denrv bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANA1","description":"ICD-JANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44312","description":"Revision of ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy swallow tst (fees)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92612","description":"Endoscopy swallow tst (fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFE1","description":"ICD-NFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJD1","description":"ICD-OBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRE0","description":"ICD-HHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam filled propulsion tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2216","description":"Foam filled propulsion tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ptfalls assess-docd ge2>/yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1100F","description":"Ptfalls assess-docd ge2>/yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUA0","description":"ICD-CFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC220","description":"Special Care High _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25D","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC21","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1154","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEA0","description":"ICD-GFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision Or Replacement (Including Removal Of Existing Device)_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69719","description":"Revision Or Replacement (Including Removal Of Existing Device)_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFC0","description":"ICD-BHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ethanolamine oleate 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1430","description":"Ethanolamine oleate 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEC0","description":"ICD-OBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) that follow-up imaging is indicated (e.g._ patient has a known malignancy that can metastasize_ other medical reason(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9755","description":"Documentation of medical reason(s) that follow-up imaging is indicated (e.g._ patient has a known malignancy that can metastasize_ other medical reason(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remis 6m w/6mos phq-9 <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9573","description":"Remis 6m w/6mos phq-9 <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLB0","description":"ICD-EGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLB0","description":"ICD-BHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEND0","description":"ICD-GEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NEURO ALZHEIMER QUAN IMAGING","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0207U","description":"NEURO ALZHEIMER QUAN IMAGING","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NuDYN SL or NuDYN SLW_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4286","description":"NuDYN SL or NuDYN SLW_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUD0","description":"ICD-MEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJID0","description":"ICD-NJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of serotonin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84260","description":"Assay of serotonin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEB0","description":"ICD-ECEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAA1","description":"ICD-NIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNA1","description":"ICD-KCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Con tissue w dble ped graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4276","description":"Con tissue w dble ped graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAF1","description":"ICD-IEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVA1","description":"ICD-BAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAE0","description":"ICD-IIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cbc without platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0307","description":"Cbc without platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQD1","description":"ICD-KBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCA1","description":"ICD-JCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEA0","description":"ICD-OBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99305","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15A","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETF1","description":"ICD-JETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ melphalan (apotex)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9249","description":"Injection_ melphalan (apotex)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cult skin graft f/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15155","description":"Cult skin graft f/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA260","description":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVC1","description":"ICD-GHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVF0","description":"ICD-NAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35189","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kt/v <1.2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3082F","description":"Kt/v <1.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0428T","description":"Rmvl nstim apnea pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSD1","description":"ICD-KDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWB0","description":"ICD-KAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0364","description":"Cone beam ct capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Organic acids qual each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83919","description":"Organic acids qual each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0937T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","description":"CPT-0937T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMA0","description":"ICD-MGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd esophagogastrc fndoplsty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43210","description":"Egd esophagogastrc fndoplsty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ talquetamab-tgvs_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9163","description":"Injection_ talquetamab-tgvs_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Igh@/Bcl2 (T(14;18)) (Eg_ Follicular Lymphoma) Translocation Analysis_ Major Breakpoint Region (Mbr) And Minor Cluster Region (Mcr) Breakpoints_ Qualitative Or Quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81278","description":"Igh@/Bcl2 (T(14;18)) (Eg_ Follicular Lymphoma) Translocation Analysis_ Major Breakpoint Region (Mbr) And Minor Cluster Region (Mcr) Breakpoints_ Qualitative Or Quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/sm tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34800","description":"Endovas aaa repr w/sm tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEE0","description":"ICD-NIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFF0","description":"ICD-BGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL31","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE105","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITF0","description":"ICD-JITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJA0","description":"ICD-GHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auditor evoke potent limit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92586","description":"Auditor evoke potent limit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXE1","description":"ICD-OKXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMA0","description":"ICD-NAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX25","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMA1","description":"ICD-FBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3A","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order(prescription)for statin therapy (e.g.patient with adverse effect_ allergy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9668","description":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order(prescription)for statin therapy (e.g.patient with adverse effect_ allergy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhcp-svs of csw_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0155","description":"Hhcp-svs of csw_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27286","description":"Fusion of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOB1","description":"ICD-PAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB20","description":"Very High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGE0","description":"ICD-KAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML07","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFA0","description":"ICD-JHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; coronary sinus (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93586","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; coronary sinus (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3C","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ldl-c >/= 130 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3050F","description":"Ldl-c >/= 130 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXC0","description":"ICD-KAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQF1","description":"ICD-OHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application long leg splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29505","description":"Application long leg splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLA0","description":"ICD-EHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEA0","description":"ICD-MGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anogenital exam child w imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99170","description":"Anogenital exam child w imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24930","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVD0","description":"ICD-OGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMF1","description":"ICD-GGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery of breast capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19370","description":"Surgery of breast capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOF0","description":"ICD-HFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No pneumococcal admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8867","description":"No pneumococcal admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD156","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMD1","description":"ICD-CCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAC0","description":"ICD-IIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3A","description":"Default_ /PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0D","description":"Very High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAF1","description":"ICD-CAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD250","description":"Special Care Low _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGF1","description":"ICD-NEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Across Major Side Branches","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33894","description":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Across Major Side Branches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sloughed off bone","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7550","description":"Removal of sloughed off bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKF1","description":"ICD-NGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDF1","description":"ICD-CBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEF0","description":"ICD-KIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHID1","description":"ICD-CHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINE0","description":"ICD-CINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAF0","description":"ICD-FEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQE1","description":"ICD-KEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEE0","description":"ICD-OFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0011","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKB1","description":"ICD-JDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQC0","description":"ICD-GDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIE1","description":"ICD-GCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Emergency Pack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1762","description":"Home Delivered Meals-Emergency Pack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBA0","description":"ICD-NCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIA1","description":"ICD-EFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASF1","description":"ICD-LASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; complete system (electrode and implantable monitor)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0530T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; complete system (electrode and implantable monitor)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD215","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGID0","description":"ICD-GGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBB0","description":"ICD-KGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long arm adult plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4005","description":"Cast sup long arm adult plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOC0","description":"ICD-CCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBA1","description":"ICD-JCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXD1","description":"ICD-NAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44346","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESA0","description":"ICD-DESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAME1","description":"ICD-EAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation and curettage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58120","description":"Dilation and curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERD1","description":"ICD-OERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANE1","description":"ICD-CANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen amphetamines 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80324","description":"Drug screen amphetamines 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAD0","description":"ICD-MBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urea-n clearance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84545","description":"Urea-n clearance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating below the heart (e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93588","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating below the heart (e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVC1","description":"ICD-NCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stool cultr aerobic bact ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87046","description":"Stool cultr aerobic bact ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28A","description":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42842","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABE1","description":"ICD-OABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCD0","description":"ICD-JHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFA0","description":"ICD-NGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMD1","description":"ICD-ODMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:1)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1728","description":"Employment - Employment Skills Development (1:1)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICB0","description":"ICD-BICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24650","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurectomy popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27326","description":"Neurectomy popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWD0","description":"ICD-OCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj bulking agent anal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8605","description":"Inj bulking agent anal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHC1","description":"ICD-OIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQD0","description":"ICD-PDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEB0","description":"ICD-OFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDA0","description":"ICD-CGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHA0","description":"ICD-AGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAC0","description":"ICD-ECAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDC1","description":"ICD-FEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harness figure of 8 dual con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6676","description":"Harness figure of 8 dual con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip/thigh fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27025","description":"Incision of hip/thigh fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRE1","description":"ICD-OHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15013","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","description":"CPT-15013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOF0","description":"ICD-CBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGC0","description":"ICD-BEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28B","description":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/ov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2210","description":"Lens sphcy bifocal 4.25-7/ov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (genetic platelet function disorder)_ genomic sequence analysis of 31 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Platelet Function Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0277U","description":"Hematology (genetic platelet function disorder)_ genomic sequence analysis of 31 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Platelet Function Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74220","description":"Contrast x-ray esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vacuum drain bottle/tube kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7048","description":"Vacuum drain bottle/tube kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJF0","description":"ICD-GBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Admin ecg contrast agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93352","description":"Admin ecg contrast agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUF0","description":"ICD-MAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABF1","description":"ICD-MABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPB1","description":"ICD-ODPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTD0","description":"ICD-NCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8F","description":"High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc comm risk calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9316","description":"Doc comm risk calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPA0","description":"ICD-NDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHA1","description":"ICD-AFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epieffect_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4278","description":"Epieffect_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4438","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","description":"HCPCS-Q4438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX16","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50010","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUB0","description":"ICD-CGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upr/lxtr art stdy 3+ lvls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93923","description":"Upr/lxtr art stdy 3+ lvls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing rbc antigens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86905","description":"Blood typing rbc antigens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harness chest/shlder saddle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6672","description":"Harness chest/shlder saddle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL14","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Voice amplifier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8510","description":"Voice amplifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx chron care addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99489","description":"Cmplx chron care addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIA0","description":"ICD-CBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stab phleb veins xtr 10-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37765","description":"Stab phleb veins xtr 10-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBC0","description":"ICD-IEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBC1","description":"ICD-AGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHD1","description":"ICD-MAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADE1","description":"ICD-JADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscope procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58579","description":"Hysteroscope procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCD0","description":"ICD-OHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52007","description":"Cystoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dexamethasone 9%_ intraocular_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9034","description":"Injection_ dexamethasone 9%_ intraocular_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-routine bl draw 3/> yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36410","description":"Non-routine bl draw 3/> yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGB0","description":"ICD-NCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oropharyngeal suction catheter_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4628","description":"Oropharyngeal suction catheter_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOB0","description":"ICD-HGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Composite drsg <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6203","description":"Composite drsg <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIA1","description":"ICD-GEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric electrophysiology mapping with simultaneous patient symptom profiling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9787","description":"Gastric electrophysiology mapping with simultaneous patient symptom profiling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTE1","description":"ICD-BGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPE1","description":"ICD-CEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18H","description":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg bk ea add cast ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5410","description":"Postop dsg bk ea add cast ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBD1","description":"ICD-FGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEF1","description":"ICD-OCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBF1","description":"ICD-KEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEED0","description":"ICD-BEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFD0","description":"ICD-GDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKE0","description":"ICD-BIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAF1","description":"ICD-NAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assess dyspnea present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1019F","description":"Assess dyspnea present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAE0","description":"ICD-FGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIB0","description":"ICD-ECIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOB1","description":"ICD-HFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWD1","description":"ICD-OBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHF0","description":"ICD-ODHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9362","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9362","description":"HCPCS-J9362","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALF0","description":"ICD-FALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCF0","description":"ICD-ADCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKC0","description":"ICD-BAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAC1","description":"ICD-ODAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQE0","description":"ICD-DAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ tubular protective absorption padded layer_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6608","description":"Gradient compression bandaging supply_ tubular protective absorption padded layer_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHD0","description":"ICD-KGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 3_ gene duplication/multiplication) (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0076U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 3_ gene duplication/multiplication) (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA11","description":"ICD-3BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14C","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWD0","description":"ICD-DBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sanopellis_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4308","description":"Sanopellis_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBA0","description":"ICD-FDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSF0","description":"ICD-LHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDE1","description":"ICD-AFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 4 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0868","description":"Pwc gp 4 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOC0","description":"ICD-GIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25645","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove prostate regrowth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52630","description":"Remove prostate regrowth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMB1","description":"ICD-MEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intend rpt dia retin msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9671","description":"Intend rpt dia retin msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYA0","description":"ICD-PIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALB1","description":"ICD-CALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHD1","description":"ICD-KFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"DI GNOTYP SLC4A1 EXON 19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0183U","description":"DI GNOTYP SLC4A1 EXON 19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLC0","description":"ICD-JFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOD0","description":"ICD-HAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8F","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25A","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal leg bone(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27360","description":"Partial removal leg bone(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRD1","description":"ICD-CGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor inhibitor test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85335","description":"Factor inhibitor test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1022T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","description":"CPT-1022T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had only urgent care visits during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1054","description":"Patient had only urgent care visits during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACC1","description":"ICD-FACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Atrial Septostomy (Tas) For Congenital Cardiac Anomalies To Create Effective Atrial Flow_ Including All Imaging Guidance By The Proceduralist_ When Performed_ An","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33741","description":"Transcatheter Atrial Septostomy (Tas) For Congenital Cardiac Anomalies To Create Effective Atrial Flow_ Including All Imaging Guidance By The Proceduralist_ When Performed_ An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg > 48 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6239","description":"Hydrocolld drg > 48 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of dibucaine number","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82638","description":"Assay of dibucaine number","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMA1","description":"ICD-BHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1072T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1072T","description":"CPT-1072T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEB0","description":"ICD-JHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic control thoracic ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2660","description":"Thoracic control thoracic ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.25-7/.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2307","description":"Lens sphcy trifocal 4.25-7/.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis nonauto w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81000","description":"Urinalysis nonauto w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA11","description":"ICD-4HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthro w/labral repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29916","description":"Hip arthro w/labral repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANE0","description":"ICD-JANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVB1","description":"ICD-CDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCF1","description":"ICD-JBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6515","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","description":"HCPCS-A6515","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for cholangiogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47531","description":"Injection for cholangiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nsclc stgi no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9063","description":"Onc dx nsclc stgi no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA31","description":"ICD-3EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRF1","description":"ICD-PLRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27592","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKD1","description":"ICD-BEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXE0","description":"ICD-FHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52320","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBA1","description":"ICD-OJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q9998","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","description":"HCPCS-Q9998","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ketogenic steroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83582","description":"Assay of ketogenic steroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9232","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9232","description":"HCPCS-J9232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary colon cancer (Lynch syndrome)_ targeted mRNA sequence analysis panel (MLH1_ MSH2_ MSH6_ PMS2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0162U","description":"Hereditary colon cancer (Lynch syndrome)_ targeted mRNA sequence analysis panel (MLH1_ MSH2_ MSH6_ PMS2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFE0","description":"ICD-NDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYA0","description":"ICD-GHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIED0","description":"ICD-IIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruct b9 lesion 1-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17110","description":"Destruct b9 lesion 1-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC11","description":"ICD-4CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Fixed Retainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8698","description":"Re-Cement Or Re-Bond Fixed Retainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHF0","description":"ICD-FHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTF0","description":"ICD-FFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drive wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2394","description":"Drive wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFD1","description":"ICD-JCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hd shck absrbr for hd man wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1017","description":"Hd shck absrbr for hd man wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64809","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXF0","description":"ICD-CIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home mgmt pprom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9209","description":"Home mgmt pprom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect tibia tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27645","description":"Resect tibia tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Procarbazine_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0182","description":"Procarbazine_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8B","description":"Low Rehab_ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp screen mammogram add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77052","description":"Comp screen mammogram add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levalbuterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7615","description":"Levalbuterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFD0","description":"ICD-NFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVF1","description":"ICD-FDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0800T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cltx med ankle fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27762","description":"Cltx med ankle fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0504","description":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35131","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE101","description":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMA1","description":"ICD-FEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0769T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech evaluation complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70371","description":"Speech evaluation complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine flow measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51736","description":"Urine flow measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWE1","description":"ICD-HIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METF0","description":"ICD-METF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sex chromatin identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88140","description":"Sex chromatin identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYA0","description":"ICD-PKYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDME1","description":"ICD-NDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKD0","description":"ICD-KHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68520","description":"Removal of tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Protein analysis w/probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88372","description":"Protein analysis w/probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise excessive skin buttck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15835","description":"Excise excessive skin buttck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst w/t/o & vag repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58263","description":"Vag hyst w/t/o & vag repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHB0","description":"ICD-CGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRB1","description":"ICD-DBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEB1","description":"ICD-FIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMA1","description":"ICD-MIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB120","description":"Special Care Low _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quant her2 ihc eval brst cx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3394F","description":"Quant her2 ihc eval brst cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61607","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bowel to bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44130","description":"Bowel to bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1501","description":"HCPCS-C1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEE1","description":"ICD-MKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYB0","description":"ICD-OGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNA1","description":"ICD-BCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDC0","description":"ICD-OKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81445","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRE0","description":"ICD-OHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61539","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test for urine cystines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82615","description":"Test for urine cystines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43246","description":"Egd place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDF1","description":"ICD-BGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Performance Met: Multimodal Pain Management Was Used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2148","description":"Performance Met: Multimodal Pain Management Was Used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv4 vacc no prsv 6-35 m im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90685","description":"Iiv4 vacc no prsv 6-35 m im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replant forearm complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20805","description":"Replant forearm complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVF0","description":"ICD-JCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36262","description":"Removal of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther injection carp tunnel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20526","description":"Ther injection carp tunnel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5149","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","description":"HCPCS-Q5149","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGC0","description":"ICD-NGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGB1","description":"ICD-CEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARB1","description":"ICD-OARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVA1","description":"ICD-ODVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKD0","description":"ICD-JDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIA0","description":"ICD-GAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIC1","description":"ICD-FBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MOST_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4328","description":"MOST_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIB0","description":"ICD-NIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ promoter methylation profiling by real-time PCR of 3 genes (GSTP1_ APC_ RASSF1)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81551","description":"Oncology (prostate)_ promoter methylation profiling by real-time PCR of 3 genes (GSTP1_ APC_ RASSF1)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28070","description":"Removal of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHF1","description":"ICD-JEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCC0","description":"ICD-NKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trim skin lesions 2 to 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11056","description":"Trim skin lesions 2 to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYB0","description":"ICD-PEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC24","description":"High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22554","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral mr contrast_ 100 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9954","description":"Oral mr contrast_ 100 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOD0","description":"ICD-LDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted procedure colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45399","description":"Unlisted procedure colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (non-small cell lung cancer)_ next-generation sequencing with identification of single nucleotide variants_ copy number variants_ insertions and deletions_ and struct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0388U","description":"Oncology (non-small cell lung cancer)_ next-generation sequencing with identification of single nucleotide variants_ copy number variants_ insertions and deletions_ and struct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIC0","description":"ICD-NLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pooling blood platelets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86965","description":"Pooling blood platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7528","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical enc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1350","description":"Patients who had a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical enc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOD0","description":"ICD-GIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rsa spine exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0348T","description":"Rsa spine exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36015","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE216","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAC0","description":"ICD-IHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lower jaw bone graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21215","description":"Lower jaw bone graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27003","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPC1","description":"ICD-KIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penile venous occlusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37790","description":"Penile venous occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical chemistry test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84999","description":"Clinical chemistry test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWD1","description":"ICD-KDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup gauntlet ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4015","description":"Cast sup gauntlet ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1021T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","description":"CPT-1021T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36589","description":"Removal tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15958","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB11","description":"ICD-2LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (genetic thrombosis)_ genomic sequence analysis of 12 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Thrombosis Panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0278U","description":"Hematology (genetic thrombosis)_ genomic sequence analysis of 12 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Thrombosis Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHC0","description":"ICD-OHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","description":"CPT-15016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQA0","description":"ICD-KDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBF0","description":"ICD-FEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat odontoid fx w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22319","description":"Treat odontoid fx w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIF1","description":"ICD-OEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18D","description":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJE1","description":"ICD-OKJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC235","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8E","description":"High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral/facial photo images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0350","description":"Oral/facial photo images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVB1","description":"ICD-NIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDA1","description":"ICD-BEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVF1","description":"ICD-NBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HIV-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87390","description":"IAAD IA HIV-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt education noc group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9446","description":"Pt education noc group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB230","description":"Clinically Complex _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBB1","description":"ICD-OLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLB1","description":"ICD-FFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRA0","description":"ICD-DDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBB1","description":"ICD-EEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUC1","description":"ICD-CAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIB0","description":"ICD-CHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGC1","description":"ICD-ODGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAE1","description":"ICD-OAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARD1","description":"ICD-KARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX05","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNC0","description":"ICD-OLNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTC0","description":"ICD-AGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSF0","description":"ICD-PJSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHD1","description":"ICD-EBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cauterization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57510","description":"Cauterization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQA0","description":"ICD-HHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo-asst vag hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58550","description":"Laparo-asst vag hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXF1","description":"ICD-BAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc pract mgmt differs trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9057","description":"Onc pract mgmt differs trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart rhythm pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93618","description":"Heart rhythm pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15B","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Design mlc device for imrt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77338","description":"Design mlc device for imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair Of Fixed Retainer_ Includes Reattachment - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8701","description":"Repair Of Fixed Retainer_ Includes Reattachment - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; hemicortical intercalary_ partial (ie_ hemicylindrical) (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20933","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; hemicortical intercalary_ partial (ie_ hemicylindrical) (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERC0","description":"ICD-PERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analyze neurostim complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95972","description":"Analyze neurostim complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODED1","description":"ICD-ODED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIA1","description":"ICD-MJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJA0","description":"ICD-GIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15940","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUC1","description":"ICD-KIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKC1","description":"ICD-CBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGE1","description":"ICD-BEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insrt/redo neurostim 1 array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61885","description":"Insrt/redo neurostim 1 array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL32","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGB0","description":"ICD-JBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL11","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYE1","description":"ICD-OJYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOA0","description":"ICD-LFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99282","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWF0","description":"ICD-DHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMF1","description":"ICD-NDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx pancreatc p r0 res no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9105","description":"Onc dx pancreatc p r0 res no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMC0","description":"ICD-EAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFC0","description":"ICD-GIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTE1","description":"ICD-BFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC51","description":"Very High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKA1","description":"ICD-BAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIE0","description":"ICD-IGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGA0","description":"ICD-FEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAF1","description":"ICD-IDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24B","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Personal care item nos each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5199","description":"Personal care item nos each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corf related serv 15 mins ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0409","description":"Corf related serv 15 mins ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46922","description":"Excision of anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ binaural_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5248","description":"Hearing aid_ binaural_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/rmv pn/gastr stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64595","description":"Revise/rmv pn/gastr stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYF1","description":"ICD-HDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrog device eval heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93289","description":"Interrog device eval heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIB1","description":"ICD-GAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAB0","description":"ICD-GHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQA1","description":"ICD-PKQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD226","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOF0","description":"ICD-GDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWD0","description":"ICD-DCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX36","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGE1","description":"ICD-KIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHE0","description":"ICD-FFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obstetric panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80081","description":"Obstetric panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUA0","description":"ICD-JEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMD1","description":"ICD-AFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYA1","description":"ICD-CIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of kidney/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50400","description":"Revision of kidney/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIF0","description":"ICD-OGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBF1","description":"ICD-FDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMB0","description":"ICD-OCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTA1","description":"ICD-AFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHA1","description":"ICD-GCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impreg gauze no h20/sal/yard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6266","description":"Impreg gauze no h20/sal/yard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj streptokinase /250000 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2995","description":"Inj streptokinase /250000 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC146","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADA1","description":"ICD-IADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAA0","description":"ICD-BEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBC0","description":"ICD-AIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37284","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","description":"CPT-37284","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAA0","description":"ICD-GGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAE0","description":"ICD-KIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bis xtracell fluid analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93702","description":"Bis xtracell fluid analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0975T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","description":"CPT-0975T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWE0","description":"ICD-GFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic source imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8035","description":"Magnetic source imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No trnsfr from anesth to cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0582F","description":"No trnsfr from anesth to cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFA0","description":"ICD-GEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96112","description":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDF0","description":"ICD-BGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEB0","description":"ICD-NEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESF0","description":"ICD-GESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug delivery system >=50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4305","description":"Drug delivery system >=50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX03","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remv/repl penis contain pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54416","description":"Remv/repl penis contain pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVC0","description":"ICD-GAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBA0","description":"ICD-AFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDID0","description":"ICD-FDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Written discharge instr prvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4014F","description":"Written discharge instr prvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr angio pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72198","description":"Mr angio pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAB0","description":"ICD-NGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCD0","description":"ICD-NFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLE1","description":"ICD-NKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC21","description":"ICD-1AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt has resp insufficiency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1504F","description":"Pt has resp insufficiency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOD1","description":"ICD-LCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIB1","description":"ICD-JDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGD0","description":"ICD-JDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIME1","description":"ICD-OIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHA0","description":"ICD-OJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service_ 16-30 minutes time Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0311","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service_ 16-30 minutes time Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pten gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81322","description":"Pten gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28072","description":"Removal of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBD0","description":"ICD-IGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Speed of Care_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1016","description":"Clinical decision support mechanism Speed of Care_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0201","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0201","description":"CDT-D0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of facial/other nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64868","description":"Fusion of facial/other nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytomeg dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87496","description":"Cytomeg dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Septal defect imp sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1817","description":"Septal defect imp sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16372","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16372","description":"CPT-16372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat vaginal bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57180","description":"Treat vaginal bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHE0","description":"ICD-KGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUD0","description":"ICD-NGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHA0","description":"ICD-EBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOD1","description":"ICD-KFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth hrt surg w/pmp age 1+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56251","description":"Anesth hrt surg w/pmp age 1+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYB0","description":"ICD-CGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted to a SPU or an ASC for monitoring and observation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0597","description":"Patient admitted to a SPU or an ASC for monitoring and observation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biofeedback peri/uro/rectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90911","description":"Biofeedback peri/uro/rectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUB0","description":"ICD-FIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTB0","description":"ICD-GBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVF1","description":"ICD-GBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adrenal cortical tumor_ biochemical assay of 25 steroid markers_ utilizing 24-hour urine specimen and clinical parameters_ prognostic algorithm reported as a clinical risk and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015M","description":"Adrenal cortical tumor_ biochemical assay of 25 steroid markers_ utilizing 24-hour urine specimen and clinical parameters_ prognostic algorithm reported as a clinical risk and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITA1","description":"ICD-IITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20A","description":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34701","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of jaw bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21044","description":"Removal of jaw bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Y90 ibritumomab_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9543","description":"Y90 ibritumomab_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNE0","description":"ICD-JFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext ecg complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0295T","description":"Ext ecg complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Episiotomy or vaginal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59300","description":"Episiotomy or vaginal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSB1","description":"ICD-HCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGB1","description":"ICD-NFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB216","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAF0","description":"ICD-KGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug/substance nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80377","description":"Drug/substance nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc of pain","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8732","description":"No doc of pain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGC0","description":"ICD-JIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAE1","description":"ICD-CEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise hip/thigh nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64766","description":"Incise hip/thigh nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31601","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSA0","description":"ICD-GCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Isoproterenol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7658","description":"Isoproterenol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0990T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","description":"CPT-0990T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYC1","description":"ICD-KBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDB0","description":"ICD-AEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVE1","description":"ICD-NBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA140","description":"Clinically Complex _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18D","description":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD234","description":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral periapical ea add","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0230","description":"Intraoral periapical ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antihist/decong rx/recom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4133F","description":"Antihist/decong rx/recom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEF1","description":"ICD-FAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAA1","description":"ICD-FAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare sperm duct x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55300","description":"Prepare sperm duct x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28B","description":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15D","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion 2 or more 3d images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0395","description":"Fusion 2 or more 3d images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1097","description":"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelet pheres leukoreduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9035","description":"Platelet pheres leukoreduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAD0","description":"ICD-AHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFD0","description":"ICD-OBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gen_ neuro_ hf_ rechg bat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1822","description":"Gen_ neuro_ hf_ rechg bat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB35","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6088","description":"Implant Supported Crown - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enfuvirtide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1324","description":"Enfuvirtide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post fusion 7-12 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22802","description":"Post fusion 7-12 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prednisone ir or dr oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7512","description":"Prednisone ir or dr oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAA1","description":"ICD-NLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBE1","description":"ICD-MEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOD0","description":"ICD-OAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nose polyp(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30110","description":"Removal of nose polyp(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFD0","description":"ICD-NHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAD1","description":"ICD-FCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retainer Crown 3/4 - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6784","description":"Retainer Crown 3/4 - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2004","description":"HCPCS-B2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exchange drainage catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49423","description":"Exchange drainage catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1248","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKB0","description":"ICD-OCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incis w/discectomy thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22222","description":"Incis w/discectomy thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert uro/ves nck sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53445","description":"Insert uro/ves nck sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3350","description":"Shoe heel wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKC0","description":"ICD-FBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHD1","description":"ICD-MBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICE0","description":"ICD-AICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15937","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt hx act drain prev 90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8560","description":"Pt hx act drain prev 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PermeaDer B_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2016","description":"PermeaDer B_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx gastro intub w/asp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43753","description":"Tx gastro intub w/asp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDF0","description":"ICD-EDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHF0","description":"ICD-KHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0877T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISC0","description":"ICD-GISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQA0","description":"ICD-PFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLE0","description":"ICD-GCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Forensic autopsy (necropsy)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88040","description":"Forensic autopsy (necropsy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARE0","description":"ICD-GARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVE0","description":"ICD-GFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21A","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJC1","description":"ICD-GEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHA0","description":"ICD-OFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVA1","description":"ICD-OKVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWD0","description":"ICD-PHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESE1","description":"ICD-LESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUF0","description":"ICD-NFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61543","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch for bar w flange/flt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4419","description":"Ost pch for bar w flange/flt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not disch home day#2 evar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8833","description":"Pt not disch home day#2 evar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54300","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Powered air mattress overlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0372","description":"Powered air mattress overlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWB1","description":"ICD-OBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERF1","description":"ICD-DERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18I","description":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHF1","description":"ICD-AFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDB0","description":"ICD-EGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise two eye muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67312","description":"Revise two eye muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXB0","description":"ICD-GGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUE1","description":"ICD-MJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2121","description":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin w/ noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2722","description":"Crown resin w/ noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Filter gone aft 3mos placmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9541","description":"Filter gone aft 3mos placmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8043","description":"Upper facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDA1","description":"ICD-OGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMC0","description":"ICD-IDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE131","description":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suture large intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44604","description":"Suture large intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQF0","description":"ICD-KHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWF1","description":"ICD-DAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCF0","description":"ICD-KHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWE1","description":"ICD-DBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0105","description":"HCPCS-A0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIE1","description":"ICD-BDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAD0","description":"ICD-JGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIE1","description":"ICD-KCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVF1","description":"ICD-GDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUA0","description":"ICD-MHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOF0","description":"ICD-KGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPF0","description":"ICD-GGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUF1","description":"ICD-FHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC214","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dispensing fee bicros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5240","description":"Dispensing fee bicros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPD0","description":"ICD-NAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE206","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHB1","description":"ICD-JDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOF1","description":"ICD-DIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAD0","description":"ICD-MLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change of percutaneous biliary drainage catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47525","description":"Change of percutaneous biliary drainage catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28102","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Augmentation lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21125","description":"Augmentation lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLA0","description":"ICD-JFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNF0","description":"ICD-JCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26433","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relocation of testis(es)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54680","description":"Relocation of testis(es)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Md document visit by npp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0454","description":"Md document visit by npp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92083","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1343","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWA0","description":"ICD-OLWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRC0","description":"ICD-GFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Personalized target development for accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state fu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0889T","description":"Personalized target development for accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Th/wght bear nar m-l brim cu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2526","description":"Th/wght bear nar m-l brim cu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC231","description":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCC0","description":"ICD-EFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76825","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUD0","description":"ICD-FGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDND1","description":"ICD-CDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove intracorporeal device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33980","description":"Remove intracorporeal device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPB1","description":"ICD-GDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMB1","description":"ICD-EBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAF0","description":"ICD-GEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHE1","description":"ICD-BBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHD0","description":"ICD-OBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJB1","description":"ICD-OAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIA1","description":"ICD-NLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYF0","description":"ICD-LHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALA1","description":"ICD-AALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHF1","description":"ICD-MKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNB1","description":"ICD-BDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDE1","description":"ICD-KDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKF0","description":"ICD-FIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93313","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEF1","description":"ICD-FGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCB1","description":"ICD-NKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stereoscopic x-ray guidance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6002","description":"Stereoscopic x-ray guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXE0","description":"ICD-CIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXB1","description":"ICD-OJXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRB1","description":"ICD-PDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5909","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5909","description":"CDT-D5909","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins/rep subq defibrillator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33270","description":"Ins/rep subq defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATC1","description":"ICD-CATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35256","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii recomb novoeight","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7182","description":"Factor viii recomb novoeight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQF0","description":"ICD-KBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic shoe w/off set heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5506","description":"Diabetic shoe w/off set heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMA1","description":"ICD-GGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray aorta leg arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75630","description":"X-ray aorta leg arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUA0","description":"ICD-KEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iliac revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37221","description":"Iliac revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMC1","description":"ICD-MFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVB1","description":"ICD-FDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism National Imaging Associates_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1005","description":"Clinical Decision Support Mechanism National Imaging Associates_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"A Model Participant (Ambulance Supplier/Provider)_ The Beneficiary Refuses Services Covered Under The Model (Transport To An Alternate Destination/Treatment In Place)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2022","description":"A Model Participant (Ambulance Supplier/Provider)_ The Beneficiary Refuses Services Covered Under The Model (Transport To An Alternate Destination/Treatment In Place)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9342","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","description":"HCPCS-J9342","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPD1","description":"ICD-OKPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENC1","description":"ICD-KENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLF0","description":"ICD-GGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2003","description":"HCPCS-B2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21079","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQA0","description":"ICD-LCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA205","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29805","description":"Shoulder arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFD0","description":"ICD-JAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTA0","description":"ICD-MJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIB1","description":"ICD-EBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko elas w/ condyle pads & jo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1820","description":"Ko elas w/ condyle pads & jo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aortic aneurysm<5cm diam ct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9001F","description":"Aortic aneurysm<5cm diam ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOA1","description":"ICD-HBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTC0","description":"ICD-NHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAB1","description":"ICD-NDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIE0","description":"ICD-FCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEC1","description":"ICD-CDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAD1","description":"ICD-OJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDA1","description":"ICD-JIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBD1","description":"ICD-AIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59821","description":"Treatment of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gauze >16<=48 no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6223","description":"Gauze >16<=48 no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYD1","description":"ICD-PEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYE1","description":"ICD-OBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Safety counseling dem order","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6102F","description":"Safety counseling dem order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq revasc byp graft 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92937","description":"Prq revasc byp graft 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient was referred to another provider or specialist during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9968","description":"Patient was referred to another provider or specialist during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIE0","description":"ICD-KAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPA0","description":"ICD-FGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogate subq defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93261","description":"Interrogate subq defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploratory shoulder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23044","description":"Exploratory shoulder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCA1","description":"ICD-IBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJA1","description":"ICD-CDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper ext fx orthosis wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3984","description":"Upper ext fx orthosis wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXA0","description":"ICD-KDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lngleg cylndr ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4036","description":"Cast sup lngleg cylndr ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHB1","description":"ICD-ECHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUF0","description":"ICD-AEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGC1","description":"ICD-NJGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Transluminal Angioplasty Of Native Or Recurrent Coarctation Of The Aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33897","description":"Percutaneous Transluminal Angioplasty Of Native Or Recurrent Coarctation Of The Aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCD0","description":"ICD-EGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25270","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFE0","description":"ICD-NAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo torsion ball bearing j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2060","description":"Hkafo torsion ball bearing j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plan of care 4 pain docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0521F","description":"Plan of care 4 pain docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHB1","description":"ICD-EAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIB0","description":"ICD-OBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVA1","description":"ICD-OBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCD0","description":"ICD-EDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCC0","description":"ICD-BDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUE1","description":"ICD-NBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMB0","description":"ICD-JFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRA0","description":"ICD-PLRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-70473","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","description":"CPT-70473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITE1","description":"ICD-IITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVF0","description":"ICD-OCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Odontics repr abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6095","description":"Odontics repr abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 1 vhd 451-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0802","description":"Pov group 1 vhd 451-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixed wing air mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0435","description":"Fixed wing air mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRC1","description":"ICD-PGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80434","description":"Insulin tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTE0","description":"ICD-GBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOD1","description":"ICD-KHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCE1","description":"ICD-MJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQF0","description":"ICD-HDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations_ based on selected intervals of interest from 12-lead elect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0897T","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations_ based on selected intervals of interest from 12-lead elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2002","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2002","description":"CDT-D2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJD0","description":"ICD-BGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBB1","description":"ICD-AHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nandrolone decanoate 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2320","description":"Nandrolone decanoate 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTE0","description":"ICD-OLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDF0","description":"ICD-NDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coagulation time activated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85347","description":"Coagulation time activated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMF0","description":"ICD-BDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEC0","description":"ICD-BCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD220","description":"Clinically Complex _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIA1","description":"ICD-BDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28297","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral supp not othrws c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9999","description":"Parenteral supp not othrws c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAD0","description":"ICD-FFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXC0","description":"ICD-FAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27450","description":"Incision of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolong clincl staff svc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99415","description":"Prolong clincl staff svc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27508","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal biliary drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47537","description":"Removal biliary drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert_ pneum wheel drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2383","description":"Insert_ pneum wheel drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of orbit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21256","description":"Reconstruction of orbit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/submuc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45335","description":"Sigmoidoscopy w/submuc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBID0","description":"ICD-FBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24A","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQE0","description":"ICD-CFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject spine w/cath crv/thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62318","description":"Inject spine w/cath crv/thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAC0","description":"ICD-NJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHE0","description":"ICD-ICHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALA0","description":"ICD-GALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATC0","description":"ICD-FATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21A","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artacent AC_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4190","description":"Artacent AC_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAD0","description":"ICD-OJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33690","description":"Reinforce pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66625","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQF0","description":"ICD-OKQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTE0","description":"ICD-NJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMF0","description":"ICD-CBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJF0","description":"ICD-CHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOE0","description":"ICD-CCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0305","description":"HCPCS-C0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLD1","description":"ICD-KDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCA0","description":"ICD-AFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMA0","description":"ICD-KGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration Not Followed By Surgical Repair_ Artery; Upper Extremity (Eg_ Axillary_ Brachial_ Radial_ Ulnar)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35702","description":"Exploration Not Followed By Surgical Repair_ Artery; Upper Extremity (Eg_ Axillary_ Brachial_ Radial_ Ulnar)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35304","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext breastprosthesis garment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8015","description":"Ext breastprosthesis garment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; each additional 20 sq cm_ or part thereof (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0492T","description":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; each additional 20 sq cm_ or part thereof (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPF1","description":"ICD-BIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral evaluation pt < 3yrs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0145","description":"Oral evaluation pt < 3yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1303","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1303","description":"CDT-D1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITD1","description":"ICD-GITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDID1","description":"ICD-EDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd injection varices","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43243","description":"Egd injection varices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIA0","description":"ICD-NFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11C","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00700","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","description":"CPT-00700","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJF1","description":"ICD-NLJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmprsburngrmnt glove-axilla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6506","description":"Cmprsburngrmnt glove-axilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTD1","description":"ICD-OFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42235","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQD0","description":"ICD-DHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical repair of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43501","description":"Surgical repair of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1004","description":"HCPCS-B1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antibiot not rxd/given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4124F","description":"Antibiot not rxd/given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMA0","description":"ICD-CAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHED0","description":"ICD-EHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILA1","description":"ICD-FILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of ureter & kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50750","description":"Fusion of ureter & kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIE0","description":"ICD-MKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBF0","description":"ICD-NKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart first pass single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78481","description":"Heart first pass single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35180","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHA0","description":"ICD-BIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRB1","description":"ICD-DCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth eye exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14851","description":"Anesth eye exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLA0","description":"ICD-AHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 2nd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36246","description":"Ins cath abd/l-ext art 2nd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUC1","description":"ICD-FGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFF1","description":"ICD-GAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93591","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYE0","description":"ICD-HDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX53","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPA0","description":"ICD-OEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHE0","description":"ICD-CDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJE0","description":"ICD-JFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Housing & integrated adhesiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7508","description":"Housing & integrated adhesiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Er and ip hosp <2 in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9521","description":"Er and ip hosp <2 in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFD0","description":"ICD-NJFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dwelling lead investigation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1029","description":"Dwelling lead investigation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOE0","description":"ICD-GEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKD0","description":"ICD-CBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIE1","description":"ICD-MDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIE0","description":"ICD-KCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUD0","description":"ICD-AFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10B","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tongue base vol reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41530","description":"Tongue base vol reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not On A Daily Aspirin Or Other Antiplatelet (E.G. History Of Gastrointestinal Bleed_ Intra-Cranial Bleed_ Blood Disorders_ Idiopathic T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2128","description":"Documentation Of Medical Reason(S) For Not On A Daily Aspirin Or Other Antiplatelet (E.G. History Of Gastrointestinal Bleed_ Intra-Cranial Bleed_ Blood Disorders_ Idiopathic T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sorbent cartridges per 10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1636","description":"Sorbent cartridges per 10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction_ technical analysis_ and result","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0477T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction_ technical analysis_ and result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACE1","description":"ICD-FACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE145","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTD0","description":"ICD-CGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGB1","description":"ICD-OFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCA1","description":"ICD-NJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAF0","description":"ICD-EIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0838T","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1607","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1607","description":"HCPCS-C1607","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD256","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDA0","description":"ICD-NKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"(Zerbaxa) Injection_ Ceftolozane 50mg And Tazobactam 25 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9452","description":"(Zerbaxa) Injection_ Ceftolozane 50mg And Tazobactam 25 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient lift hydraulic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0630","description":"Patient lift hydraulic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Straight tip urine catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4351","description":"Straight tip urine catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKD1","description":"ICD-GAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Toe loop/holder_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0952","description":"Toe loop/holder_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36903","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX22","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplant femur ridge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27140","description":"Transplant femur ridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Buttock fasciotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27027","description":"Buttock fasciotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBD0","description":"ICD-OIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7565","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7565","description":"HCPCS-C7565","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj fem cont inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64448","description":"N block inj fem cont inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICD1","description":"ICD-CICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPE0","description":"ICD-FFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOB1","description":"ICD-DGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAE1","description":"ICD-IBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISD0","description":"ICD-HISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAF1","description":"ICD-ECAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace non-molded thigh lac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4045","description":"Replace non-molded thigh lac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWF1","description":"ICD-PHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOD0","description":"ICD-HHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERB1","description":"ICD-OERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAD1","description":"ICD-MBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0C","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTE1","description":"ICD-NKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision pericoronal gingiva","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7971","description":"Excision pericoronal gingiva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXA0","description":"ICD-NEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWB0","description":"ICD-LCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLB1","description":"ICD-BCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRA1","description":"ICD-KIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADC0","description":"ICD-KADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBF1","description":"ICD-FFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22C","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam&tx estab pt 1/>vst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92014","description":"Eye exam&tx estab pt 1/>vst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9616","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","description":"HCPCS-A9616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score shdl < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8664","description":"Fun stat score shdl < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1170","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray 1 view frontal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71010","description":"Chest x-ray 1 view frontal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHC1","description":"ICD-EFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81219","description":"Calr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PuraPly AM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4196","description":"PuraPly AM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOF1","description":"ICD-HHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A5102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","description":"HCPCS-A5102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNB1","description":"ICD-CBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl perph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33969","description":"Ecmo/ecls rmvl perph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWC1","description":"ICD-OAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct head/brain w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70450","description":"Ct head/brain w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit high risk/escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9381","description":"Hit high risk/escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGED1","description":"ICD-MGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRF1","description":"ICD-KCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Galsulfase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1458","description":"Galsulfase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLF0","description":"ICD-JDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWB0","description":"ICD-HGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 35","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0408","description":"Inpt/tele follow up 35","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCF0","description":"ICD-NLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTD0","description":"ICD-CHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMF0","description":"ICD-GDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPE0","description":"ICD-NDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGE0","description":"ICD-KHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27756","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESC0","description":"ICD-CESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99224","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhv-6 dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87532","description":"Hhv-6 dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASC1","description":"ICD-OASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36483","description":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/.12-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2303","description":"Lens sphcy trifocal 4.0/.12-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWB1","description":"ICD-OAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for salivary x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42550","description":"Injection for salivary x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWF0","description":"ICD-OAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBA1","description":"ICD-JDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQE0","description":"ICD-GAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJD0","description":"ICD-OEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLD1","description":"ICD-OHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUF1","description":"ICD-MLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aortobi-iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35538","description":"Art byp grft aortobi-iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin beta_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9972","description":"Epoetin beta_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFC0","description":"ICD-BIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYA1","description":"ICD-HIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise prosth vag graft lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57426","description":"Revise prosth vag graft lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRB1","description":"ICD-CFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXE0","description":"ICD-NIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sewho airplane w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3973","description":"Sewho airplane w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB217","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct midface w/graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7949","description":"Reconstruct midface w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQB1","description":"ICD-GCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl tip cane/crutch/walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4637","description":"Repl tip cane/crutch/walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXF0","description":"ICD-JDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1105","description":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hd bed tilted 1st day vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4167F","description":"Hd bed tilted 1st day vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXD0","description":"ICD-NDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPD0","description":"ICD-OEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0517F","description":"Glaucoma plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45520","description":"Treatment of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDE0","description":"ICD-AGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKE1","description":"ICD-KHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA141","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB215","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28192","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair hand joint with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26542","description":"Repair hand joint with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen meniscus implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0428","description":"Collagen meniscus implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnosticmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0206","description":"Diagnosticmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD131","description":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHA1","description":"ICD-FCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27507","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMC1","description":"ICD-CDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVB0","description":"ICD-FFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRB1","description":"ICD-PFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral - bitewing radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0708","description":"Intraoral - bitewing radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQD1","description":"ICD-CIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cuffs adj lock w/ active con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3740","description":"Cuffs adj lock w/ active con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE104","description":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCD1","description":"ICD-JBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl garment for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0608","description":"Repl garment for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tcd emboli detect w/o inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93892","description":"Tcd emboli detect w/o inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJA0","description":"ICD-KDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACF1","description":"ICD-IACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28A","description":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHD1","description":"ICD-MDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ cell enumeration of circulating tumor cells_ utilizing whole blood_ algorithm_ for the presence of adenoma or cancer_ reported as a positive o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0091U","description":"Oncology (colorectal) screening_ cell enumeration of circulating tumor cells_ utilizing whole blood_ algorithm_ for the presence of adenoma or cancer_ reported as a positive o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6562","description":"Gradient compression stocking_ waist length_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNB1","description":"ICD-JGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1 pc ost pou w built-in conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5057","description":"1 pc ost pou w built-in conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOC1","description":"ICD-KGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9876","description":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX21","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE225","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVC0","description":"ICD-CHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESF1","description":"ICD-PESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUE0","description":"ICD-NIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB135","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronidase recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3473","description":"Hyaluronidase recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSF1","description":"ICD-GFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCB0","description":"ICD-CGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHC0","description":"ICD-BAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 1-2 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP02","description":"Auto.test pane pricing code_ 1-2 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90965","description":"Esrd home pt serv p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJB1","description":"ICD-OCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hexagnal phosph pltlt neutrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85598","description":"Hexagnal phosph pltlt neutrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visual funct status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1055F","description":"Visual funct status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67311","description":"Revise eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYF0","description":"ICD-HDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRA1","description":"ICD-PHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rebase hybrid prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5725","description":"Rebase hybrid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cell function assay w/stim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86352","description":"Cell function assay w/stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78607","description":"Brain imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of proinsulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84206","description":"Assay of proinsulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantable tissue marker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4648","description":"Implantable tissue marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fqhc visit_ mh estab pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0470","description":"Fqhc visit_ mh estab pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko derot ant cruciate custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1840","description":"Ko derot ant cruciate custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBND0","description":"ICD-GBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy l/s facet jnt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64636","description":"Destroy l/s facet jnt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSA0","description":"ICD-PBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHID0","description":"ICD-AHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRC0","description":"ICD-DHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXD1","description":"ICD-BGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACE0","description":"ICD-GACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7529","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUD0","description":"ICD-EBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIC1","description":"ICD-MGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conversion ext bil drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47535","description":"Conversion ext bil drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74430","description":"Contrast x-ray bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/insert drug implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11983","description":"Remove/insert drug implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip bone les super","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27065","description":"Remove hip bone les super","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUC1","description":"ICD-FAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAE0","description":"ICD-GEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricular pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7537","description":"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricular pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXE1","description":"ICD-OFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKA1","description":"ICD-CEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35306","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA31","description":"ICD-2KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTB1","description":"ICD-IGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54800","description":"Biopsy of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLE0","description":"ICD-MGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23174","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUA1","description":"ICD-FHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDC1","description":"ICD-ODDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTA0","description":"ICD-IGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27893","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA31","description":"ICD-1BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACA0","description":"ICD-JACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJA1","description":"ICD-BGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neutralization test viral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86382","description":"Neutralization test viral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINF0","description":"ICD-OINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mannitol for inhaler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7665","description":"Mannitol for inhaler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB46","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXF0","description":"ICD-GCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYA1","description":"ICD-KBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elevated or hypertensive blood pressure reading documented_ and the indicated follow-up is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1278","description":"Elevated or hypertensive blood pressure reading documented_ and the indicated follow-up is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFC0","description":"ICD-FBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACD1","description":"ICD-FACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65420","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduct compnd facial bone fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7780","description":"Reduct compnd facial bone fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl bat t.e.n.s. own by pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4630","description":"Repl bat t.e.n.s. own by pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimpanzee adenovirus Oxford 1 (ChAdOx1) vector_ pre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91302","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimpanzee adenovirus Oxford 1 (ChAdOx1) vector_ pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery electrocorticogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95829","description":"Surgery electrocorticogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trans shoe caliper plate new","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3610","description":"Trans shoe caliper plate new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap myotomy heller","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43279","description":"Lap myotomy heller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAD0","description":"ICD-BIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28436","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit cont anticoag diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9336","description":"Hit cont anticoag diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration; with imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10022","description":"Fine needle aspiration; with imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFD1","description":"ICD-NBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27602","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMF1","description":"ICD-NLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDB1","description":"ICD-NCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Completion pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32488","description":"Completion pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOC1","description":"ICD-KHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice long term care_ r&b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2046","description":"Hospice long term care_ r&b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFD1","description":"ICD-CIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDB1","description":"ICD-FHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCND1","description":"ICD-JCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFA1","description":"ICD-KAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99378","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5A","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic belt/harness/boot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0944","description":"Pelvic belt/harness/boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supplies for external insulin infusion pump_ syringe type cartridge_ sterile_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4225","description":"Supplies for external insulin infusion pump_ syringe type cartridge_ sterile_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRA0","description":"ICD-LFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLF0","description":"ICD-BHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI jnt of lwr extre w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73721","description":"MRI jnt of lwr extre w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lung lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32140","description":"Removal of lung lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADD1","description":"ICD-AADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICA0","description":"ICD-CICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I131 iodide cap_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9517","description":"I131 iodide cap_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58290","description":"Vag hyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruct premalg les 2-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17003","description":"Destruct premalg les 2-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41130","description":"Partial removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual semi-reclining back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1225","description":"Manual semi-reclining back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAB0","description":"ICD-GGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vis field assmnt tech suppt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0379T","description":"Vis field assmnt tech suppt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFB0","description":"ICD-GFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUF1","description":"ICD-MBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRF0","description":"ICD-OLRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCF0","description":"ICD-OBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAA0","description":"ICD-MEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAE0","description":"ICD-OJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMA0","description":"ICD-NEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem oct rta phys/qhp ea 30d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0606T","description":"Rem oct rta phys/qhp ea 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arch suprt att to sho longit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3070","description":"Arch suprt att to sho longit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETB0","description":"ICD-JETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNF1","description":"ICD-OCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC140","description":"Clinically Complex _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tilt table evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93660","description":"Tilt table evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60100","description":"Biopsy of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0804","description":"HCPCS-C0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52700","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVC1","description":"ICD-NGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUC0","description":"ICD-OAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Port_ indwelling_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1788","description":"Port_ indwelling_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHD0","description":"ICD-MIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCA1","description":"ICD-JHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26600","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair brow defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67900","description":"Repair brow defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19369","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin full grft face/genit/hf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15240","description":"Skin full grft face/genit/hf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA55","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCD1","description":"ICD-OKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPC1","description":"ICD-FBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Weight record","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2001F","description":"Weight record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair anorectal fist w/plug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46707","description":"Repair anorectal fist w/plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCND0","description":"ICD-KCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I131 iodobenguate_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9508","description":"I131 iodobenguate_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine accessory nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63191","description":"Incise spine accessory nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOB0","description":"ICD-OCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86408","description":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB25","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1A","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74742","description":"X-ray fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBD0","description":"ICD-JFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTF1","description":"ICD-AFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWE1","description":"ICD-GAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01953","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","description":"CPT-01953","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tcd vasoreactivity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93890","description":"Tcd vasoreactivity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNF0","description":"ICD-FHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAB0","description":"ICD-ECAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair Of Orthodontic Appliance - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8697","description":"Repair Of Orthodontic Appliance - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWA1","description":"ICD-OHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis c ab test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86803","description":"Hepatitis c ab test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BioNextPATCH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4228","description":"BioNextPATCH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEC0","description":"ICD-OFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMB1","description":"ICD-NCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41009","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13A","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHD0","description":"ICD-EBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXB0","description":"ICD-FEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sp bone algrft morsel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20930","description":"Sp bone algrft morsel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93930","description":"Upper extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWB1","description":"ICD-DIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAA0","description":"ICD-ACAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl electrode for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0609","description":"Repl electrode for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0189T","description":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBD1","description":"ICD-NFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIC1","description":"ICD-MKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55709","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","description":"CPT-55709","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOC1","description":"ICD-OGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKC1","description":"ICD-CHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ctlso milwauke initial model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1000","description":"Ctlso milwauke initial model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADC1","description":"ICD-OADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain stem w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70552","description":"MRI brain stem w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXE1","description":"ICD-FBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB46","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHC1","description":"ICD-NIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE136","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Structured Day Habilitation Group 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0105","description":"Structured Day Habilitation Group 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDF1","description":"ICD-MKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYA1","description":"ICD-HAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEA1","description":"ICD-OGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0561T","description":"Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26765","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB06","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44404","description":"Colonoscopy w/injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pm/icd remote tech serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93296","description":"Pm/icd remote tech serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQB0","description":"ICD-PFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQC0","description":"ICD-DHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag r an/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0648","description":"Lso sag r an/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental prophylaxis adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1110","description":"Dental prophylaxis adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contour of face bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21029","description":"Contour of face bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ olaratumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9485","description":"Injection_ olaratumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBE0","description":"ICD-EBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQF0","description":"ICD-LDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0938T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","description":"CPT-0938T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB245","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE201","description":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of toe tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28011","description":"Incision of toe tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Environmental manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90882","description":"Environmental manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB160","description":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHB0","description":"ICD-FHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIC1","description":"ICD-MHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ crizanlizumab-tmca_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9053","description":"Injection_ crizanlizumab-tmca_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCE1","description":"ICD-OGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKE1","description":"ICD-FIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJD1","description":"ICD-FHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCA1","description":"ICD-ACCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGF0","description":"ICD-CAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln part mand chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5741","description":"Denture reln part mand chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFB1","description":"ICD-BEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak pelvic control belt light","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5692","description":"Ak pelvic control belt light","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc extend prosth init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34825","description":"Endovasc extend prosth init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJF1","description":"ICD-OEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Construct bowel bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50820","description":"Construct bowel bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alloskin ac_ 1 cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4141","description":"Alloskin ac_ 1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00562","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","description":"CPT-00562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHA0","description":"ICD-JAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAE1","description":"ICD-EGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ldr prostate brachy comp rat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0458","description":"Ldr prostate brachy comp rat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRB1","description":"ICD-LFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment plan development","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1007","description":"Treatment plan development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYF0","description":"ICD-OFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1203","description":"HCPCS-B1203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIF1","description":"ICD-OHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA31","description":"ICD-2CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHA1","description":"ICD-MHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52290","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIE0","description":"ICD-BHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWB0","description":"ICD-LEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANA1","description":"ICD-KANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBF0","description":"ICD-NJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIB0","description":"ICD-EFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPC1","description":"ICD-FIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ age 12 years or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31552","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ age 12 years or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAA1","description":"ICD-GGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35266","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEB1","description":"ICD-ODEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAB0","description":"ICD-IHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kyphectomy 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22819","description":"Kyphectomy 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSD1","description":"ICD-GHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC42","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/drug abuse svc nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0047","description":"Alcohol/drug abuse svc nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXA1","description":"ICD-FHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preparation for bladder xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51605","description":"Preparation for bladder xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAA0","description":"ICD-GIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDA1","description":"ICD-JEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB21","description":"High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth bladder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91051","description":"Anesth bladder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syme typ expandabl wall sckt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5630","description":"Syme typ expandabl wall sckt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLA1","description":"ICD-NJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOD0","description":"ICD-CIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLB0","description":"ICD-IDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRE1","description":"ICD-HHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAF1","description":"ICD-AFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBC1","description":"ICD-EBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYC1","description":"ICD-CFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYA1","description":"ICD-OKYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYF0","description":"ICD-HGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAA0","description":"ICD-JFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX32","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5271","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE115","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of esophagus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43101","description":"Excision of esophagus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBF1","description":"ICD-ABBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43832","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANF0","description":"ICD-KANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX20","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43620","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10D","description":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJC0","description":"ICD-NLJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES301","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABD1","description":"ICD-JABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLC0","description":"ICD-NJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYA1","description":"ICD-PAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCE0","description":"ICD-GFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00934","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","description":"CPT-00934","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNA0","description":"ICD-NGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIF0","description":"ICD-MKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEND0","description":"ICD-FEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUB1","description":"ICD-BGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1006T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","description":"CPT-1006T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0424U","description":"Oncology (prostate)_ exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGC0","description":"ICD-JDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUB1","description":"ICD-IDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0802","description":"HCPCS-B0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTD1","description":"ICD-MCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clear outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69200","description":"Clear outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal_ subcutaneous cardiac rhythm monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33286","description":"Removal_ subcutaneous cardiac rhythm monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid trnso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43180","description":"Esophagoscopy rigid trnso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult daycare services 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5100","description":"Adult daycare services 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42305","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEC0","description":"ICD-MAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVC0","description":"ICD-CAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-inhalation drug for dme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7799","description":"Non-inhalation drug for dme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLD1","description":"ICD-GCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of iris prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0616T","description":"Insertion of iris prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRE0","description":"ICD-KGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOF0","description":"ICD-DAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDE0","description":"ICD-FHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8X","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAB0","description":"ICD-JFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDF1","description":"ICD-MHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infuse radioactive materials","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77750","description":"Infuse radioactive materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUA0","description":"ICD-JFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infect agent det by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0003","description":"Infect agent det by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide for amniocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76946","description":"Echo guide for amniocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDC1","description":"ICD-EDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCA1","description":"ICD-MFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm system_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5281","description":"Ald fm/dm system_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5B","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIF0","description":"ICD-EBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIB0","description":"ICD-KAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQC1","description":"ICD-LFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"L hrt cath trnsptl puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93462","description":"L hrt cath trnsptl puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70330","description":"X-ray exam of jaw joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wet mounts/ w preparations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0111","description":"Wet mounts/ w preparations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87634","description":"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carbidopa levodopa enteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7340","description":"Carbidopa levodopa enteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQB0","description":"ICD-GEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antistreptolysin o screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86063","description":"Antistreptolysin o screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKD0","description":"ICD-OKKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDND0","description":"ICD-FDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBF0","description":"ICD-CEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvef not performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8396","description":"Lvef not performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation tx management x5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77427","description":"Radiation tx management x5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPF1","description":"ICD-BDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 2.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12011","description":"Rpr f/e/e/n/l/m 2.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each multiplex probe stain procedure (List separately in addition to code for prima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0850T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each multiplex probe stain procedure (List separately in addition to code for prima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX16","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHD0","description":"ICD-NLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy_ arrhythmia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0747T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy_ arrhythmia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXF0","description":"ICD-NBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26605","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHB0","description":"ICD-MGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33510","description":"Cabg vein single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removable Unilateral Partial Denture - One Piece Resin - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5286","description":"Removable Unilateral Partial Denture - One Piece Resin - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSD0","description":"ICD-OKSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spec stains not for microorg","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0477","description":"Spec stains not for microorg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA206","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTA1","description":"ICD-NKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEME1","description":"ICD-FEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQC0","description":"ICD-DAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical opening of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43510","description":"Surgical opening of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cephalothin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1890","description":"Cephalothin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supp maint employ_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2026","description":"Supp maint employ_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1427","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","description":"HCPCS-M1427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOA1","description":"ICD-LAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAND1","description":"ICD-KAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINF0","description":"ICD-FINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPD0","description":"ICD-GIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0107","description":"Stroke with Motor >26.15 & Motor <30.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPC1","description":"ICD-NIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trichomonas vagin dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87660","description":"Trichomonas vagin dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJB0","description":"ICD-GDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEB0","description":"ICD-BFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJB0","description":"ICD-FFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEA1","description":"ICD-JDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor intestine/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44720","description":"Prep donor intestine/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38572","description":"Laparoscopy lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31580","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oocyte identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89254","description":"Oocyte identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caloric vstblr test w/rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92538","description":"Caloric vstblr test w/rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIF1","description":"ICD-GBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDC0","description":"ICD-ICDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUF0","description":"ICD-IAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQA0","description":"ICD-OBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHD0","description":"ICD-NKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCA0","description":"ICD-FFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd us fine needle bx/aspir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43242","description":"Egd us fine needle bx/aspir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWD0","description":"ICD-DHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE160","description":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharm dx agent noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4641","description":"Radiopharm dx agent noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTC0","description":"ICD-GGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMA0","description":"ICD-BIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDF0","description":"ICD-NGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28D","description":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRE1","description":"ICD-PHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria lmtd add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33257","description":"Ablate atria lmtd add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAA1","description":"ICD-FHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX40","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLE0","description":"ICD-ODLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQB0","description":"ICD-GIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDD0","description":"ICD-CFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE113","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA115","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDC1","description":"ICD-EEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L4-L5 inters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0196T","description":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L4-L5 inters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services used by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9709","description":"Hospice services used by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine 3vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72072","description":"X-ray exam thorac spine 3vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc with wrong event","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8912","description":"Pt doc with wrong event","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOB1","description":"ICD-CDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEA0","description":"ICD-NEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lipase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83690","description":"Assay of lipase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Administration of caregiver-focused health risk assessment instrument (eg_ depression inventory) for the benefit of the patient_ with scoring and documentation_ per standardiz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96161","description":"Administration of caregiver-focused health risk assessment instrument (eg_ depression inventory) for the benefit of the patient_ with scoring and documentation_ per standardiz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of thiocyanate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84430","description":"Assay of thiocyanate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB125","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJA0","description":"ICD-GDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECF0","description":"ICD-FECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBE0","description":"ICD-IFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2007","description":"Limited (30 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFB0","description":"ICD-CEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1709","description":"Pfizer-BioNTech Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJE1","description":"ICD-KCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0976T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","description":"CPT-0976T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEF0","description":"ICD-AFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFF1","description":"ICD-FHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBE1","description":"ICD-CBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PTEN (phosphatase and tensin homolog) (eg_ Cowden syndrome_ PTEN hamartoma tumor syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0235U","description":"PTEN (phosphatase and tensin homolog) (eg_ Cowden syndrome_ PTEN hamartoma tumor syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPE0","description":"ICD-GDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIC1","description":"ICD-KFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s])_ including vessel catheterization_ all imaging guidance_ and pulse generator initial ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33276","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s])_ including vessel catheterization_ all imaging guidance_ and pulse generator initial ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 4 vsts p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90957","description":"Esrd srv 4 vsts p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEE1","description":"ICD-JAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLE1","description":"ICD-NLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42106","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0569","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","description":"HCPCS-G0569","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYC1","description":"ICD-LEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp cont lens eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0592","description":"Comp cont lens eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDTB&VINCULIN IGG ANTB IA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0176U","description":"CDTB&VINCULIN IGG ANTB IA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSE0","description":"ICD-PDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sesamoid bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28315","description":"Removal of sesamoid bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDE0","description":"ICD-OBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEA1","description":"ICD-NIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup hip spica plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4025","description":"Cast sup hip spica plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC17","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAE0","description":"ICD-CGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCB1","description":"ICD-BCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYA1","description":"ICD-KDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37248","description":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAD1","description":"ICD-KFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2197","description":"Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDE0","description":"ICD-EDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLC0","description":"ICD-FBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX35","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult electric hand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7007","description":"Adult electric hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRE1","description":"ICD-DIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUE1","description":"ICD-ABUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGD0","description":"ICD-BAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge resin w/high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6250","description":"Bridge resin w/high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0675U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675U","description":"CPT-0675U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXE1","description":"ICD-JHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impact tooth remov soft tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7220","description":"Impact tooth remov soft tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99255","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA13","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD131","description":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nervous system nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78699","description":"Nervous system nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUC1","description":"ICD-MGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct hrt w/o dye w/ca test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75571","description":"Ct hrt w/o dye w/ca test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUE1","description":"ICD-CGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYE1","description":"ICD-DEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCE1","description":"ICD-KGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCB0","description":"ICD-GGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rear whl compl pneum tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0070","description":"Rear whl compl pneum tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Composite skin graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15760","description":"Composite skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIF1","description":"ICD-FEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD217","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPB1","description":"ICD-OKPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic analysis of vestibular implant_ unilateral; with subsequent programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0729T","description":"Diagnostic analysis of vestibular implant_ unilateral; with subsequent programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGME0","description":"ICD-KGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sys<140 and dia<90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9273","description":"Sys<140 and dia<90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMB0","description":"ICD-NAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJB0","description":"ICD-KHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWC0","description":"ICD-GEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC146","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23500","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC204","description":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKE1","description":"ICD-GDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHD0","description":"ICD-KDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWE1","description":"ICD-HGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJE1","description":"ICD-GGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRB0","description":"ICD-PBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8G","description":"Medium Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35231","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDF1","description":"ICD-MFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKA0","description":"ICD-CDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect enlarged toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28341","description":"Resect enlarged toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0513","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection and post administration monitoring_ subsequent repeat doses","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0240","description":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection and post administration monitoring_ subsequent repeat doses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDD1","description":"ICD-IIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYB1","description":"ICD-HHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPD1","description":"ICD-OAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7513","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sc ther infusion up to 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96369","description":"Sc ther infusion up to 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay serum cholinesterase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82480","description":"Assay serum cholinesterase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPF0","description":"ICD-KDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remv&replc pm gen mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33229","description":"Remv&replc pm gen mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUD0","description":"ICD-FAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMF0","description":"ICD-GCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESA1","description":"ICD-GESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj dupuytren cord w/enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20527","description":"Inj dupuytren cord w/enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mis sup/acc imp vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0508","description":"Mis sup/acc imp vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69725","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrmng 4 surg normothermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4250F","description":"Wrmng 4 surg normothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEA0","description":"ICD-JIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programming Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Iterative Adjustment Of The Implantable Device To Te","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0575T","description":"Programming Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Iterative Adjustment Of The Implantable Device To Te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total knee arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27447","description":"Total knee arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHME0","description":"ICD-GHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27427","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUB1","description":"ICD-CHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDA0","description":"ICD-CEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic shoe w/roller/rockr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5503","description":"Diabetic shoe w/roller/rockr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc ob care/deliver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59898","description":"Laparo proc ob care/deliver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSD0","description":"ICD-DBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bl push transfuse 2 yr/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36440","description":"Bl push transfuse 2 yr/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAC0","description":"ICD-KEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87478","description":"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95978","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWC1","description":"ICD-CAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA210","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28D","description":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVA0","description":"ICD-GEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Agile MD_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1012","description":"Clinical decision support mechanism Agile MD_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMC0","description":"ICD-FBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRC0","description":"ICD-KGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","description":"CPT-15015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRE0","description":"ICD-KHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJF0","description":"ICD-NIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temp anchorage dev w/o flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7294","description":"Temp anchorage dev w/o flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACB0","description":"ICD-BACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHD0","description":"ICD-MKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOC0","description":"ICD-OLOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37265","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","description":"CPT-37265","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTD1","description":"ICD-JDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNA1","description":"ICD-ODNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker leg extenders set of4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0158","description":"Walker leg extenders set of4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIE1","description":"ICD-OFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wc planar back cush wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2621","description":"Wc planar back cush wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal m1 w/mets prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9094","description":"Onc dx rectal m1 w/mets prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28I","description":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQC1","description":"ICD-GCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABA0","description":"ICD-EABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX17","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNB1","description":"ICD-OLNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1487","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","description":"HCPCS-M1487","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITF1","description":"ICD-KITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKA1","description":"ICD-ODKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHF0","description":"ICD-MDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUE1","description":"ICD-ODUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRF0","description":"ICD-GFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx mult myeloma stg2 hig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9129","description":"Onc dx mult myeloma stg2 hig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso full corset","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0976","description":"Lso full corset","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8A","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1805","description":"HCPCS-B1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLB0","description":"ICD-FFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVA0","description":"ICD-OGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMF0","description":"ICD-EFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXE1","description":"ICD-FDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHC1","description":"ICD-JIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"H&p for surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0260","description":"H&p for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ neurostimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1778","description":"Lead_ neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCE0","description":"ICD-EFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNF0","description":"ICD-BGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIE0","description":"ICD-NDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEB1","description":"ICD-GGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBB0","description":"ICD-FBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9918","description":"Functional status not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1C","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravasc us heart add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92979","description":"Intravasc us heart add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecg/monitoring and analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93271","description":"Ecg/monitoring and analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKB0","description":"ICD-OFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neg pres wound ther drsg set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6550","description":"Neg pres wound ther drsg set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tafasitamab-cxix_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9070","description":"Injection_ tafasitamab-cxix_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiopha dx beta amyloid pet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9599","description":"Radiopha dx beta amyloid pet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDF1","description":"ICD-JDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Routine venipuncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36415","description":"Routine venipuncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67420","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5B","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval aud rehab status","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92626","description":"Eval aud rehab status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; each additional device (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0450T","description":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; each additional device (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXD1","description":"ICD-JHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXD1","description":"ICD-GAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9834","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEA1","description":"ICD-FDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUE1","description":"ICD-NCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMF1","description":"ICD-MJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99233","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTC0","description":"ICD-MDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAD1","description":"ICD-MKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Milwaukee type superstructur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1230","description":"Milwaukee type superstructur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOD0","description":"ICD-DGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC31","description":"ICD-2EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compression bandage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8431","description":"Compression bandage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOE0","description":"ICD-KIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8A","description":"Medium Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0525U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","description":"CPT-0525U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor ix fc fusion recomb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7201","description":"Factor ix fc fusion recomb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCC1","description":"ICD-NDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFF1","description":"ICD-JIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Becaplermin gel 1%_ 0.5 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0157","description":"Becaplermin gel 1%_ 0.5 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQC1","description":"ICD-KGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATF0","description":"ICD-MATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder passive restor comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6310","description":"Shoulder passive restor comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBF1","description":"ICD-BEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glycine receptor alpha1 IgG_ serum or cerebrospinal fluid (CSF)_ live cell-binding assay (LCBA)_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0431U","description":"Glycine receptor alpha1 IgG_ serum or cerebrospinal fluid (CSF)_ live cell-binding assay (LCBA)_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUA0","description":"ICD-KGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFC0","description":"ICD-BCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFB0","description":"ICD-JAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIA0","description":"ICD-FGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lat lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22533","description":"Lat lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCME0","description":"ICD-CCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ adalimumab-afzb (abrilada)_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5132","description":"Injection_ adalimumab-afzb (abrilada)_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrics (expanded carrier screening)_ 145 genes by nextgeneration sequencing_ fragment analysis and multiplex ligationdependent probe amplification_ DNA_ reported as carrie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0400U","description":"Obstetrics (expanded carrier screening)_ 145 genes by nextgeneration sequencing_ fragment analysis and multiplex ligationdependent probe amplification_ DNA_ reported as carrie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC155","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB251","description":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYE1","description":"ICD-KCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXE1","description":"ICD-NDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAED1","description":"ICD-CAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX35","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTB1","description":"ICD-ACTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUB1","description":"ICD-FGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAE1","description":"ICD-CDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27156","description":"Revision of hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay carboxyhb qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82376","description":"Assay carboxyhb qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations_ orders or referrals for positive screen (e.g._ patient in pal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9924","description":"Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations_ orders or referrals for positive screen (e.g._ patient in pal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPF0","description":"ICD-GBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAB1","description":"ICD-JIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECF1","description":"ICD-KECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25D","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQB0","description":"ICD-HFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biodfence 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4140","description":"Biodfence 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB215","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB05","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYB0","description":"ICD-PFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWB0","description":"ICD-PEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elliotts b solution per ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9175","description":"Elliotts b solution per ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9175","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9175","description":"HCPCS-C9175","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB43","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIED0","description":"ICD-BIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close bladder-uterus fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51920","description":"Close bladder-uterus fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOA1","description":"ICD-HIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYC1","description":"ICD-HEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGC0","description":"ICD-JFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECA1","description":"ICD-FECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy lesion ablate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43229","description":"Esophagoscopy lesion ablate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61686","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attach ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65140","description":"Attach ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pca3/klk3 antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81313","description":"Pca3/klk3 antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22B","description":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86053","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC114","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRC0","description":"ICD-DFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDD0","description":"ICD-OJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult foster care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5140","description":"Adult foster care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unscheduled dressing change","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4920","description":"Unscheduled dressing change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove & treat brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61544","description":"Remove & treat brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32480","description":"Partial removal of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWC1","description":"ICD-KDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOC0","description":"ICD-CBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRF1","description":"ICD-CDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBA1","description":"ICD-NEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDE1","description":"ICD-OLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oasis wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4102","description":"Oasis wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCE0","description":"ICD-IBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compres burngarment bodysuit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6501","description":"Compres burngarment bodysuit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93242","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSC1","description":"ICD-DFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPF1","description":"ICD-JEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCB0","description":"ICD-JGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84586","description":"Assay of vip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair lung hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32800","description":"Repair lung hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBD0","description":"ICD-IEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFD1","description":"ICD-NHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJA0","description":"ICD-NAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1061T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1061T","description":"CPT-1061T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFF1","description":"ICD-CAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAB1","description":"ICD-NAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKF1","description":"ICD-GGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/drug service 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0050","description":"Alcohol/drug service 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIE1","description":"ICD-NDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHND0","description":"ICD-JHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQD0","description":"ICD-PKQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Baclofen intrathecal trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0476","description":"Baclofen intrathecal trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct colonography screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74263","description":"Ct colonography screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo cholangiopancreatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43261","description":"Endo cholangiopancreatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIF0","description":"ICD-ODIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPC0","description":"ICD-JBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUA1","description":"ICD-EBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGB1","description":"ICD-FCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSF1","description":"ICD-LCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fondaparinux sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1652","description":"Fondaparinux sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNE0","description":"ICD-OJNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSD0","description":"ICD-DFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21452","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Expandable controller_ repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2376","description":"Expandable controller_ repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIE1","description":"ICD-NBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Underarm crutch pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4635","description":"Underarm crutch pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1295","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23100","description":"Biopsy of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vkorc1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81355","description":"Vkorc1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAD1","description":"ICD-KCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PreTRM®_ Sera Prognostics_ Sera Prognostics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0247U","description":"PreTRM®_ Sera Prognostics_ Sera Prognostics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical opening esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43351","description":"Surgical opening esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt reas no hcv infect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9453","description":"Pt reas no hcv infect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strep a dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87650","description":"Strep a dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBF1","description":"ICD-MKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_phys coor-care ovrsght","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9008","description":"Mccd_phys coor-care ovrsght","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTE1","description":"ICD-OLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKB0","description":"ICD-FCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8F","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2004","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2004","description":"CDT-D2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTA1","description":"ICD-NHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med service out of office","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99056","description":"Med service out of office","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSE1","description":"ICD-OCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXA1","description":"ICD-FFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNA1","description":"ICD-JBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9294","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","description":"HCPCS-A9294","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHD0","description":"ICD-MDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1805","description":"HCPCS-A1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASE0","description":"ICD-CASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41113","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87638","description":"CPT-87638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGE1","description":"ICD-KFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRD0","description":"ICD-OIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFF0","description":"ICD-NDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADB0","description":"ICD-JADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTE1","description":"ICD-NJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIC0","description":"ICD-CCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37260","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","description":"CPT-37260","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apheresis plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36514","description":"Apheresis plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply long leg cast brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29358","description":"Apply long leg cast brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQA0","description":"ICD-CIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQC1","description":"ICD-PJQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAE1","description":"ICD-NEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTB1","description":"ICD-EFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAE1","description":"ICD-FBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTD1","description":"ICD-FCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUE1","description":"ICD-GIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc brst cncr stage 1 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3374F","description":"Ajcc brst cncr stage 1 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24D","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB21","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDB1","description":"ICD-ACDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFF0","description":"ICD-FDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93965","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood osmolality","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83930","description":"Assay of blood osmolality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXB1","description":"ICD-GHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASE1","description":"ICD-DASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADE1","description":"ICD-KADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVD1","description":"ICD-CCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYF0","description":"ICD-ODYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2390","description":"Solid drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANF0","description":"ICD-BANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transect pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33922","description":"Transect pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSD0","description":"ICD-GBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXA0","description":"ICD-OEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82627","description":"Dehydroepiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWF0","description":"ICD-PCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44147","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx esophageal mets recur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9098","description":"Onc dx esophageal mets recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28F","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIC0","description":"ICD-CHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIB1","description":"ICD-ODIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bile duct cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47715","description":"Excision of bile duct cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of brain tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61545","description":"Excision of brain tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plicamycin (mithramycin) inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9270","description":"Plicamycin (mithramycin) inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE204","description":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No wet-dry drssings rx recmd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4266F","description":"No wet-dry drssings rx recmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24576","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUE1","description":"ICD-EEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEB0","description":"ICD-CBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary rehab w exer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0424","description":"Pulmonary rehab w exer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKE0","description":"ICD-OLKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36569","description":"Insert picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ex for nonspeech dev rx add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92618","description":"Ex for nonspeech dev rx add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUC1","description":"ICD-JDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLE1","description":"ICD-GFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWF1","description":"ICD-KCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection intraop add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48400","description":"Injection intraop add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ C1 esterase inhibitor (human)_ Haegarda_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9015","description":"Injection_ C1 esterase inhibitor (human)_ Haegarda_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5514","description":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBA0","description":"ICD-KGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHF0","description":"ICD-KIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHED1","description":"ICD-NHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove penis & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54130","description":"Remove penis & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heparin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85520","description":"Heparin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINF1","description":"ICD-JINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVE1","description":"ICD-JFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteochondral talus autogrft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28446","description":"Osteochondral talus autogrft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLB0","description":"ICD-FHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ob us nuchal meas 1 gest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76813","description":"Ob us nuchal meas 1 gest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection eye drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67028","description":"Injection eye drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC11","description":"ICD-4LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0492U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","description":"CPT-0492U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFC1","description":"ICD-BBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMB0","description":"ICD-AGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 3 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64495","description":"Inj paravert f jnt l/s 3 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJF0","description":"ICD-NHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYC0","description":"ICD-CIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90912","description":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVE0","description":"ICD-GAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scope plantar fasciotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29893","description":"Scope plantar fasciotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIA1","description":"ICD-NIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mitomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9280","description":"Mitomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom breast prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8035","description":"Custom breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGE0","description":"ICD-KCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures maxill part metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5213","description":"Dentures maxill part metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stance phase only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5858","description":"Stance phase only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCD1","description":"ICD-NCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 30-40 mmhg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6552","description":"Gradient compression stocking_ below knee_ 30-40 mmhg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA236","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drill skull for implantation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61107","description":"Drill skull for implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAA0","description":"ICD-ECAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHB1","description":"ICD-OAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPE1","description":"ICD-NGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMC0","description":"ICD-AHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOE1","description":"ICD-GFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACC0","description":"ICD-NACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXB0","description":"ICD-BCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYD1","description":"ICD-LGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMD1","description":"ICD-BHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIC0","description":"ICD-GAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; osteoarticular_ including articular surface and contiguous bone (List separately in a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20932","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; osteoarticular_ including articular surface and contiguous bone (List separately in a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery_ procedure or test with analysis_ review and report_ leadle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0390T","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery_ procedure or test with analysis_ review and report_ leadle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia)_ same leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36471","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia)_ same leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (oropharyngeal)_ detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets_ cell-free HPV 16 and 18 DNA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0470U","description":"Oncology (oropharyngeal)_ detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets_ cell-free HPV 16 and 18 DNA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0C","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIA1","description":"ICD-KHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1173","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enterovirus antibody dfa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87267","description":"Enterovirus antibody dfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg_CT studies performed for radiation treatment)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9323","description":"Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg_CT studies performed for radiation treatment)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSC0","description":"ICD-DHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Not all data norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9324","description":"Not all data norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index cli","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1353","description":"Patients who did not have a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index cli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOE0","description":"ICD-PJOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASF0","description":"ICD-CASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acupunct w/o stimul 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97810","description":"Acupunct w/o stimul 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICA0","description":"ICD-JICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant eye drug system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67027","description":"Implant eye drug system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18F","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kneecap bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27340","description":"Removal of kneecap bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cancer stage docd metast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3301F","description":"Cancer stage docd metast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psytx complex interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90785","description":"Psytx complex interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5A","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1073","description":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA155","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35458","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychiatry (eg_ depression_ anxiety)_ genomic sequence analysis panel_ variant analysis of 13 genes_ saliva or buccal swab_ report of each gene phenotype","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0419U","description":"Neuropsychiatry (eg_ depression_ anxiety)_ genomic sequence analysis panel_ variant analysis of 13 genes_ saliva or buccal swab_ report of each gene phenotype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy volvul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45321","description":"Proctosigmoidoscopy volvul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound prep f/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15004","description":"Wound prep f/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLB1","description":"ICD-MGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crisis interven svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2011","description":"Crisis interven svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraabdominal pressure test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51797","description":"Intraabdominal pressure test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFF1","description":"ICD-BAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOA1","description":"ICD-HHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOF1","description":"ICD-OJOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1032T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1032T","description":"CPT-1032T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4649","description":"Surgical supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDB0","description":"ICD-JEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg pain was measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months) post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1053","description":"Leg pain was measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months) post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score hip not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8654","description":"Fun stat score hip not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDD1","description":"ICD-AEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62325","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection into brain canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61026","description":"Injection into brain canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27637","description":"Remove/graft leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAME1","description":"ICD-FAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC251","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEC0","description":"ICD-FAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDC1","description":"ICD-JEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHE1","description":"ICD-KBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"R-T Spctrl Alys Prst8 Tiss Fluorescenc Spctrscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0443T","description":"R-T Spctrl Alys Prst8 Tiss Fluorescenc Spctrscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWE1","description":"ICD-GBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXD0","description":"ICD-KHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replc sockt shldr dis/interc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6885","description":"Replc sockt shldr dis/interc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrics/Gynecology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4018","description":"Obstetrics/Gynecology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ex arm/elbow tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24073","description":"Ex arm/elbow tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFE1","description":"ICD-FAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC31","description":"ICD-3FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteopath manj 5-6 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98927","description":"Osteopath manj 5-6 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPB1","description":"ICD-NLPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ 120 or more drugs and substances_ definitive tandem mass spectrometry with chromatography_ urine_ qualitative report of presence (including quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0006U","description":"Prescription drug monitoring_ 120 or more drugs and substances_ definitive tandem mass spectrometry with chromatography_ urine_ qualitative report of presence (including quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block stellate ganglion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64510","description":"N block stellate ganglion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNC1","description":"ICD-BGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28H","description":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRB1","description":"ICD-HDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRF1","description":"ICD-GBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB23","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA216","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMA1","description":"ICD-OFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlamydia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86631","description":"Chlamydia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8870","description":"Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70300","description":"X-ray exam of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEB0","description":"ICD-OGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCB1","description":"ICD-JHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDA1","description":"ICD-GCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44370","description":"Small bowel endoscopy/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWF0","description":"ICD-LBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCF0","description":"ICD-EDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixed bilat space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1515","description":"Fixed bilat space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYE1","description":"ICD-OGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIA1","description":"ICD-OAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETA1","description":"ICD-EETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure of windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31820","description":"Closure of windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQD1","description":"ICD-OGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0543U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","description":"CPT-0543U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB14","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9187","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9187","description":"HCPCS-J9187","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surg dx exam anorectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45990","description":"Surg dx exam anorectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc stent & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37231","description":"Tib/per revasc stent & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5930","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5930","description":"CDT-D5930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0682U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682U","description":"CPT-0682U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mirikizumab-mrkz_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9168","description":"Injection_ mirikizumab-mrkz_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIA0","description":"ICD-KCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRD1","description":"ICD-HIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lube sterile packet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4332","description":"Lube sterile packet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIB0","description":"ICD-BIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTC1","description":"ICD-IFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMB1","description":"ICD-BGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWE1","description":"ICD-KCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPB0","description":"ICD-KFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grafix Prime and GrafixPL Prime_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4133","description":"Grafix Prime and GrafixPL Prime_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla ii typing 1 allele hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81383","description":"Hla ii typing 1 allele hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ diagnostic algorithm reported as a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0367U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ diagnostic algorithm reported as a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5B","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49595","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled air analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94690","description":"Exhaled air analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dry pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0184","description":"Dry pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJF1","description":"ICD-NBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1176","description":"Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVA1","description":"ICD-JHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interferential stim 2 chan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8130","description":"Interferential stim 2 chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0677","description":"Non-pneumatic sequential compression garment_ trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHF1","description":"ICD-BEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c acc_saf belt pelv strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0978","description":"W/c acc_saf belt pelv strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapy activation of implanted phrenic nerve stimulator system_ including all interrogation and programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93150","description":"Therapy activation of implanted phrenic nerve stimulator system_ including all interrogation and programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 9 genotyping (HPA-9w)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex_ antigen CD41] [GPIIb]) (eg_ neonatal alloimmune thromb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81111","description":"Human Platelet Antigen 9 genotyping (HPA-9w)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex_ antigen CD41] [GPIIb]) (eg_ neonatal alloimmune thromb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAA1","description":"ICD-JDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow mold outsid lock hinge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6200","description":"Elbow mold outsid lock hinge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of larynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31512","description":"Removal of larynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUD1","description":"ICD-EIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Norsn no dicom format doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9329","description":"Norsn no dicom format doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27538","description":"Treat knee fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGC0","description":"ICD-BFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lipoprotein bld by nmr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83704","description":"Lipoprotein bld by nmr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALC0","description":"ICD-JALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGD0","description":"ICD-ODGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACB1","description":"ICD-BACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37292","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","description":"CPT-37292","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMF0","description":"ICD-OAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLA0","description":"ICD-EFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53275","description":"Repair of urethra defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIB0","description":"ICD-FHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Renin stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80417","description":"Renin stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQD1","description":"ICD-OLQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHD1","description":"ICD-IDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYD0","description":"ICD-DHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUD0","description":"ICD-KCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9184","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","description":"HCPCS-J9184","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB231","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alveoloplasty not w/extracts","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7321","description":"Alveoloplasty not w/extracts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRC0","description":"ICD-PKRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAED1","description":"ICD-GAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29895","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hypertonic saline sol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7131","description":"Hypertonic saline sol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meals per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9977","description":"Meals per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEF1","description":"ICD-MBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWC1","description":"ICD-LHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACD0","description":"ICD-CACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJF1","description":"ICD-OLJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ isatuximab-irfc_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9227","description":"Injection_ isatuximab-irfc_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-tibial shell molded to p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2340","description":"Pre-tibial shell molded to p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40451","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXF0","description":"ICD-GBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient with transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9929","description":"Patient with transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRB1","description":"ICD-GBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAC0","description":"ICD-CFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEA0","description":"ICD-ABEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBA1","description":"ICD-OLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPE0","description":"ICD-CFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAF0","description":"ICD-MLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLD0","description":"ICD-JBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound warming device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0231","description":"Wound warming device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC36","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASF1","description":"ICD-GASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKED1","description":"ICD-MKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUD1","description":"ICD-NLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99177","description":"Ocular instrumnt screen bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58700","description":"Removal of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antithrombin iii injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7197","description":"Antithrombin iii injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCD0","description":"ICD-CCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLA1","description":"ICD-JDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSA0","description":"ICD-PLSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIME0","description":"ICD-CIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLA1","description":"ICD-GGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAE0","description":"ICD-MJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ntrk2 (Neurotrophic Receptor Tyrosine Kinase 2) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81192","description":"Ntrk2 (Neurotrophic Receptor Tyrosine Kinase 2) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAA1","description":"ICD-FBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ corticotropin (Acthar Gel)_ up to 40 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0801","description":"Injection_ corticotropin (Acthar Gel)_ up to 40 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal fat absorpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3708","description":"Gastrointestinal fat absorpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIB0","description":"ICD-CDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATF1","description":"ICD-MATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9762","description":"Patient had at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01402","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","description":"CPT-01402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12D","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1452","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","description":"HCPCS-M1452","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTE1","description":"ICD-EGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPB0","description":"ICD-FHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHD0","description":"ICD-JCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITF1","description":"ICD-CITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOE1","description":"ICD-HFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ mRNA lipid nanoparticles_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90683","description":"Respiratory syncytial virus vaccine_ mRNA lipid nanoparticles_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fosphenytoin inj pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2009","description":"Fosphenytoin inj pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ semiquantitative measurement of thymidine kinase activity by immunoassay_ serum_ results reported as risk of disease progression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0404U","description":"Oncology (breast)_ semiquantitative measurement of thymidine kinase activity by immunoassay_ serum_ results reported as risk of disease progression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Donor serv ivf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4025","description":"Donor serv ivf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXC0","description":"ICD-CFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCC0","description":"ICD-JBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ mRNA_ gene expression profiling by massively parallel sequencing for analysis of 51 genes_ utilizing formalin-fixed paraffin-embedded tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0057U","description":"Oncology (solid organ neoplasia)_ mRNA_ gene expression profiling by massively parallel sequencing for analysis of 51 genes_ utilizing formalin-fixed paraffin-embedded tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCD0","description":"ICD-MCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0560T","description":"Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHE0","description":"ICD-ABHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply rigid leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29445","description":"Apply rigid leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90612","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","description":"CPT-90612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWB1","description":"ICD-GFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYE0","description":"ICD-CIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBF0","description":"ICD-JCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB250","description":"Special Care Low _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31238","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth heart surg w/arrest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56351","description":"Anesth heart surg w/arrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPC0","description":"ICD-CHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEC1","description":"ICD-FHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test socket hemipelvectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5628","description":"Test socket hemipelvectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRB0","description":"ICD-HFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGB0","description":"ICD-FEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMB0","description":"ICD-JCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDE1","description":"ICD-AGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mental health service_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0046","description":"Mental health service_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIE0","description":"ICD-NGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDC0","description":"ICD-FFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct entire forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21179","description":"Reconstruct entire forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg cong cyst malf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2402","description":"Fetal surg cong cyst malf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE116","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (wg critical care)_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0613","description":"Injection_ calcium gluconate (wg critical care)_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQD1","description":"ICD-OKQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTF1","description":"ICD-EBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKE1","description":"ICD-CFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self-adher band w <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6453","description":"Self-adher band w <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDB1","description":"ICD-ODDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc abdl tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22900","description":"Exc abdl tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQB1","description":"ICD-OAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78122","description":"Blood volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision benign lesion>1.25c","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7411","description":"Excision benign lesion>1.25c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk knee joints polycentric p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5677","description":"Bk knee joints polycentric p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARB0","description":"ICD-PARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDC1","description":"ICD-KIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOB1","description":"ICD-LFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD144","description":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tob user recd cess interv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9458","description":"Tob user recd cess interv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seat ht <17 or >=21 ltwt wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0056","description":"Seat ht <17 or >=21 ltwt wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-op asst doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9615","description":"Pre-op asst doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHD1","description":"ICD-OJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFE0","description":"ICD-FEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1498","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","description":"HCPCS-M1498","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90281","description":"Human ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHD1","description":"ICD-MHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00500","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","description":"CPT-00500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled air analysis o2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94680","description":"Exhaled air analysis o2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing care not clinically indicated because the patient needed a home program only_ referral to another provider or facility_ or consultation only_ as documented in the medi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1146","description":"Ongoing care not clinically indicated because the patient needed a home program only_ referral to another provider or facility_ or consultation only_ as documented in the medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11444","description":"Exc face-mm b9+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYC0","description":"ICD-KGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATD1","description":"ICD-EATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYE0","description":"ICD-GIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"2d tte w or w/o fol w/con_fu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8924","description":"2d tte w or w/o fol w/con_fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYE0","description":"ICD-PIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMD1","description":"ICD-NHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBC1","description":"ICD-CGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emergency surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9752","description":"Emergency surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20B","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAD1","description":"ICD-IBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCF1","description":"ICD-NHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14C","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct hrt w/3d image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75572","description":"Ct hrt w/3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD106","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hd hosp bed_ 350-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0301","description":"Hd hosp bed_ 350-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOD0","description":"ICD-ODOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVE1","description":"ICD-NFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTA1","description":"ICD-OKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJE1","description":"ICD-GAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERA1","description":"ICD-GERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALA1","description":"ICD-IALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRB0","description":"ICD-OGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJD0","description":"ICD-BAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00218","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","description":"CPT-00218","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device [screw retained plate]_ requiring flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7298","description":"Removal of temporary anchorage device [screw retained plate]_ requiring flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No mrs score in 90d followup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9647","description":"No mrs score in 90d followup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16075","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16075","description":"CPT-16075","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kcentra_ per i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9132","description":"Kcentra_ per i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp preop assess cat surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014F","description":"Comp preop assess cat surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23C","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4C","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSA0","description":"ICD-PCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0201","description":"HCPCS-C0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cid ext controller repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8628","description":"Cid ext controller repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB21","description":"ICD-4GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIE1","description":"ICD-MEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBC0","description":"ICD-MBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove colloid cyst w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62162","description":"Remove colloid cyst w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21A","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINA0","description":"ICD-KINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Establish inner ear window","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69820","description":"Establish inner ear window","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ra disease activity mod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3471F","description":"Ra disease activity mod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75870","description":"Vein x-ray skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLB0","description":"ICD-KHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune (rheumatoid arthritis)_ next-generation sequencing (NGS)_ gene expression testing of 19 genes_ whole blood_ with analysis of anti-cyclic citrullinated peptides (CCP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0456U","description":"Autoimmune (rheumatoid arthritis)_ next-generation sequencing (NGS)_ gene expression testing of 19 genes_ whole blood_ with analysis of anti-cyclic citrullinated peptides (CCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23B","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68130","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE126","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50045","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDD1","description":"ICD-CDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session_ core maintenance session_ or ongoing maintenance session furnished b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9890","description":"Bridge payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session_ core maintenance session_ or ongoing maintenance session furnished b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSE1","description":"ICD-KHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4388","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","description":"HCPCS-Q4388","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remis 6m w/o 6mos phq-9 <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9574","description":"Remis 6m w/o 6mos phq-9 <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; each additional 30 minutes of technician time (List separate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0367T","description":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; each additional 30 minutes of technician time (List separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC05","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/ foot r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1180","description":"Wheelchair amputee w/ foot r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial_ fungal_ or viral infection)_ semiquantitative biomechanical assessment (via deformability cytometry)_ whole blood_ with algorithmic analysis and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0441U","description":"Infectious disease (bacterial_ fungal_ or viral infection)_ semiquantitative biomechanical assessment (via deformability cytometry)_ whole blood_ with algorithmic analysis and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic elbo simultaneous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7181","description":"Electronic elbo simultaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRD0","description":"ICD-LIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25530","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ercp w/specimen collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43260","description":"Ercp w/specimen collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74450","description":"X-ray urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"64 lead ecg w/i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0178T","description":"64 lead ecg w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES344","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSB1","description":"ICD-OJSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVA1","description":"ICD-CIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Protect body sock ea pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0984","description":"Protect body sock ea pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBA0","description":"ICD-NIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIB0","description":"ICD-KIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Daprodustat_ oral_ 1 mg_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0889","description":"Daprodustat_ oral_ 1 mg_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5B","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFB0","description":"ICD-OAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEB1","description":"ICD-JIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYE1","description":"ICD-PFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 3 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3388F","description":"Ajcc cln cncr stage 3 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis_ solid organ neoplasm_ DNA analysis of 324 genes_ interrogation for sequence variants_ gene copy number amplifications_ gene rearrangements_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0037U","description":"Targeted genomic sequence analysis_ solid organ neoplasm_ DNA analysis of 324 genes_ interrogation for sequence variants_ gene copy number amplifications_ gene rearrangements_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVF0","description":"ICD-BCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx gastric unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9104","description":"Onc dx gastric unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC21","description":"ICD-2EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXD1","description":"ICD-NBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermatology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4000","description":"Dermatology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bckdhb gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81205","description":"Bckdhb gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10C","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHA0","description":"ICD-CHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low-level laser trmt 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8948","description":"Low-level laser trmt 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHA0","description":"ICD-BHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Histochemical stains add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88314","description":"Histochemical stains add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant mandible for augment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7996","description":"Implant mandible for augment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHB1","description":"ICD-JHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILA0","description":"ICD-JILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 3.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4168","description":"Parenteral sol amino acid 3.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0010","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLC1","description":"ICD-CDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCD0","description":"ICD-BDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preparation palate mold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42280","description":"Preparation palate mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBD0","description":"ICD-EDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen concentrator_ dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1391","description":"Oxygen concentrator_ dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIA1","description":"ICD-CEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1023","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1023","description":"HCPCS-E1023","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFA1","description":"ICD-KGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absorp drg <= 16 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0744","description":"Absorp drg <= 16 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYF0","description":"ICD-CHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIA0","description":"ICD-JFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluoro polarize fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83663","description":"Fluoro polarize fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCA1","description":"ICD-OLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay blood catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82383","description":"Assay blood catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scan proc cranial extra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61782","description":"Scan proc cranial extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cervical head harness/halter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0942","description":"Cervical head harness/halter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTF1","description":"ICD-MLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYE1","description":"ICD-DHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Megestrol 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0179","description":"Megestrol 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8B","description":"Medium Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Instr xrcz back pain 12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4240F","description":"Instr xrcz back pain 12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPC1","description":"ICD-OAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXA1","description":"ICD-NLXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec hand ind art digits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6880","description":"Elec hand ind art digits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJE1","description":"ICD-CHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Instillation of antineoplastic pharmacologic/biologic agent into renal pelvis_ any method_ including all imaging guidance_including volumetric measurement if performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9789","description":"Instillation of antineoplastic pharmacologic/biologic agent into renal pelvis_ any method_ including all imaging guidance_including volumetric measurement if performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD151","description":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diab manage trn ind/group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0109","description":"Diab manage trn ind/group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped complete soy based","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4159","description":"Ef ped complete soy based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOF0","description":"ICD-KHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Natalizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2323","description":"Natalizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0632U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0632U","description":"CPT-0632U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIA0","description":"ICD-BGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVC1","description":"ICD-JIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNC1","description":"ICD-FDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETE1","description":"ICD-KETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNF0","description":"ICD-FDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiological examination_ surgical specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76098","description":"Radiological examination_ surgical specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of tyrosine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84510","description":"Assay of tyrosine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHE1","description":"ICD-KGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFC1","description":"ICD-KHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBB0","description":"ICD-EEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc drug-el cor stent bran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9601","description":"Perc drug-el cor stent bran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHA0","description":"ICD-JGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42104","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLA0","description":"ICD-EGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Miro3D_ per cu cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2025","description":"Miro3D_ per cu cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair detachable arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1060","description":"Wheelchair detachable arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise sacral spine tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49215","description":"Excise sacral spine tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thiotepa injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9340","description":"Thiotepa injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for ureter x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50684","description":"Injection for ureter x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABE0","description":"ICD-MABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMD1","description":"ICD-KAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGA0","description":"ICD-FHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQE1","description":"ICD-GHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC256","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB52","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAC0","description":"ICD-NKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKC1","description":"ICD-CAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCA0","description":"ICD-MLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTC1","description":"ICD-NDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOB0","description":"ICD-PKOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGA1","description":"ICD-JBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAB1","description":"ICD-MJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33019","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEC0","description":"ICD-IDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX40","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64658","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","description":"CPT-64658","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical procedures that included the use of silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9757","description":"Surgical procedures that included the use of silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQF0","description":"ICD-CGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHD1","description":"ICD-GBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain blood from under nail","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11740","description":"Drain blood from under nail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALE1","description":"ICD-BALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATE0","description":"ICD-CATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc foot/toe tum deep <1.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28045","description":"Exc foot/toe tum deep <1.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOD1","description":"ICD-PLOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; battery component only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0862T","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; battery component only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETA0","description":"ICD-GETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/2.1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2204","description":"Lens sphcy bifocal 4.00d/2.1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPD0","description":"ICD-GEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETD0","description":"ICD-GETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA101","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFB1","description":"ICD-NIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFB0","description":"ICD-KEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (autosomal dominant congenital thrombocytopenia)_ genomic sequence analysis of 14 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Autosomal Dominant Thromboc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0269U","description":"Hematology (autosomal dominant congenital thrombocytopenia)_ genomic sequence analysis of 14 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Autosomal Dominant Thromboc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHD0","description":"ICD-EGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67904","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHA1","description":"ICD-NFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8902","description":"Mra w/o fol w/cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64417","description":"N block inj axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTC1","description":"ICD-ACTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVE0","description":"ICD-NDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAF1","description":"ICD-BFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKD1","description":"ICD-NGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microdissection manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88381","description":"Microdissection manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2C","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJA0","description":"ICD-FAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preventive Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4029","description":"Preventive Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetics 100-300","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88275","description":"Cytogenetics 100-300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35311","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr guidance for needle place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77021","description":"Mr guidance for needle place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bladder opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51880","description":"Repair of bladder opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBD0","description":"ICD-FCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD201","description":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57280","description":"Suspension of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0041A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 3rd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36247","description":"Ins cath abd/l-ext art 3rd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMD0","description":"ICD-AAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp geriatr assmt team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0250","description":"Comp geriatr assmt team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUA1","description":"ICD-OFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEC0","description":"ICD-ICEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB31","description":"ICD-3FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29822","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo molded plas rig ant tib","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1945","description":"Afo molded plas rig ant tib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUF1","description":"ICD-IBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRA1","description":"ICD-KHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor renal graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50325","description":"Prep donor renal graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laminotomy single cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63040","description":"Laminotomy single cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVD1","description":"ICD-OFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDE0","description":"ICD-KDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMF0","description":"ICD-GGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Av fuse uppr arm basilic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36819","description":"Av fuse uppr arm basilic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYC1","description":"ICD-OEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSF1","description":"ICD-CFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49616","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAD1","description":"ICD-EIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRA0","description":"ICD-PBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKF0","description":"ICD-FEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0550","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","description":"HCPCS-G0550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAED0","description":"ICD-EAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77262","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX43","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEA0","description":"ICD-MFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid frame hyperex pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0472","description":"Tlso rigid frame hyperex pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVA0","description":"ICD-FAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTB0","description":"ICD-BHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures adjust cmplt mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5411","description":"Dentures adjust cmplt mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJA0","description":"ICD-NGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Measure kidney pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50396","description":"Measure kidney pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFED0","description":"ICD-MFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRE1","description":"ICD-OIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Accessing and retorquing loose implant screw - per screw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6089","description":"Accessing and retorquing loose implant screw - per screw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHD0","description":"ICD-EEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine HCL (Belrapzo)_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9042","description":"Injection_ bendamustine HCL (Belrapzo)_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRF1","description":"ICD-KDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOA1","description":"ICD-OJOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peripheral vascular rehab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93668","description":"Peripheral vascular rehab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fracture frame attachmnts ce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0948","description":"Fracture frame attachmnts ce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFB1","description":"ICD-CGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMC0","description":"ICD-OCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIA1","description":"ICD-MGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMC0","description":"ICD-ICMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ toe caps_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6573","description":"Gradient compression garment_ toe caps_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64795","description":"Biopsy of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCC1","description":"ICD-BGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBF1","description":"ICD-NFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay dipstick","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83518","description":"Immunoassay dipstick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinsert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65155","description":"Reinsert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disease activity not assessed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1006","description":"Disease activity not assessed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA250","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDE0","description":"ICD-KGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFC1","description":"ICD-JIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXF1","description":"ICD-JHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1144","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDE0","description":"ICD-JGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21407","description":"Opn tx orbit fx w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB12","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sedation (non-iv)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9248","description":"Sedation (non-iv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1041","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 12.6-20 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12055","description":"Intmd rpr face/mm 12.6-20 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEA0","description":"ICD-KHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (pemfexy)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9304","description":"Injection_ pemetrexed (pemfexy)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28H","description":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVC1","description":"ICD-JFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWB0","description":"ICD-PKWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colistimethate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0770","description":"Colistimethate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHA0","description":"ICD-MLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44405","description":"Colonoscopy w/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVA0","description":"ICD-BCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens fitting for tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92071","description":"Contact lens fitting for tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLA1","description":"ICD-IHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGD1","description":"ICD-CBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIA0","description":"ICD-AAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINA0","description":"ICD-NINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aortbifemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35540","description":"Art byp grft aortbifemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasm)_ genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm_ quantification of dominant clonal sequence(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0364U","description":"Oncology (hematolymphoid neoplasm)_ genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm_ quantification of dominant clonal sequence(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRA0","description":"ICD-GCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8X","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor stent ather br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9603","description":"Perc d-e cor stent ather br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISF0","description":"ICD-PISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA117","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of pancreas open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48100","description":"Biopsy of pancreas open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lung lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32540","description":"Removal of lung lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2172","description":"All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1370","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","description":"HCPCS-J1370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOA1","description":"ICD-LCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIF0","description":"ICD-MDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI neck spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72141","description":"MRI neck spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient discharged alive following endovascular AAA repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9263","description":"Documentation of patient discharged alive following endovascular AAA repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise esophagus & stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43325","description":"Revise esophagus & stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUF0","description":"ICD-NCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBD0","description":"ICD-IFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADD0","description":"ICD-BADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carrier screening for severe inherited conditions (eg_ cystic fibrosis_ spinal muscular atrophy_ beta hemoglobinopathies [including sickle cell disease]_ alpha thalassemia)_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0449U","description":"Carrier screening for severe inherited conditions (eg_ cystic fibrosis_ spinal muscular atrophy_ beta hemoglobinopathies [including sickle cell disease]_ alpha thalassemia)_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54328","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rerevise eye muscles add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67332","description":"Rerevise eye muscles add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQE0","description":"ICD-DDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zinc paste band w >=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6456","description":"Zinc paste band w >=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHB1","description":"ICD-JCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICE1","description":"ICD-GICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain lower leg bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27604","description":"Drain lower leg bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEE1","description":"ICD-JIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos air press not prescribe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8853","description":"Pos air press not prescribe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9979","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXB1","description":"ICD-FHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0958T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","description":"CPT-0958T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30450","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv trunk musc 1-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64646","description":"Chemodenerv trunk musc 1-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cst hgh nble mtl inlay >=3sr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6603","description":"Cst hgh nble mtl inlay >=3sr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB140","description":"Reduced Physical Function _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQF0","description":"ICD-PCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB136","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEED1","description":"ICD-BEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKB1","description":"ICD-CEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLA1","description":"ICD-FHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEA1","description":"ICD-ADEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8010","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8010","description":"HCPCS-C8010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHC1","description":"ICD-IEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJD0","description":"ICD-GDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61608","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ pegylated-aucl (Jivi)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9141","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ pegylated-aucl (Jivi)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBA0","description":"ICD-CIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRC1","description":"ICD-OLRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mens shoes hightop depth inl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3222","description":"Mens shoes hightop depth inl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No ret for surg w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9307","description":"No ret for surg w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHC0","description":"ICD-FEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKE0","description":"ICD-KGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery for liver lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47300","description":"Surgery for liver lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ballistocardiogram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3902","description":"Ballistocardiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMA1","description":"ICD-CBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESC0","description":"ICD-OESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKE1","description":"ICD-BGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPF0","description":"ICD-NGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXD0","description":"ICD-FEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL02","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert non-tunnel cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36556","description":"Insert non-tunnel cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc death after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9260","description":"Doc death after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dronabinol 2.5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0167","description":"Dronabinol 2.5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIA1","description":"ICD-CDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA40","description":"Default_ /60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUB1","description":"ICD-GIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21A","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQD0","description":"ICD-KFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCC1","description":"ICD-MJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHF1","description":"ICD-CGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef hydrolyzed/amino acids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4153","description":"Ef hydrolyzed/amino acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIE0","description":"ICD-FDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2C","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gi wireless capsule measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91112","description":"Gi wireless capsule measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCD0","description":"ICD-MGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHND0","description":"ICD-KHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1029","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYB0","description":"ICD-OLYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYC0","description":"ICD-OIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAD0","description":"ICD-FCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suture small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44602","description":"Suture small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOF0","description":"ICD-PEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0669U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0669U","description":"CPT-0669U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient is using hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9714","description":"Patient is using hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRA1","description":"ICD-PGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEF1","description":"ICD-NKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVF0","description":"ICD-NFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSA1","description":"ICD-CCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m labeled rbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9560","description":"Tc99m labeled rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE224","description":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 11 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP11","description":"Auto.test pane pricing code_ 11 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLA0","description":"ICD-MDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported)_ upper extremity(ies)_ lower extremity(ies) and/or trunk_ initial orthotic(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97760","description":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported)_ upper extremity(ies)_ lower extremity(ies) and/or trunk_ initial orthotic(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVF1","description":"ICD-OHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDD1","description":"ICD-BIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVD0","description":"ICD-NBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHD0","description":"ICD-JAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC21","description":"Very High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical psychologist or clinical social worker time_ per calendar month. (these services inc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0323","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical psychologist or clinical social worker time_ per calendar month. (these services inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainable pch ex wear convex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4390","description":"Drainable pch ex wear convex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBA1","description":"ICD-MGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Near ifr guide of vasc site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0287T","description":"Near ifr guide of vasc site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPD0","description":"ICD-JCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser tx skin < 250 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96920","description":"Laser tx skin < 250 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHD0","description":"ICD-NIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYC1","description":"ICD-DEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKA0","description":"ICD-CIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pcp prophylaxis rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4279F","description":"Pcp prophylaxis rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onlay titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6634","description":"Onlay titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALA0","description":"ICD-OALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQC0","description":"ICD-KFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHA1","description":"ICD-BBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apheresis wbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36511","description":"Apheresis wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVF0","description":"ICD-GEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB212","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYA1","description":"ICD-PLYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQD0","description":"ICD-GEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove transplanted kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50370","description":"Remove transplanted kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMF1","description":"ICD-BBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXC1","description":"ICD-OFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33766","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUB0","description":"ICD-JEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External Ambulatory Infusion Pump_ Insulin_ Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0787","description":"External Ambulatory Infusion Pump_ Insulin_ Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0679","description":"Non-pneumatic sequential compression garment_ half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX26","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC136","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Soft tissue graft firsttooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4277","description":"Soft tissue graft firsttooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLB1","description":"ICD-EGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXB1","description":"ICD-KEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enteral ng tubing w/ stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4081","description":"Enteral ng tubing w/ stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bypass graft patency/patch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35685","description":"Bypass graft patency/patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening for sleep related breathing disorders","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9957","description":"Screening for sleep related breathing disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMC1","description":"ICD-MAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEA1","description":"ICD-GCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0507","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOF1","description":"ICD-CAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHB0","description":"ICD-MIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFB0","description":"ICD-JEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42330","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood thymol turbidity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2033","description":"Blood thymol turbidity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3D printing of a 3D dental surfacet scan","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0396","description":"3D printing of a 3D dental surfacet scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 50NCG/0.25ML IM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91306","description":"SARSCOV2 VAC 50NCG/0.25ML IM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWA1","description":"ICD-CFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Soft liner for complete or partial removable denture - indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5765","description":"Soft liner for complete or partial removable denture - indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair safety vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0980","description":"Wheelchair safety vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQC1","description":"ICD-DGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIA1","description":"ICD-JHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENB1","description":"ICD-GENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENF0","description":"ICD-CENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGE1","description":"ICD-JHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering zoster vaccine (e.g._ prior anaphylaxis due to the zoster vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1175","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g._ prior anaphylaxis due to the zoster vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Helicobacter pylori detection and antibiotic resistance_ DNA_ 16S and 23S rRNA_ gyrA_ pbp1_ rdxA and rpoB_ next generation sequencing_ formalin-fixed paraffin embedded or fres","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0008U","description":"Helicobacter pylori detection and antibiotic resistance_ DNA_ 16S and 23S rRNA_ gyrA_ pbp1_ rdxA and rpoB_ next generation sequencing_ formalin-fixed paraffin embedded or fres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUD0","description":"ICD-NHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXD1","description":"ICD-KCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC36","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINC1","description":"ICD-BINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0202","description":"HCPCS-B0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute resp synd coronavirus 2 (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preserv free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula formula_ for intramus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91305","description":"Severe acute resp synd coronavirus 2 (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preserv free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula formula_ for intramus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEA1","description":"ICD-KBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA21","description":"ICD-4BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc chro sin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9607","description":"Perc d-e cor revasc chro sin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKF0","description":"ICD-FBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPF0","description":"ICD-NCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKE1","description":"ICD-FCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise/drain tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68400","description":"Incise/drain tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Individual_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96158","description":"Health Behavior Intervention_ Individual_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDD0","description":"ICD-CHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFND1","description":"ICD-FFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIC0","description":"ICD-JIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photochemotherapy with uv-a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96912","description":"Photochemotherapy with uv-a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrocardiogram tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93005","description":"Electrocardiogram tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFD1","description":"ICD-GEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABA1","description":"ICD-CABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLF0","description":"ICD-MHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11102","description":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYB0","description":"ICD-DFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES130","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKD1","description":"ICD-KEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath w/drainage 2-way latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4314","description":"Cath w/drainage 2-way latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antithromb no presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8697","description":"Antithromb no presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHA1","description":"ICD-BGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYE1","description":"ICD-CIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12C","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDD0","description":"ICD-OBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOD0","description":"ICD-GBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDB0","description":"ICD-MCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKB1","description":"ICD-CHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ Pressure-Generating_ One-Way Valve_ Intermittently Occlusive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1982","description":"Catheter_ Pressure-Generating_ One-Way Valve_ Intermittently Occlusive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8G","description":"Very High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FLT3 (fms-related tyrosine kinase 3) (eg_ acute myeloid leukemia) internal tandem duplication (ITD) variants_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0046U","description":"FLT3 (fms-related tyrosine kinase 3) (eg_ acute myeloid leukemia) internal tandem duplication (ITD) variants_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRF1","description":"ICD-LHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGED1","description":"ICD-KGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lsh uterus above 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58543","description":"Lsh uterus above 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk thigh lacer glut/ischia m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5682","description":"Bk thigh lacer glut/ischia m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electromagntic tx for ulcers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0329","description":"Electromagntic tx for ulcers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27238","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days_ or SNF notified untimely of MSP denial_ or SNF notified untimely of revocation of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA00","description":"Default_ /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days_ or SNF notified untimely of MSP denial_ or SNF notified untimely of revocation of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTE0","description":"ICD-JHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressants class 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80332","description":"Antidepressants class 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thor rib belt custom fabrica","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0220","description":"Thor rib belt custom fabrica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tongue nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64740","description":"Incision of tongue nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22844","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAB0","description":"ICD-BGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFE0","description":"ICD-FHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth correct heart rhythm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41051","description":"Anesth correct heart rhythm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc of dsm-iv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9213","description":"No doc of dsm-iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13D","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comb art/venous blood tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4755","description":"Comb art/venous blood tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBB1","description":"ICD-CIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCC1","description":"ICD-EHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBA1","description":"ICD-NLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging without contrast_ breast; bilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8907","description":"Magnetic resonance imaging without contrast_ breast; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METD0","description":"ICD-METD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMA1","description":"ICD-JHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kit gene analys d816 variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81273","description":"Kit gene analys d816 variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00529","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","description":"CPT-00529","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQD0","description":"ICD-PEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage lymph node lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38300","description":"Drainage lymph node lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXC1","description":"ICD-KDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJA1","description":"ICD-KBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ue >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8667","description":"Fun stat score ue >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLF0","description":"ICD-BGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRF0","description":"ICD-GIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMD1","description":"ICD-MFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation cone locator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5985","description":"Radiation cone locator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX15","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19083","description":"Bx breast 1st lesion us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55708","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","description":"CPT-55708","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21050","description":"Removal of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVB0","description":"ICD-OHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOF0","description":"ICD-LHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRB0","description":"ICD-DHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBC0","description":"ICD-NEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC01","description":"Medium Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLD1","description":"ICD-BCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWD1","description":"ICD-CIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81596","description":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Admit w/in 180d req surg rev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9412","description":"Admit w/in 180d req surg rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDC1","description":"ICD-IEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEB1","description":"ICD-AAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc abdm/per/oment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49329","description":"Laparo proc abdm/per/oment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cane adjust/fixed quad/3 pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0105","description":"Cane adjust/fixed quad/3 pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46753","description":"Reconstruction of anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a medication dispensing event indicator of a history of asthma any time during the patient_s history through the end of the measure period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9799","description":"Patients with a medication dispensing event indicator of a history of asthma any time during the patient_s history through the end of the measure period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEF0","description":"ICD-IFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAB0","description":"ICD-AGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36560","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analyze spine infus pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62367","description":"Analyze spine infus pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBD0","description":"ICD-GIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENA0","description":"ICD-OENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA31","description":"ICD-3DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy clamp_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4363","description":"Ostomy clamp_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERD0","description":"ICD-PERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFD1","description":"ICD-FEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBF1","description":"ICD-CHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transdermal gfr monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0603T","description":"Transdermal gfr monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB113","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHF0","description":"ICD-NEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of anal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46050","description":"Incision of anal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01160","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","description":"CPT-01160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0651U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0651U","description":"CPT-0651U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fit aphakia spectcl multifoc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92353","description":"Fit aphakia spectcl multifoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auric/peri pain assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1116F","description":"Auric/peri pain assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICF0","description":"ICD-KICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA34","description":"Low Rehab_ ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUF1","description":"ICD-OLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPA0","description":"ICD-KHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69661","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest wall manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94667","description":"Chest wall manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECC1","description":"ICD-GECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bilirubin total transcut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88720","description":"Bilirubin total transcut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUB0","description":"ICD-IFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGB1","description":"ICD-OCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0004","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYF1","description":"ICD-DDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQF1","description":"ICD-KHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAED1","description":"ICD-OAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0659U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0659U","description":"CPT-0659U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBE0","description":"ICD-IGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETE0","description":"ICD-BETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTA1","description":"ICD-ADTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAD1","description":"ICD-OKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELA1","description":"ICD-JELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTF0","description":"ICD-ACTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCB0","description":"ICD-NHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mmr vaccine sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90707","description":"Mmr vaccine sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachy linear_ non-str_p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2636","description":"Brachy linear_ non-str_p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heterophile antibody absrbj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86310","description":"Heterophile antibody absrbj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYD1","description":"ICD-GGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrical stimulator supplies (external) for use with implantable neurostimulator_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8678","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNF0","description":"ICD-KDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBE0","description":"ICD-FGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJA0","description":"ICD-FIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removable unilateral partial denture - one piece cast metal_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5282","description":"Removable unilateral partial denture - one piece cast metal_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of head of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23195","description":"Removal of head of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20C","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUA0","description":"ICD-CDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHE1","description":"ICD-ACHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2039","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","description":"HCPCS-A2039","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENC1","description":"ICD-OENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDD0","description":"ICD-KBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2040","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","description":"HCPCS-A2040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHA1","description":"ICD-NLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28062","description":"Removal of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEB0","description":"ICD-MIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emer rspns system purchase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5162","description":"Emer rspns system purchase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLA0","description":"ICD-KBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44363","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4046F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABE1","description":"ICD-CABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUA1","description":"ICD-EGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL36","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWF0","description":"ICD-LDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26715","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPA1","description":"ICD-NDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ruconest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0596","description":"Injection_ ruconest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69635","description":"Repair eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25A","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glycosylated acute phase proteins (GlycA)_ nuclear magnetic resonance spectroscopy_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0024U","description":"Glycosylated acute phase proteins (GlycA)_ nuclear magnetic resonance spectroscopy_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90833","description":"Psytx pt&/fam w/e&m 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXB0","description":"ICD-NAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual standing system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2230","description":"Manual standing system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92004","description":"Eye exam new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBB1","description":"ICD-BEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWD0","description":"ICD-PKWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPF0","description":"ICD-GHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lancet device each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4258","description":"Lancet device each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ retifanlimab-dlwr_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9345","description":"Injection_ retifanlimab-dlwr_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDE1","description":"ICD-BHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHC0","description":"ICD-GEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mobility d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8980","description":"Mobility d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chloroprocaine hcl ophthalmic_ 3% gel_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2403","description":"Chloroprocaine hcl ophthalmic_ 3% gel_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJB0","description":"ICD-JDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA26","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACF1","description":"ICD-FACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTB0","description":"ICD-ACTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQF0","description":"ICD-CAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA250","description":"Clinically Complex _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLB0","description":"ICD-GHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMD1","description":"ICD-FDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64893","description":"Nerve graft arm/leg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wbc antibody identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86021","description":"Wbc antibody identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace pump_ alt press pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0182","description":"Replace pump_ alt press pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd diagnostic brush wash","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43235","description":"Egd diagnostic brush wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVB1","description":"ICD-NGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62302","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch drain/barr lk flng/f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4427","description":"Ost pch drain/barr lk flng/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRA0","description":"ICD-OFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSA1","description":"ICD-OFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programmable infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0783","description":"Programmable infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk pn xm on init visit date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2040F","description":"Bk pn xm on init visit date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Technetium tc-99m auto wbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9569","description":"Technetium tc-99m auto wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stimulated iui case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4035","description":"Stimulated iui case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTA0","description":"ICD-MHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRF1","description":"ICD-OIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alarm symp assessed-absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1070F","description":"Alarm symp assessed-absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB131","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respite care_ in the home_ p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9125","description":"Respite care_ in the home_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOB1","description":"ICD-OEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received active chemotherapy any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1156","description":"Patient received active chemotherapy any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABF0","description":"ICD-JABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1 or more neuropsych","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8947","description":"1 or more neuropsych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOE1","description":"ICD-GGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKB1","description":"ICD-CAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALE0","description":"ICD-BALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEA1","description":"ICD-OIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMF0","description":"ICD-JCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVA0","description":"ICD-KBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPE1","description":"ICD-GGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB25","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLA0","description":"ICD-JDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTA1","description":"ICD-KDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continuous ppi or h2ra rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4185F","description":"Continuous ppi or h2ra rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32400","description":"Needle biopsy chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWF0","description":"ICD-HBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUA1","description":"ICD-MIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSD1","description":"ICD-LDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBD0","description":"ICD-MEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDE1","description":"ICD-BGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRF1","description":"ICD-LDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATC0","description":"ICD-OATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXC1","description":"ICD-GFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENF1","description":"ICD-KENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICB0","description":"ICD-NICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC206","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9128","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9128","description":"CDT-D9128","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAD1","description":"ICD-NDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNB0","description":"ICD-GCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKD1","description":"ICD-BDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB24","description":"Low Rehab_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNA0","description":"ICD-OJNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD213","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ DNA and RNA by next-generation sequencing_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_ 437 genes_ interpretive report for single nucleoti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0391U","description":"Oncology (solid tumor)_ DNA and RNA by next-generation sequencing_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_ 437 genes_ interpretive report for single nucleoti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8E","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEA0","description":"ICD-ICEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAC0","description":"ICD-MLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJF1","description":"ICD-NAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-93146","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","description":"CPT-93146","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx combined","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21387","description":"Opn tx orbit fx combined","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSC1","description":"ICD-GGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ prothrombin complex concentrate (human)_ balfaxar_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9159","description":"Injection_ prothrombin complex concentrate (human)_ balfaxar_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJE0","description":"ICD-FHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEA1","description":"ICD-EDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastrin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82938","description":"Gastrin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55877","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","description":"CPT-55877","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGF0","description":"ICD-FHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMA1","description":"ICD-ODMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBB0","description":"ICD-KFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBED0","description":"ICD-IBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tendon for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20924","description":"Removal of tendon for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNB0","description":"ICD-JGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEE1","description":"ICD-CHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDE0","description":"ICD-IEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHA1","description":"ICD-JCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCE0","description":"ICD-NFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGF1","description":"ICD-OEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKC0","description":"ICD-BEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1008T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","description":"CPT-1008T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLD0","description":"ICD-CFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTA0","description":"ICD-NCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17108","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEC0","description":"ICD-IEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEED0","description":"ICD-FEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Belt_ strap_ sleeve_ garment_ or covering_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4467","description":"Belt_ strap_ sleeve_ garment_ or covering_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retinal prosth int/ext comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1841","description":"Retinal prosth int/ext comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTB1","description":"ICD-EHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLA1","description":"ICD-ECLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJE0","description":"ICD-NLJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISF0","description":"ICD-OISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA154","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNF1","description":"ICD-JHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9767","description":"Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMC0","description":"ICD-JCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPE1","description":"ICD-CIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place cath carotid/inom art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36222","description":"Place cath carotid/inom art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemotaxis assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86155","description":"Chemotaxis assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC241","description":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQC0","description":"ICD-HCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic shoe with wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5504","description":"Diabetic shoe with wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46060","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-131 iodide cap_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9528","description":"Iodine i-131 iodide cap_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pw actuator replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2378","description":"Pw actuator replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36558","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWC1","description":"ICD-OKWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBB0","description":"ICD-CHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBB1","description":"ICD-IEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMC0","description":"ICD-KHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUB1","description":"ICD-IHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA146","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial exam involved joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2004F","description":"Initial exam involved joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOA1","description":"ICD-OEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKF0","description":"ICD-NCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES312","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lifestyle mod 2 or 3 stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0341","description":"Lifestyle mod 2 or 3 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prior thyroid dise dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9553","description":"Prior thyroid dise dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGF0","description":"ICD-GHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lateral thoracic extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1210","description":"Lateral thoracic extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYB0","description":"ICD-PAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUF1","description":"ICD-KAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12D","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLE1","description":"ICD-EHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTE0","description":"ICD-CBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18C","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60240","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATD1","description":"ICD-KATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJB0","description":"ICD-KDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28C","description":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYA0","description":"ICD-KEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKA1","description":"ICD-JBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser tx skin 250-500 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96921","description":"Laser tx skin 250-500 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48140","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8I","description":"Low Rehab_ ADL Index 0-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Othe therapist at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9478","description":"Othe therapist at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dsm-5 info mdd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1040F","description":"Dsm-5 info mdd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQA1","description":"ICD-OKQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFF0","description":"ICD-NLFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Above elbow prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6500","description":"Above elbow prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOD0","description":"ICD-LBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00950","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","description":"CPT-00950","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML45","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCA0","description":"ICD-OBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFD1","description":"ICD-JHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBB0","description":"ICD-NEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHA1","description":"ICD-NKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs)_ from cultured CSCs and primary tumor cells_ categorical drug response reported based on cytotox","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0435U","description":"Oncology_ chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs)_ from cultured CSCs and primary tumor cells_ categorical drug response reported based on cytotox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84651","description":"Anesth hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26740","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHB1","description":"ICD-FEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73130","description":"X-ray exam of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWA0","description":"ICD-CDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vascular access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53251","description":"Anesth vascular access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUA0","description":"ICD-BFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB11","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMC1","description":"ICD-MLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC46","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMD0","description":"ICD-IAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35184","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Etoposide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9181","description":"Etoposide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPD1","description":"ICD-OHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL10","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Palliative care services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1309","description":"Palliative care services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEE1","description":"ICD-MIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulp vitality test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0460","description":"Pulp vitality test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25D","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEE0","description":"ICD-MKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARB0","description":"ICD-CARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis b dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87517","description":"Hepatitis b dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBME0","description":"ICD-OBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBC0","description":"ICD-GBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye/insert implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65103","description":"Remove eye/insert implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect prox finger tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26260","description":"Resect prox finger tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1001","description":"HCPCS-A1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEB1","description":"ICD-IIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft trunk add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15201","description":"Skin full graft trunk add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKA1","description":"ICD-OGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88153","description":"Cytopath c/v redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemagglutination inhibition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86280","description":"Hemagglutination inhibition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOD0","description":"ICD-PCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty tricuspid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33463","description":"Valvuloplasty tricuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 4.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2300","description":"Lens sphere trifocal 4.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHB1","description":"ICD-CHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQD1","description":"ICD-KHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEE1","description":"ICD-BCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rocking bed w/ or w/o side r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0462","description":"Rocking bed w/ or w/o side r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBC1","description":"ICD-JEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5A","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy remove segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32669","description":"Thoracoscopy remove segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSC1","description":"ICD-KFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVC0","description":"ICD-FEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIA0","description":"ICD-OHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peanut allergen specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA)_ blood_ individual epitope results and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0165U","description":"Peanut allergen specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA)_ blood_ individual epitope results and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYA0","description":"ICD-LDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder blade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73010","description":"X-ray exam of shoulder blade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68330","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUD0","description":"ICD-MKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compre dental tx adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8090","description":"Compre dental tx adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA04","description":"Default_ /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYC0","description":"ICD-HDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (list separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37250","description":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (list separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12D","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPC0","description":"ICD-BHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0A","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUA0","description":"ICD-MIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 3","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA36","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFD1","description":"ICD-CEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCE1","description":"ICD-BFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKA1","description":"ICD-CDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLC1","description":"ICD-OCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deb bone 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11044","description":"Deb bone 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEF1","description":"ICD-ABEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJE0","description":"ICD-NGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAID0","description":"ICD-OAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTD0","description":"ICD-NGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWD0","description":"ICD-OAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYE0","description":"ICD-PJYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMF1","description":"ICD-KDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIE1","description":"ICD-IBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-META0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"META0","description":"ICD-META0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLC0","description":"ICD-CCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTF1","description":"ICD-BHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ekg tracing for initial prev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0404","description":"Ekg tracing for initial prev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDE0","description":"ICD-AFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shwr cov elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0501","description":"Shwr cov elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28546","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE160","description":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWD0","description":"ICD-KIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMC0","description":"ICD-JHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ antihemophilic factor (recombinant)_ (Esperoct)_ glycopegylated-exei_ per IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7204","description":"Injection_ Factor VIII_ antihemophilic factor (recombinant)_ (Esperoct)_ glycopegylated-exei_ per IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEF0","description":"ICD-ACEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUF0","description":"ICD-CAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEME1","description":"ICD-EEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHE0","description":"ICD-NCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anaphylaxis due to the vaccine on or before the date of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1219","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELB0","description":"ICD-MELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUA0","description":"ICD-CAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD240","description":"Reduced Physical Function _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQC0","description":"ICD-DBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBD0","description":"ICD-AFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSB1","description":"ICD-DGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAND1","description":"ICD-GAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Misc vision item or service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2799","description":"Misc vision item or service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOA0","description":"ICD-LAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATC1","description":"ICD-JATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4336","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","description":"HCPCS-Q4336","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Forensic cytopathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88125","description":"Forensic cytopathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ eteplirsen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9484","description":"Injection_ eteplirsen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTF1","description":"ICD-JCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triptorelin extended release_ 3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9016","description":"Injection_ triptorelin extended release_ 3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC34","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJD0","description":"ICD-BCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo anti-neopl sq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96401","description":"Chemo anti-neopl sq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUA1","description":"ICD-NIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1504","description":"HCPCS-C1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIE0","description":"ICD-GDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDA1","description":"ICD-GEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNB1","description":"ICD-OFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dil retina exam interp rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2022F","description":"Dil retina exam interp rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed semi-electr w/ matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0260","description":"Hosp bed semi-electr w/ matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILA0","description":"ICD-OILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJB1","description":"ICD-BEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGE0","description":"ICD-KIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain arm/elbow bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23935","description":"Drain arm/elbow bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCE1","description":"ICD-MGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Betamethasone acet&sod phosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0702","description":"Betamethasone acet&sod phosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELE1","description":"ICD-JELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDB1","description":"ICD-MBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFF0","description":"ICD-KGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMF0","description":"ICD-AEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB140","description":"Special Care High _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abx pres w/in 10 dys of symp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9505","description":"Abx pres w/in 10 dys of symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICC1","description":"ICD-NICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHC0","description":"ICD-AEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMB0","description":"ICD-KCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE141","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOB0","description":"ICD-GBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87428","description":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNB0","description":"ICD-JDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd pneum dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87485","description":"Chylmd pneum dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Botulism ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90288","description":"Botulism ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open biopsy of lung pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32098","description":"Open biopsy of lung pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contracted services per day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1022","description":"Contracted services per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSD0","description":"ICD-DHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSB1","description":"ICD-HHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obstructive sleep apnea mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8900","description":"Obstructive sleep apnea mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA234","description":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Children who were screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9966","description":"Children who were screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUB1","description":"ICD-ODUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKD0","description":"ICD-KEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXF0","description":"ICD-OBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKC1","description":"ICD-JGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGC1","description":"ICD-FGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42320","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary’s home.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0246","description":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary’s home.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEF1","description":"ICD-CIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKC0","description":"ICD-JCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIB1","description":"ICD-GDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUE0","description":"ICD-FIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr epigastric hern reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49570","description":"Rpr epigastric hern reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIF0","description":"ICD-EEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29520","description":"Strapping of hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRD1","description":"ICD-CBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQE0","description":"ICD-OJQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECE1","description":"ICD-OECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1191","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDE0","description":"ICD-MCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVF1","description":"ICD-NIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophgl motil w/stim/perfus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91013","description":"Esophgl motil w/stim/perfus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELB1","description":"ICD-FELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0566","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","description":"HCPCS-G0566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65755","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDE0","description":"ICD-EFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHD0","description":"ICD-OAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Full mouth x-ray of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70320","description":"Full mouth x-ray of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVA0","description":"ICD-FBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Matristem burn matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4120","description":"Matristem burn matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBB0","description":"ICD-MDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKF0","description":"ICD-GHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42300","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDID1","description":"ICD-GDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diaphragm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4266","description":"Diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"removal of non-resorbable barrier","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4286","description":"removal of non-resorbable barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc neg elder mal no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8734","description":"Doc neg elder mal no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-49188","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","description":"CPT-49188","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEF0","description":"ICD-OAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50075","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIME0","description":"ICD-FIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound breast complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76641","description":"Ultrasound breast complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRC1","description":"ICD-CBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins endovas vena cava filtr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37191","description":"Ins endovas vena cava filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELC1","description":"ICD-EELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLC1","description":"ICD-BHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYA0","description":"ICD-OJYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJE1","description":"ICD-CDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJE0","description":"ICD-KGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHF0","description":"ICD-FDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLB0","description":"ICD-JGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCB1","description":"ICD-FFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2920","description":"Methylprednisolone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9937","description":"Diagnostic colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip canad sing axi cons fric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5250","description":"Hip canad sing axi cons fric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln cmplt maxil ch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5730","description":"Denture reln cmplt maxil ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy control bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46614","description":"Anoscopy control bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKA0","description":"ICD-JGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJA1","description":"ICD-GDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXB0","description":"ICD-JDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQC0","description":"ICD-GFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ocrelizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2350","description":"Injection_ ocrelizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIC1","description":"ICD-NEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKB1","description":"ICD-FBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCC0","description":"ICD-MDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Distal shoe space maintainer - fixed - unilateral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1575","description":"Distal shoe space maintainer - fixed - unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHD0","description":"ICD-IAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0642T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indexing for osteotomy using dynamic robotic assisted or dynamic navigation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7939","description":"Indexing for osteotomy using dynamic robotic assisted or dynamic navigation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPC1","description":"ICD-JAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tongue and neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41135","description":"Tongue and neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ONC BRST CA AI ASSMT 12 FEAT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0220U","description":"ONC BRST CA AI ASSMT 12 FEAT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSD1","description":"ICD-GGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg_ Neisseria meningitidis_ Streptococcus pneumoniae_ Listeria_ Haemophilus influenza","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87483","description":"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg_ Neisseria meningitidis_ Streptococcus pneumoniae_ Listeria_ Haemophilus influenza","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01940","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","description":"CPT-01940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIB0","description":"ICD-JFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fats/lipids feces qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82705","description":"Fats/lipids feces qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision malig lesion<=1.25c","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7413","description":"Excision malig lesion<=1.25c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTB0","description":"ICD-JBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qual card diag prior 12 mons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1460F","description":"Qual card diag prior 12 mons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSC1","description":"ICD-DBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIF1","description":"ICD-AGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ra meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8499","description":"Ra meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQF1","description":"ICD-DCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCD1","description":"ICD-BDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc_ l/r_ cmv-neg_ irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9058","description":"Rbc_ l/r_ cmv-neg_ irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBF1","description":"ICD-KDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decitabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0894","description":"Decitabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mobility cart pneum vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0502","description":"Mobility cart pneum vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVD1","description":"ICD-OKVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMB1","description":"ICD-BBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHC1","description":"ICD-FAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB160","description":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANB1","description":"ICD-BANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGID0","description":"ICD-CGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCD0","description":"ICD-JFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEID1","description":"ICD-AEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSD0","description":"ICD-OFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHD1","description":"ICD-CBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post-op hip abduct custom fa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1685","description":"Post-op hip abduct custom fa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ targeted genomic sequence analysis panel of 361 genes_ interrogation for gene fusions_ translocations_ or other rearrangements_ using DNA fro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0444U","description":"Oncology (solid organ neoplasia)_ targeted genomic sequence analysis panel of 361 genes_ interrogation for gene fusions_ translocations_ or other rearrangements_ using DNA fro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Darbepoetin alfa_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0882","description":"Darbepoetin alfa_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAD1","description":"ICD-CCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-surg tx root canal obs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3331","description":"Non-surg tx root canal obs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCF0","description":"ICD-NJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQA1","description":"ICD-LBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12B","description":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDA0","description":"ICD-EDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Novachor_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4194","description":"Novachor_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00797","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","description":"CPT-00797","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBB1","description":"ICD-CGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect radius tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24152","description":"Resect radius tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBF1","description":"ICD-MIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1358","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEF1","description":"ICD-OKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology Care Model (OCM) Monthly Enhanced Oncology Oncology Services (MEOS) payment for enhanced care management services for OCM beneficiaries.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9678","description":"Oncology Care Model (OCM) Monthly Enhanced Oncology Oncology Services (MEOS) payment for enhanced care management services for OCM beneficiaries.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHB1","description":"ICD-NAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patch_ lidocaine/tetracaine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9285","description":"Patch_ lidocaine/tetracaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/plcmt stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45347","description":"Sigmoidoscopy w/plcmt stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYD1","description":"ICD-DCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48000","description":"Drainage of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29838","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUE1","description":"ICD-OLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB55","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDC0","description":"ICD-FHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVB1","description":"ICD-BDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA215","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RARE DS GEN DNA ALYS PROBAND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0212U","description":"RARE DS GEN DNA ALYS PROBAND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOA1","description":"ICD-KAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7530","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7530","description":"HCPCS-J7530","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLE0","description":"ICD-GBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDE1","description":"ICD-IDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATE1","description":"ICD-OATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9883","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt referral for ect docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4067F","description":"Pt referral for ect docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAD0","description":"ICD-MEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEB1","description":"ICD-JFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESB1","description":"ICD-PESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee joint drop lock ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2405","description":"Knee joint drop lock ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALA0","description":"ICD-KALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEE1","description":"ICD-KEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit picc insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5520","description":"Hit picc insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOD0","description":"ICD-OLOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHE1","description":"ICD-JHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCD0","description":"ICD-BGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPC0","description":"ICD-CAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Specimen fat stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89125","description":"Specimen fat stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNB0","description":"ICD-CGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert 1 electrode pm-defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33216","description":"Insert 1 electrode pm-defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA25","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19020","description":"Incision of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo molded to patient plasti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1940","description":"Afo molded to patient plasti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+cell cnt 200-499 cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3495F","description":"Cd4+cell cnt 200-499 cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8H","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXB0","description":"ICD-NEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features_ reported as a recurrence score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0418U","description":"Oncology (breast)_ augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features_ reported as a recurrence score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knuckle with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26852","description":"Fusion of knuckle with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise tendon forearm/wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25109","description":"Excise tendon forearm/wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEE1","description":"ICD-IIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53665","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTA0","description":"ICD-OFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair mngment training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97542","description":"Wheelchair mngment training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHF0","description":"ICD-JIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSA0","description":"ICD-HGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOC0","description":"ICD-PIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art pressure waveform analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93050","description":"Art pressure waveform analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXB0","description":"ICD-BIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray stereo frontal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71015","description":"Chest x-ray stereo frontal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMA0","description":"ICD-NLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2389","description":"Foam caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact layer >16<= 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6207","description":"Contact layer >16<= 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUA0","description":"ICD-OBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spec rpt no doc class histo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9425","description":"Spec rpt no doc class histo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEME1","description":"ICD-CEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBD0","description":"ICD-GBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compl gift case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4013","description":"Compl gift case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFD0","description":"ICD-BGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD224","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOE0","description":"ICD-LCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion of cipaglucosidase alfa-atga_ including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of recei","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0138","description":"Intravenous infusion of cipaglucosidase alfa-atga_ including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of recei","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tenolysis triceps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24332","description":"Tenolysis triceps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medicaid certified community behavioral health clinic services_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1040","description":"Medicaid certified community behavioral health clinic services_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC226","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1094T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1094T","description":"CPT-1094T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQD0","description":"ICD-OEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHF1","description":"ICD-GCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9846","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enlarge breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19324","description":"Enlarge breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWD0","description":"ICD-PLWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMD1","description":"ICD-KIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METC0","description":"ICD-METC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24155","description":"Removal of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heavy duty control cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6660","description":"Heavy duty control cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIF1","description":"ICD-OKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB240","description":"Clinically Complex _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBE0","description":"ICD-OFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98013","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","description":"CPT-98013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGA0","description":"ICD-NJGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist endoscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29848","description":"Wrist endoscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTA0","description":"ICD-MDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUE0","description":"ICD-KDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9892","description":"Documentation of patient reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMD0","description":"ICD-EFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWE0","description":"ICD-GAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12C","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acp discuss/dscn mkr docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1123F","description":"Acp discuss/dscn mkr docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOF0","description":"ICD-OHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUF0","description":"ICD-JEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPB0","description":"ICD-JBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVA0","description":"ICD-GCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADA0","description":"ICD-AADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAF0","description":"ICD-NAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYC0","description":"ICD-PLYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGC0","description":"ICD-CBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNF0","description":"ICD-OGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUD0","description":"ICD-OCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4005","description":"Family Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise & repair chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32905","description":"Revise & repair chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKD1","description":"ICD-KBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDA0","description":"ICD-NLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYA1","description":"ICD-OFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ic lbw inf < 1500 gm subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99478","description":"Ic lbw inf < 1500 gm subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSD0","description":"ICD-HCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRF0","description":"ICD-OFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam caster tire any size ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2219","description":"Foam caster tire any size ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAB1","description":"ICD-EEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRB0","description":"ICD-HBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVB1","description":"ICD-CFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDB0","description":"ICD-IDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92314","description":"Prescription of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAF1","description":"ICD-GBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDB0","description":"ICD-NJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITA0","description":"ICD-AITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOF0","description":"ICD-PIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEB0","description":"ICD-IEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBA1","description":"ICD-GBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFED0","description":"ICD-OFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20A","description":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostoma stent/stud/bttn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7524","description":"Tracheostoma stent/stud/bttn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98984","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","description":"CPT-98984","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUB1","description":"ICD-JCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLA1","description":"ICD-ADLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES314","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathogen reduced plasma pool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9070","description":"Pathogen reduced plasma pool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26841","description":"Fusion of thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tens four lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0730","description":"Tens four lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDE1","description":"ICD-CBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath fl nongyn smears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88104","description":"Cytopath fl nongyn smears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHA1","description":"ICD-CDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE156","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31382","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ tumor immunohistochemistry (eg_ Her-2/neu_ estrogen receptor/progesterone receptor)_ quantitative or semiqua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0763T","description":"Digitization of glass microscope slides for morphometric analysis_ tumor immunohistochemistry (eg_ Her-2/neu_ estrogen receptor/progesterone receptor)_ quantitative or semiqua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDE0","description":"ICD-NEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD260","description":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCA0","description":"ICD-MDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AJCC breast cancer stage I: T1 mic or T1a documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9704","description":"AJCC breast cancer stage I: T1 mic or T1a documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEC0","description":"ICD-GEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIC0","description":"ICD-FHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAD0","description":"ICD-OCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reoperation carotid add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35390","description":"Reoperation carotid add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFD0","description":"ICD-KDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental retainr cast metl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6545","description":"Dental retainr cast metl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYF0","description":"ICD-CGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJE0","description":"ICD-NKJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam unilat ribs/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71101","description":"X-ray exam unilat ribs/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA204","description":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls initiation venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33946","description":"Ecmo/ecls initiation venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERB1","description":"ICD-CERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1813","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","description":"HCPCS-E1813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB44","description":"High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid lined pre one pie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0488","description":"Tlso rigid lined pre one pie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYF0","description":"ICD-KDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96934","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2211","description":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMF0","description":"ICD-CAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPE0","description":"ICD-NEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXE1","description":"ICD-GIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFE1","description":"ICD-BDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUA1","description":"ICD-OAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Volume deplete of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38214","description":"Volume deplete of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGD0","description":"ICD-FGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHF1","description":"ICD-BAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDB1","description":"ICD-BCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTA0","description":"ICD-GCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJE1","description":"ICD-CBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1133","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERF0","description":"ICD-KERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed hvy dty xtra wide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0303","description":"Hosp bed hvy dty xtra wide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan (sodium hyaluronate) or derivative_ durolane_ intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7318","description":"Hyaluronan (sodium hyaluronate) or derivative_ durolane_ intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth special head surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21851","description":"Anesth special head surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enteral infusion pump w/ ala","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9002","description":"Enteral infusion pump w/ ala","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx chron care w/o pt vsit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99487","description":"Cmplx chron care w/o pt vsit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1103","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1103","description":"CDT-D1103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthodontic retention","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8680","description":"Orthodontic retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRB1","description":"ICD-DIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYE1","description":"ICD-CEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEF0","description":"ICD-EBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albuterol ipratrop non-comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7620","description":"Albuterol ipratrop non-comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKA0","description":"ICD-CCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCC0","description":"ICD-OHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 52mg 5 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7298","description":"Levonorgestrel iu 52mg 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQC0","description":"ICD-DGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exercise class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9451","description":"Exercise class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTF1","description":"ICD-JFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sympt show clin import drop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1451F","description":"Sympt show clin import drop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22B","description":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB206","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allergen specific igg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86001","description":"Allergen specific igg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of neck/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21550","description":"Biopsy of neck/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPC0","description":"ICD-JAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35005","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply multlay comprs lwr leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29581","description":"Apply multlay comprs lwr leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45385","description":"Colonoscopy w/lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTA1","description":"ICD-OBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRC0","description":"ICD-CCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57100","description":"Biopsy of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASA1","description":"ICD-HASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDD1","description":"ICD-OJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pegaspargase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9266","description":"Pegaspargase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKF1","description":"ICD-CAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ortho sidebar disconnect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2768","description":"Ortho sidebar disconnect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASF0","description":"ICD-KASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEF1","description":"ICD-KAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0752","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","description":"HCPCS-J0752","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPD1","description":"ICD-BIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAA0","description":"ICD-GAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIA1","description":"ICD-EEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELE1","description":"ICD-OELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCF1","description":"ICD-FDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWB0","description":"ICD-DDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2123","description":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHME0","description":"ICD-CHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99336","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIA1","description":"ICD-CIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50783","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKA1","description":"ICD-BCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exam of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57452","description":"Exam of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRB0","description":"ICD-LCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGC1","description":"ICD-CGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDA0","description":"ICD-GCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKA1","description":"ICD-BHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD160","description":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLA0","description":"ICD-NDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBE1","description":"ICD-FFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTF1","description":"ICD-FGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECA1","description":"ICD-OECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cricotracheal resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31592","description":"Cricotracheal resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFA1","description":"ICD-GGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOB0","description":"ICD-OHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADA0","description":"ICD-MADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0594U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","description":"CPT-0594U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization admin by intramuscular injection of s (SARS-CoV-2)  vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose form first dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051A","description":"Immunization admin by intramuscular injection of s (SARS-CoV-2)  vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose form first dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQE0","description":"ICD-DBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No eval opi use instr/intv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9585","description":"No eval opi use instr/intv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of breast tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19300","description":"Removal of breast tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOE1","description":"ICD-PCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSD1","description":"ICD-PGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB60","description":"Medium Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINC1","description":"ICD-NINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAF0","description":"ICD-GCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPF0","description":"ICD-BAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUF1","description":"ICD-JIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61531","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","description":"HCPCS-J1164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIE0","description":"ICD-JHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration femoral artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35721","description":"Exploration femoral artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anticoag thx rx at dischrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4075F","description":"Anticoag thx rx at dischrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPC0","description":"ICD-FDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray eye for foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70030","description":"X-ray eye for foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dev delay prev dp ch_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2037","description":"Dev delay prev dp ch_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPA1","description":"ICD-OGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise finger joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26135","description":"Revise finger joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFA1","description":"ICD-FAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMC0","description":"ICD-FDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens gas permeable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2531","description":"Contact lens gas permeable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBA1","description":"ICD-CIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neonatal emergency transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0225","description":"Neonatal emergency transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part removal hip bone deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27071","description":"Part removal hip bone deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29897","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXD1","description":"ICD-BFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADE0","description":"ICD-EADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFF0","description":"ICD-CCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged service inpatient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99357","description":"Prolonged service inpatient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep c rna done prior to med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9203","description":"Hep c rna done prior to med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision/drain abscess extra","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7521","description":"Incision/drain abscess extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANE1","description":"ICD-GANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLF0","description":"ICD-CDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Access av dial grft for proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36148","description":"Access av dial grft for proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Molecular testing for a public health related pathogen_ including coronavirus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0606","description":"Molecular testing for a public health related pathogen_ including coronavirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUE1","description":"ICD-BGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTA1","description":"ICD-IFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuromend nerve wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9361","description":"Neuromend nerve wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RARE DS XOM DNA ALYS EA COMP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0215U","description":"RARE DS XOM DNA ALYS EA COMP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthovisc inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7324","description":"Orthovisc inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHC1","description":"ICD-ADHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0366U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWC1","description":"ICD-GFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELA1","description":"ICD-NELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDF1","description":"ICD-NHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42107","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLF0","description":"ICD-BFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abrasion lesion single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15786","description":"Abrasion lesion single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYF0","description":"ICD-OHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIA0","description":"ICD-KIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABB0","description":"ICD-KABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBA0","description":"ICD-GGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75880","description":"Vein x-ray eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35372","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWC0","description":"ICD-KHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVC1","description":"ICD-NIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPD1","description":"ICD-KBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNF0","description":"ICD-BBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy_ includes angioplasty within the same vessel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9774","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy_ includes angioplasty within the same vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOA1","description":"ICD-HGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHB1","description":"ICD-EIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTA0","description":"ICD-GGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown full cast high noble m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2790","description":"Crown full cast high noble m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pros sheath/sock w gel cushn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8417","description":"Pros sheath/sock w gel cushn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB121","description":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDD0","description":"ICD-BIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dostarlimab-gxly_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9272","description":"Injection_ dostarlimab-gxly_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKD1","description":"ICD-GFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1028T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1028T","description":"CPT-1028T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENA1","description":"ICD-NENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27712","description":"Realignment of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid plastic cust fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0484","description":"Tlso rigid plastic cust fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGC0","description":"ICD-JAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHB1","description":"ICD-OHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIE0","description":"ICD-IIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65875","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44361","description":"Small bowel endoscopy/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKE0","description":"ICD-GGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mdd severe w/psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3091F","description":"Mdd severe w/psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCE0","description":"ICD-IHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCB0","description":"ICD-IFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9245","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9245","description":"CDT-D9245","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYA0","description":"ICD-DAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFA0","description":"ICD-CFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0879","description":"Pwc gp4 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRE0","description":"ICD-LIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCD0","description":"ICD-IDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGE0","description":"ICD-JEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26450","description":"Incision of palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFE0","description":"ICD-JFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subtalar arthro w/deb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29906","description":"Subtalar arthro w/deb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq art m-thrombect &/nfs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61645","description":"Perq art m-thrombect &/nfs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTE1","description":"ICD-CCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cochlear implt f/up exam 7/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92603","description":"Cochlear implt f/up exam 7/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1048","description":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMD0","description":"ICD-NHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue not image intraop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8874","description":"Tissue not image intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQD0","description":"ICD-OGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGC0","description":"ICD-ODGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fecal microbiota_ live - jslm_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1440","description":"Fecal microbiota_ live - jslm_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEE0","description":"ICD-AIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c medial thigh support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0957","description":"W/c medial thigh support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18I","description":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise abdomen-venous shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49426","description":"Revise abdomen-venous shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray male genital tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74440","description":"X-ray male genital tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35001","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLD0","description":"ICD-IBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPB0","description":"ICD-NCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFID0","description":"ICD-NFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove by ligat int hem grp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46945","description":"Remove by ligat int hem grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA21","description":"ICD-2JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostoma filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4481","description":"Tracheostoma filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDED0","description":"ICD-MDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPA0","description":"ICD-BFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBD1","description":"ICD-NCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYB1","description":"ICD-KGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko double upright pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1845","description":"Ko double upright pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUD1","description":"ICD-JFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBC0","description":"ICD-MKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLE0","description":"ICD-BFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction Of Mixture Of Saline And Air For Sonosalpingography To Confirm Occlusion Of Fallopian Tubes_ Transcervical Approach_ Including Transvaginal Ultrasound And Pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0568T","description":"Introduction Of Mixture Of Saline And Air For Sonosalpingography To Confirm Occlusion Of Fallopian Tubes_ Transcervical Approach_ Including Transvaginal Ultrasound And Pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ delandistrogene moxeparvovec-rokl_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1413","description":"Injection_ delandistrogene moxeparvovec-rokl_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYB0","description":"ICD-KIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41114","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery blockage each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75968","description":"Repair artery blockage each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer dome & mouthpiece","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7016","description":"Nebulizer dome & mouthpiece","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33851","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay test for blood fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82274","description":"Assay test for blood fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLE1","description":"ICD-KDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Splint supplies misc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4051","description":"Splint supplies misc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIID0","description":"ICD-BIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWD1","description":"ICD-HEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0494","description":"Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1703","description":"HCPCS-A1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQF1","description":"ICD-PEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFC0","description":"ICD-OFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD230","description":"Reduced Physical Function _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE111","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who received cervical cytology or an HPV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9806","description":"Patients who received cervical cytology or an HPV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXE1","description":"ICD-OAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1323","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEE0","description":"ICD-EEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEA1","description":"ICD-IBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUA1","description":"ICD-NLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24605","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCF0","description":"ICD-KCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBF1","description":"ICD-FBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of anterior segment aqueous drainage device_ with creation of intraocular reservoir_ internal approach_ into the supraciliary space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0474T","description":"Insertion of anterior segment aqueous drainage device_ with creation of intraocular reservoir_ internal approach_ into the supraciliary space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc hand les sc 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26111","description":"Exc hand les sc 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDB0","description":"ICD-MHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJC1","description":"ICD-JEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJE1","description":"ICD-KGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYF0","description":"ICD-PHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRE0","description":"ICD-LBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11302","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18E","description":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replc sockt below e/w disa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6883","description":"Replc sockt below e/w disa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHID0","description":"ICD-CHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYB0","description":"ICD-LIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCB1","description":"ICD-FGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dark field examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87166","description":"Dark field examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction w/percutaneous coronary revascularization during acute myocardial infarction_ including catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0659T","description":"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction w/percutaneous coronary revascularization during acute myocardial infarction_ including catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAB1","description":"ICD-FIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attendance at delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99464","description":"Attendance at delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEB0","description":"ICD-MHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20605","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMD1","description":"ICD-NJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"corticotomy - four or more teeth or tooth spaces_ per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7297","description":"corticotomy - four or more teeth or tooth spaces_ per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62287","description":"Percutaneous diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60220","description":"Partial removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSC0","description":"ICD-PBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKB0","description":"ICD-CCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC26","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJF0","description":"ICD-KIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0624T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepc gn tstng docd b/4txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3266F","description":"Hepc gn tstng docd b/4txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXE1","description":"ICD-GGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ arm_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6522","description":"Gradient compression garment_ arm_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELC1","description":"ICD-BELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBE1","description":"ICD-FBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAE0","description":"ICD-GDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device without flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7300","description":"Removal of temporary anchorage device without flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Paraffin bath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97018","description":"Paraffin bath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIA1","description":"ICD-GCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flunisolide comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7641","description":"Flunisolide comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flu vac pandem prsrv free im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90666","description":"Flu vac pandem prsrv free im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEF1","description":"ICD-OHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISE0","description":"ICD-DISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAD1","description":"ICD-FDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLE1","description":"ICD-JHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4334","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","description":"HCPCS-Q4334","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ire abltj 1+tumors open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0601T","description":"Ire abltj 1+tumors open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27516","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEB1","description":"ICD-NJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVC1","description":"ICD-BEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Motor speech d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9158","description":"Motor speech d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEF0","description":"ICD-KCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCA1","description":"ICD-BDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0162","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","description":"HCPCS-J0162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPD1","description":"ICD-JFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove inner ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69910","description":"Remove inner ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFA1","description":"ICD-KIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBD0","description":"ICD-GCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFF0","description":"ICD-NAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIC0","description":"ICD-BAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVD0","description":"ICD-JDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8E","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSF0","description":"ICD-CHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mononuclear cell antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86356","description":"Mononuclear cell antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6077","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor_ including system ac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0448T","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor_ including system ac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYE0","description":"ICD-GDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33864","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEC0","description":"ICD-NFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWC0","description":"ICD-GBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA251","description":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB32","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSB0","description":"ICD-OLSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANC0","description":"ICD-GANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric restrictive procedure_ endoscopic sleeve gastroplasty_ with esophagogastroduodenoscopy and intraluminal tube insertion_ if performed_ including all system and tissue a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9784","description":"Gastric restrictive procedure_ endoscopic sleeve gastroplasty_ with esophagogastroduodenoscopy and intraluminal tube insertion_ if performed_ including all system and tissue a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Procedure-Related Bp_S Not Taken During An Outpatient Visit. Examples Include Same Day Surgery_ Ambulatory Service Center_ G.I. Lab_ Dialysis_ Infusion Center_ Chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2129","description":"Procedure-Related Bp_S Not Taken During An Outpatient Visit. Examples Include Same Day Surgery_ Ambulatory Service Center_ G.I. Lab_ Dialysis_ Infusion Center_ Chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prism lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2715","description":"Prism lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAB0","description":"ICD-JDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Basiliximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0480","description":"Basiliximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEA0","description":"ICD-GBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Talymed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4127","description":"Talymed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13A","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL10","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMD1","description":"ICD-FFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1738","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1738","description":"HCPCS-C1738","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVC0","description":"ICD-GGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair by enlargement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33610","description":"Repair by enlargement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auricular prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5914","description":"Auricular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preventive behavior change_ online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum_ provided to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0488T","description":"Preventive behavior change_ online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum_ provided to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD254","description":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Csi per asx pt w/pci 2 yrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8963","description":"Csi per asx pt w/pci 2 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trach/laryn tube cuffed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7521","description":"Trach/laryn tube cuffed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; download review_ interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0536T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; download review_ interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGE0","description":"ICD-CDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBC0","description":"ICD-CIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJF1","description":"ICD-GGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2151","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","description":"HCPCS-J2151","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUD0","description":"ICD-NDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0021","description":"Alcohol and/or drug training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPF0","description":"ICD-OCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompressive lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61323","description":"Decompressive lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unusual physician travel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99082","description":"Unusual physician travel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYA1","description":"ICD-PIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28150","description":"Removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLB1","description":"ICD-MBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGD1","description":"ICD-BDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE115","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIA0","description":"ICD-AIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00948","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","description":"CPT-00948","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of midface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21188","description":"Reconstruction of midface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNF1","description":"ICD-GHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKF0","description":"ICD-CIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKF1","description":"ICD-BFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAF1","description":"ICD-FHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69915","description":"Incise inner ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ controlled by phone application","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0492","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ controlled by phone application","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63081","description":"Remove vert body dcmprn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"DNA analysis_ fecal_ for colorectal cancer screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3890","description":"DNA analysis_ fecal_ for colorectal cancer screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65205","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICB0","description":"ICD-OICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1102","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1102","description":"CDT-D1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4438","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBC1","description":"ICD-FDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Female patients unable to bear children","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1016","description":"Female patients unable to bear children","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJF1","description":"ICD-KEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10C","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pentamidine iseth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0080","description":"Injection_ pentamidine iseth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seizure type& frequ docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1200F","description":"Seizure type& frequ docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLE0","description":"ICD-IGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQE1","description":"ICD-PCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo torsion bil rot straps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2040","description":"Hkafo torsion bil rot straps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJE1","description":"ICD-FIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSC0","description":"ICD-HCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair rotator cuff chronic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23412","description":"Repair rotator cuff chronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAF0","description":"ICD-IHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITB0","description":"ICD-KITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33903","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1604","description":"HCPCS-A1604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration for testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54560","description":"Exploration for testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Translum dil eye canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66174","description":"Translum dil eye canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50953","description":"Endoscopy of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVD1","description":"ICD-OGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEED1","description":"ICD-FEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce/graft eye wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67255","description":"Reinforce/graft eye wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTC1","description":"ICD-GGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUD1","description":"ICD-MGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74000","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01320","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","description":"CPT-01320","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-emer transport wait time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2007","description":"Non-emer transport wait time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lens lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66830","description":"Removal of lens lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonic lavage_ 35 or more liters of water_ gravity-fed_ with induced defecation_ including insertion of rectal catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0736T","description":"Colonic lavage_ 35 or more liters of water_ gravity-fed_ with induced defecation_ including insertion of rectal catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c manual swingaway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1028","description":"W/c manual swingaway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB256","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELC0","description":"ICD-EELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gs mg intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9237","description":"Gs mg intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRB1","description":"ICD-KDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whlchr special size/constrc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1220","description":"Whlchr special size/constrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMD0","description":"ICD-FBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUE1","description":"ICD-IEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24420","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC21","description":"ICD-3JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28I","description":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pjp proph ordered low cd4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9222","description":"Pjp proph ordered low cd4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES134","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ACApatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4325","description":"ACApatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDD0","description":"ICD-EBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSE1","description":"ICD-HHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIC1","description":"ICD-NKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare donor intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44715","description":"Prepare donor intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/lithotripsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52353","description":"Cystouretero w/lithotripsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBF0","description":"ICD-CCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1603","description":"HCPCS-C1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) a","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX03","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESD0","description":"ICD-GESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis delta agent antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86692","description":"Hepatitis delta agent antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJF1","description":"ICD-CFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","description":"HCPCS-J2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44389","description":"Colonoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0788T","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWA1","description":"ICD-LBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXC0","description":"ICD-NIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYC0","description":"ICD-HBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lanreotide_ (Cipla)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1932","description":"Injection_ lanreotide_ (Cipla)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRF0","description":"ICD-CIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLA0","description":"ICD-CDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIC0","description":"ICD-AGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVF0","description":"ICD-BHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWB0","description":"ICD-HEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITC1","description":"ICD-GITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEE1","description":"ICD-ADEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXE0","description":"ICD-CCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA225","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1552","description":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"GYPA GNOTYP NTRNS 1 5 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0189U","description":"GYPA GNOTYP NTRNS 1 5 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe metatarsal bar wedge ro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3400","description":"Shoe metatarsal bar wedge ro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ivig non-lyophilized_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1599","description":"Ivig non-lyophilized_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHA1","description":"ICD-EIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVF1","description":"ICD-BCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11C","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEID0","description":"ICD-CEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28405","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTB0","description":"ICD-EGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Routine footcare pt w lops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0247","description":"Routine footcare pt w lops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCA0","description":"ICD-ABCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2002","description":"Limited (30 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNB1","description":"ICD-NCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd dilate stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43245","description":"Egd dilate stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE204","description":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip disart canadian sach ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5331","description":"Hip disart canadian sach ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI fetal sngl/1st gestation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74712","description":"MRI fetal sngl/1st gestation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOC0","description":"ICD-CEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fast/dir ldl = 190 mg/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9663","description":"Fast/dir ldl = 190 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIE1","description":"ICD-JEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOD0","description":"ICD-GEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caries susceptibility test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0425","description":"Caries susceptibility test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMC1","description":"ICD-EEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABD1","description":"ICD-NABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28G","description":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mycoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86738","description":"Mycoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ unilateral; one view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73500","description":"Radiologic examination_ hip_ unilateral; one view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/family 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90832","description":"Psytx pt&/family 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCF0","description":"ICD-FHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMF0","description":"ICD-EEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45395","description":"Lap removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66988","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHF0","description":"ICD-NIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8610","description":"Ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEED0","description":"ICD-NEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBE0","description":"ICD-OKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASB0","description":"ICD-OASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aortic circulation assist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33970","description":"Aortic circulation assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine 2vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72070","description":"X-ray exam thorac spine 2vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNF0","description":"ICD-KBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66991","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKA1","description":"ICD-GEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUD1","description":"ICD-OIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22B","description":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCA1","description":"ICD-ECCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1269","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long leg plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4029","description":"Cast sup long leg plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAE1","description":"ICD-CFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt/caregiver counsel safety","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6090F","description":"Pt/caregiver counsel safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deliver placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59414","description":"Deliver placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31530","description":"Laryngoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient is not currently on a daily aspirin or other antiplatelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9795","description":"Patient is not currently on a daily aspirin or other antiplatelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20D","description":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHC1","description":"ICD-MEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVC1","description":"ICD-NAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0825T","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvis/hip joint surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27299","description":"Pelvis/hip joint surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99315","description":"Nursing fac discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLF0","description":"ICD-OBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACD0","description":"ICD-KACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35190","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant tcat pulm vlv perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33477","description":"Implant tcat pulm vlv perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTC0","description":"ICD-CFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFC0","description":"ICD-CHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQA1","description":"ICD-KAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25442","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCME0","description":"ICD-MCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical home level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9149","description":"Medical home level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKD1","description":"ICD-JEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTA1","description":"ICD-AGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26735","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMA1","description":"ICD-BCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAC1","description":"ICD-JAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNA0","description":"ICD-CCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11606","description":"Exc tr-ext mal+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18E","description":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bartonella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86611","description":"Bartonella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKA0","description":"ICD-GGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chore services per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5121","description":"Chore services per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5171","description":"HCPCS-Q5171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-125 sodium iodide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9527","description":"Iodine i-125 sodium iodide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76140","description":"X-ray consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPC1","description":"ICD-GFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; assessment of bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0556T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; assessment of bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFB1","description":"ICD-OCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zaire ebolavirus vaccine_ live_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90758","description":"Zaire ebolavirus vaccine_ live_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCB1","description":"ICD-JFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27562","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTE1","description":"ICD-ABTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQA0","description":"ICD-PDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2B","description":"Very High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIB1","description":"ICD-JEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debride infected skin add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11001","description":"Debride infected skin add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICA0","description":"ICD-GICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNF0","description":"ICD-KCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj calcitriol per 0.1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0636","description":"Inj calcitriol per 0.1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQA1","description":"ICD-PBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43045","description":"Incision of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCB1","description":"ICD-IBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEB0","description":"ICD-FAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9761","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bamlanivimab and etesevimab_ 2100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0245","description":"Injection_ bamlanivimab and etesevimab_ 2100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYD1","description":"ICD-DGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial complete study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93886","description":"Intracranial complete study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASC1","description":"ICD-LASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEB1","description":"ICD-NEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ sch team conf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9007","description":"Mccd_ sch team conf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Isoetharine non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7648","description":"Isoetharine non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laps rmvl vgl arry&pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0314T","description":"Laps rmvl vgl arry&pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDB1","description":"ICD-EGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB31","description":"ICD-4DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIED1","description":"ICD-EIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDE1","description":"ICD-NCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45308","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJF1","description":"ICD-CEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric analy w/ph ea spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82930","description":"Gastric analy w/ph ea spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylindr 4.00d/2.12-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2104","description":"Spherocylindr 4.00d/2.12-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLF0","description":"ICD-OKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECB1","description":"ICD-KECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sex transformation f to m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55980","description":"Sex transformation f to m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ cervical or vaginal (any reporting system)_ requiring interpretation by physician (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0831T","description":"Digitization of glass microscope slides for cytopathology_ cervical or vaginal (any reporting system)_ requiring interpretation by physician (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCD1","description":"ICD-JFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1024","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neg press wound therapy pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2402","description":"Neg press wound therapy pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBF0","description":"ICD-ODBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ secukinumab_ IV_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3247","description":"Injection_ secukinumab_ IV_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVD1","description":"ICD-JFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABD1","description":"ICD-CABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKA1","description":"ICD-OLKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73610","description":"X-ray exam of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vbac delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59612","description":"Vbac delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOF1","description":"ICD-LFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUA1","description":"ICD-FAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMC0","description":"ICD-GFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCE0","description":"ICD-KHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sterile saline or water","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4218","description":"Sterile saline or water","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00563","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","description":"CPT-00563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker_ battery powered_ wheeled_ folding_ adjustable or fixed height","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0152","description":"Walker_ battery powered_ wheeled_ folding_ adjustable or fixed height","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flowcytometry/read 9-15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88188","description":"Flowcytometry/read 9-15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67141","description":"Treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49605","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng esa thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4171F","description":"Pt rcvng esa thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKE0","description":"ICD-CHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNF0","description":"ICD-CHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDA0","description":"ICD-MKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAND0","description":"ICD-BAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAE0","description":"ICD-KEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc neck les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21552","description":"Exc neck les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTF1","description":"ICD-OCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLE1","description":"ICD-BCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSB1","description":"ICD-GGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUA1","description":"ICD-JIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKE0","description":"ICD-FAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct capture tmj","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0384","description":"Cone beam ct capture tmj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N-et; commerc carrier pass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2004","description":"N-et; commerc carrier pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement (including removal of existing device)_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69730","description":"Replacement (including removal of existing device)_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1450","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","description":"HCPCS-M1450","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBD0","description":"ICD-FEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWA1","description":"ICD-OGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care prof when the vaccine(s) is not admin on the same date of service for ages under 21_ 16-30 min Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0313","description":"Imm counseling by a physician or other qualified health care prof when the vaccine(s) is not admin on the same date of service for ages under 21_ 16-30 min Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOB1","description":"ICD-LEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCE0","description":"ICD-OJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYE1","description":"ICD-ODYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVF1","description":"ICD-KGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJD1","description":"ICD-JCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sewho airplan desig abdu pos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3960","description":"Sewho airplan desig abdu pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMF1","description":"ICD-MGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28665","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"D/c hemo or perit dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9523","description":"D/c hemo or perit dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIB1","description":"ICD-EGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28415","description":"Treat heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay growth hormone (hgh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83003","description":"Assay growth hormone (hgh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBD0","description":"ICD-MFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABB1","description":"ICD-JABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair double ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33611","description":"Repair double ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIF1","description":"ICD-KHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8E","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0902T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","description":"CPT-0902T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJC1","description":"ICD-NKJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMD1","description":"ICD-KHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64804","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISE0","description":"ICD-PISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (heart transplant)_ cell-free DNA_ PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets)_ plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0055U","description":"Cardiology (heart transplant)_ cell-free DNA_ PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets)_ plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJC1","description":"ICD-CHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOB0","description":"ICD-DDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transvaginal us obstetric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76817","description":"Transvaginal us obstetric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUC1","description":"ICD-NBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of catheter-delivered prosthetic pulmonary valve_ endovascular approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0262T","description":"Implantation of catheter-delivered prosthetic pulmonary valve_ endovascular approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N blk inj sciatic cont inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64446","description":"N blk inj sciatic cont inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBE1","description":"ICD-AHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr trunk 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14000","description":"Tis trnfr trunk 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1A","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML05","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECE1","description":"ICD-IECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap rmvl gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43772","description":"Lap rmvl gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGC1","description":"ICD-CBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEC1","description":"ICD-OHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No transfercare chklist used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0584F","description":"No transfercare chklist used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nitroblue tetrazolium dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86384","description":"Nitroblue tetrazolium dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASD0","description":"ICD-KASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56151","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens polycarb or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2784","description":"Lens polycarb or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ with qualified health care professional in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96119","description":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ with qualified health care professional in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHE0","description":"ICD-GFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dispensing fee_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5241","description":"Dispensing fee_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEF1","description":"ICD-MAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECC0","description":"ICD-CECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M.tuberculo dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87556","description":"M.tuberculo dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nitrogen n-13 ammonia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9526","description":"Nitrogen n-13 ammonia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20C","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLC1","description":"ICD-JHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDD0","description":"ICD-IFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc share dec prior proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9296","description":"Doc share dec prior proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGC1","description":"ICD-KFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIE1","description":"ICD-KBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJD1","description":"ICD-NJJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD217","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUD1","description":"ICD-CFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAD1","description":"ICD-FIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse pancreas cyst and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48540","description":"Fuse pancreas cyst and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11601","description":"Exc tr-ext mal+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vital capacity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94150","description":"Vital capacity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEF0","description":"ICD-BAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA30","description":"Ultra High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHB0","description":"ICD-GBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0684U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684U","description":"CPT-0684U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10D","description":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABA1","description":"ICD-NABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0986T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","description":"CPT-0986T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1504","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1504","description":"CDT-D1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Receiver (Monitor)_ dedicated_ for use with therapeutic continuous glucose mnitor system.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0554","description":"Receiver (Monitor)_ dedicated_ for use with therapeutic continuous glucose mnitor system.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLF1","description":"ICD-ICLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUC0","description":"ICD-GDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQD0","description":"ICD-PIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 2 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3376F","description":"Ajcc brstcncr stage 2 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFC1","description":"ICD-NBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWC1","description":"ICD-GHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sp bone agrft struct add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20938","description":"Sp bone agrft struct add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-invasive vagus nerve stimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0735","description":"Non-invasive vagus nerve stimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21196","description":"Reconst lwr jaw w/fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACF0","description":"ICD-BACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBF1","description":"ICD-EDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5B","description":"Default_ /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYC0","description":"ICD-LIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33779","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysat sol fld vol > 249cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4720","description":"Dialysat sol fld vol > 249cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOA0","description":"ICD-PLOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Agriflu vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2034","description":"Agriflu vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43631","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUC1","description":"ICD-EBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ pmkr/aicd combination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1899","description":"Lead_ pmkr/aicd combination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01924","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","description":"CPT-01924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTA0","description":"ICD-MLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Review_ Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0713T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Review_ Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIA0","description":"ICD-EGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX06","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA50","description":"Default_ /90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8F","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECA1","description":"ICD-EECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTD0","description":"ICD-IFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUE0","description":"ICD-BHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC225","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQA1","description":"ICD-CCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATB1","description":"ICD-EATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hrdtry brst ca-rlatd dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81433","description":"Hrdtry brst ca-rlatd dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHED0","description":"ICD-FHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHD0","description":"ICD-KEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX54","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBA0","description":"ICD-MIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETA1","description":"ICD-GETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLA1","description":"ICD-IBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise spine eltrd perq aray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63663","description":"Revise spine eltrd perq aray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sealant_ pulmonary_ liquid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2615","description":"Sealant_ pulmonary_ liquid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX44","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSA0","description":"ICD-PDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sugars single qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84376","description":"Sugars single qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVD1","description":"ICD-FEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELF1","description":"ICD-JELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eia hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0432","description":"Eia hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red cell mass single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78120","description":"Red cell mass single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Appliance cleaner","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5131","description":"Appliance cleaner","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB11","description":"ICD-3FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genotype cytomegalovirus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87910","description":"Genotype cytomegalovirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIC0","description":"ICD-MHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKC0","description":"ICD-OGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIE0","description":"ICD-NHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDD0","description":"ICD-EIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKA1","description":"ICD-KHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinician Determines Patient Does Not Require Referral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0038","description":"Clinician Determines Patient Does Not Require Referral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69620","description":"Repair of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJC0","description":"ICD-OJJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Talk pt/crgvr re areds prev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4177F","description":"Talk pt/crgvr re areds prev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mrs disc pain alg alys data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0611T","description":"Mrs disc pain alg alys data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECE1","description":"ICD-AECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOE1","description":"ICD-LBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBA1","description":"ICD-AGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1045T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1045T","description":"CPT-1045T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trans shoe solid stirrup new","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3630","description":"Trans shoe solid stirrup new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0584U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","description":"CPT-0584U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBD1","description":"ICD-JIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDA1","description":"ICD-NGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-cov surg proc_clin trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0293","description":"Non-cov surg proc_clin trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKF0","description":"ICD-BHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tte w/o doppler complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93307","description":"Tte w/o doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTF1","description":"ICD-BGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYC1","description":"ICD-CBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6780","description":"Crown 3/4 high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair & adjust spectacles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92370","description":"Repair & adjust spectacles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXD0","description":"ICD-FDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42405","description":"Biopsy of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lang comp current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9159","description":"Lang comp current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs and metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ includes specimen validity and a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0328U","description":"Drug assay_ definitive_ 120 or more drugs and metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ includes specimen validity and a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRA0","description":"ICD-KFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYB0","description":"ICD-OBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1473","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","description":"HCPCS-M1473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect foot/toe tumor 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28047","description":"Resect foot/toe tumor 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricul","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7538","description":"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gated heart planar single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78472","description":"Gated heart planar single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Normal blood pressure reading documented_ follow-up not required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1294","description":"Normal blood pressure reading documented_ follow-up not required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PMS2 (PMS1 homolog 2_ mismatch repair system component) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0161U","description":"PMS2 (PMS1 homolog 2_ mismatch repair system component) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHB1","description":"ICD-KFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45379","description":"Colonoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPC1","description":"ICD-BFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter therapy_ infusion other than for thrombolysis_ any type (eg_ spasmolytic_ vasoconstrictive)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37202","description":"Transcatheter therapy_ infusion other than for thrombolysis_ any type (eg_ spasmolytic_ vasoconstrictive)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transab or transvag us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8806","description":"Transab or transvag us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1355","description":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluid flow or fluid GF_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4206","description":"Fluid flow or fluid GF_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43831","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt reas not rec hcv srn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9385","description":"Doc pt reas not rec hcv srn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain image w/flow 4 + views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78606","description":"Brain image w/flow 4 + views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDC1","description":"ICD-AEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISB0","description":"ICD-HISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTB0","description":"ICD-GFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13C","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sgmdsc w/band ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45350","description":"Sgmdsc w/band ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle transfer shoulder/arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23395","description":"Muscle transfer shoulder/arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0A","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKA1","description":"ICD-NEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occult bld feces 1-3 tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82272","description":"Occult bld feces 1-3 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Oral); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2068","description":"Medication Assisted Treatment_ Buprenorphine (Oral); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monitor elec or comb vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0484","description":"Monitor elec or comb vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB31","description":"ICD-3JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25040","description":"Explore/treat wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary pouch w st wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4392","description":"Urinary pouch w st wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary rubber pouch w fcplt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4380","description":"Urinary rubber pouch w fcplt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47133","description":"Removal of donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIA1","description":"ICD-BIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAB0","description":"ICD-AIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardioversion electric int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92961","description":"Cardioversion electric int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22513","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJB0","description":"ICD-KFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for reconstructive procedures of eyelid (eg_ blepharoplasty_ pto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0114U","description":"Anesthesia for reconstructive procedures of eyelid (eg_ blepharoplasty_ pto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB117","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHC1","description":"ICD-ABHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx gastric recurrent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9103","description":"Onc dx gastric recurrent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUE0","description":"ICD-EEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIC0","description":"ICD-JFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQE0","description":"ICD-OIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracorp shock wv tx ms nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019T","description":"Extracorp shock wv tx ms nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBE0","description":"ICD-IIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMB1","description":"ICD-FAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA21","description":"ICD-4DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYF0","description":"ICD-DGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRD0","description":"ICD-GGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNC0","description":"ICD-CDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCB0","description":"ICD-FFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icatibant injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1744","description":"Icatibant injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30430","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUC1","description":"ICD-GCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy & duct catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52010","description":"Cystoscopy & duct catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24582","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJE0","description":"ICD-OBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPA1","description":"ICD-GAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcath occlusion cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61624","description":"Transcath occlusion cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABF1","description":"ICD-BABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC51","description":"Medium Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPE1","description":"ICD-JCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit wound care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9097","description":"Home visit wound care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lt compres band <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6448","description":"Lt compres band <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No admit w/in 180d req remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9411","description":"No admit w/in 180d req remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBF0","description":"ICD-MGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal shunt placement w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59076","description":"Fetal shunt placement w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFF0","description":"ICD-FAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA31","description":"ICD-1KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIA0","description":"ICD-AEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCB0","description":"ICD-CDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Gemcitabine Hydrochloride (Infugem)_ 200 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9199","description":"Injection_ Gemcitabine Hydrochloride (Infugem)_ 200 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerv col sr foam 2pc pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0172","description":"Cerv col sr foam 2pc pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXD1","description":"ICD-NHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYD1","description":"ICD-CGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIE0","description":"ICD-AHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVD0","description":"ICD-GIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg urin trac obstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2401","description":"Fetal surg urin trac obstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAF0","description":"ICD-NLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; second","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22870","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; second","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPB0","description":"ICD-KAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Primary closure sinus perf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7261","description":"Primary closure sinus perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUC1","description":"ICD-MDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long leg fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4030","description":"Cast sup long leg fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3D","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tamoxifen 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0187","description":"Tamoxifen 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28I","description":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD205","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-61715","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","description":"CPT-61715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovaginal Cryogen-Cooled_ Monopolar Radiofrequency Remodeling Of The Tissues Surrounding The Female Bladder Neck And Proximal Urethra For Urinary Incontinence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0672T","description":"Endovaginal Cryogen-Cooled_ Monopolar Radiofrequency Remodeling Of The Tissues Surrounding The Female Bladder Neck And Proximal Urethra For Urinary Incontinence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXC0","description":"ICD-JHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70310","description":"X-ray exam of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00846","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","description":"CPT-00846","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALB1","description":"ICD-MALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKC1","description":"ICD-OFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFF0","description":"ICD-CGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBF0","description":"ICD-JGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEC0","description":"ICD-GHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCV2 10MCG TRS-SUCR 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071A","description":"ADM SARSCV2 10MCG TRS-SUCR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ue pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8669","description":"Fun stat score ue pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXA1","description":"ICD-GGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQA1","description":"ICD-GHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES217","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVA0","description":"ICD-NLVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft splenorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35536","description":"Art byp grft splenorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carboplatin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9045","description":"Carboplatin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB14","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by abdominal or retroperitoneal inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34833","description":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by abdominal or retroperitoneal inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXD1","description":"ICD-FFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD140","description":"Special Care High _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sinusitis comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9464","description":"Sinusitis comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tacrine hydrochloride_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0014","description":"Tacrine hydrochloride_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUB0","description":"ICD-OLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenervation of abductor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2340","description":"Chemodenervation of abductor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWD1","description":"ICD-DCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC241","description":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX53","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44365","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9326","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","description":"HCPCS-J9326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCF1","description":"ICD-JGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTC1","description":"ICD-IBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare embryo for transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89255","description":"Prepare embryo for transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSA1","description":"ICD-DHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECF1","description":"ICD-MECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDC0","description":"ICD-OCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg strap each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0038","description":"Leg strap each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLF0","description":"ICD-ECLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXD0","description":"ICD-NCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGC0","description":"ICD-CHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6062","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUB0","description":"ICD-KCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAB1","description":"ICD-ABAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydromorphone 250 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0092","description":"Hydromorphone 250 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQA1","description":"ICD-LDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Snrpn/ube3a gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81331","description":"Snrpn/ube3a gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a normal neurological examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9535","description":"Patients with a normal neurological examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carpal tunnel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64721","description":"Carpal tunnel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure_ for example patient bilateral amputee; patient has condition tha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2178","description":"Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure_ for example patient bilateral amputee; patient has condition tha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMC1","description":"ICD-KBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo guidance radiotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6001","description":"Echo guidance radiotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEE0","description":"ICD-MLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX25","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCE1","description":"ICD-EHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDD1","description":"ICD-EEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove thoracic lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38746","description":"Remove thoracic lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ abdominal_ with contrast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9744","description":"Ultrasound_ abdominal_ with contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAD0","description":"ICD-JCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLB1","description":"ICD-FDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEB1","description":"ICD-EHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin pinch graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15050","description":"Skin pinch graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWF0","description":"ICD-GIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGF1","description":"ICD-KDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBA1","description":"ICD-OBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tocilizumab-bavi (tofidence)_ biosimilar_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5133","description":"Injection_ tocilizumab-bavi (tofidence)_ biosimilar_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQD0","description":"ICD-CDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surveillance colonoscopy - personal history of colonic polyps_ colon cancer_ or other malignant neoplasm of rectum_ rectosigmoid junction_ and anus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9936","description":"Surveillance colonoscopy - personal history of colonic polyps_ colon cancer_ or other malignant neoplasm of rectum_ rectosigmoid junction_ and anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQA0","description":"ICD-KAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0063","description":"Cardiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Or Replacement Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0680T","description":"Insertion Or Replacement Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood/uric acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84550","description":"Assay of blood/uric acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"intravenous moderate  (conscious) sedation/analgesia- first 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9239","description":"intravenous moderate  (conscious) sedation/analgesia- first 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal kidney open radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50230","description":"Removal kidney open radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychoanalysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90845","description":"Psychoanalysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIA0","description":"ICD-ADIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I125 iothalamate_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9554","description":"I125 iothalamate_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRB0","description":"ICD-LDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol wipes per box","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4245","description":"Alcohol wipes per box","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMF1","description":"ICD-NIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD116","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap jejunostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44186","description":"Lap jejunostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFC1","description":"ICD-FHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Full Gene Sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81307","description":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Full Gene Sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko dbl upright w/air pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1848","description":"Ko dbl upright w/air pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUD0","description":"ICD-BBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPA1","description":"ICD-OFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLC1","description":"ICD-CCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic donning sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7600","description":"Prosthetic donning sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg congen hernia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2400","description":"Fetal surg congen hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAC1","description":"ICD-ABAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore neck vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35800","description":"Explore neck vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50949","description":"Laparoscope proc ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syringe w/wo needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4657","description":"Syringe w/wo needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIB1","description":"ICD-AGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHA0","description":"ICD-NJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIE1","description":"ICD-JGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGF0","description":"ICD-NCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIND1","description":"ICD-JIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEA0","description":"ICD-NIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHA0","description":"ICD-KGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC06","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAD1","description":"ICD-NKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient is currently on a statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9796","description":"Patient is currently on a statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Order for ceph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9197","description":"Order for ceph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE234","description":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins bone device for rsa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0347T","description":"Ins bone device for rsa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20B","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWA1","description":"ICD-CHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPB0","description":"ICD-GDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECF0","description":"ICD-EECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Audit/dast over 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99409","description":"Audit/dast over 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKD1","description":"ICD-BCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSF1","description":"ICD-HHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Formoterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7640","description":"Formoterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath smear prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0480","description":"Cytopath smear prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPB1","description":"ICD-OCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAD0","description":"ICD-BEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo ankle gauntlet pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1902","description":"Afo ankle gauntlet pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 1 Channel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77785","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 1 Channel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFD0","description":"ICD-CBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (fresenius kabi)_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0612","description":"Injection_ calcium gluconate (fresenius kabi)_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11B","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEED0","description":"ICD-EEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQA1","description":"ICD-CAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00530","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","description":"CPT-00530","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBD0","description":"ICD-JBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sialodochoplasty","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7982","description":"Sialodochoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNF1","description":"ICD-KDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam pelvic complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76856","description":"Us exam pelvic complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTB0","description":"ICD-KDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ home monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9006","description":"Mccd_ home monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALF0","description":"ICD-NALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAB1","description":"ICD-MHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEC0","description":"ICD-JBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLE1","description":"ICD-ADLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ropivacaine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2795","description":"Ropivacaine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nudge control elbow lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6637","description":"Nudge control elbow lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28H","description":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOC1","description":"ICD-HCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rectal control system for vaginal insertion_ for long term use_ includes pump and all supplies and accessories_ any type each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4563","description":"Rectal control system for vaginal insertion_ for long term use_ includes pump and all supplies and accessories_ any type each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXA1","description":"ICD-KIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00211","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","description":"CPT-00211","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEC0","description":"ICD-NIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVE1","description":"ICD-OIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo femoral fx cast soft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2132","description":"Kafo femoral fx cast soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interprof phone/online 31/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99449","description":"Interprof phone/online 31/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brentuximab vedotin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9042","description":"Brentuximab vedotin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTE0","description":"ICD-MFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 std port seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0820","description":"Pwc gp 2 std port seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCD1","description":"ICD-OGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSC1","description":"ICD-PFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIC0","description":"ICD-GBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monosuspension arm/hand supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2630","description":"Monosuspension arm/hand supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc of neg or man pos tb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9360","description":"No doc of neg or man pos tb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Punch biopsy of skin (including simple closure_ when performed); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11104","description":"Punch biopsy of skin (including simple closure_ when performed); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esw wound healing init wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0299T","description":"Esw wound healing init wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINE1","description":"ICD-KINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Herpes simplex nes antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86694","description":"Herpes simplex nes antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQC1","description":"ICD-PBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRA0","description":"ICD-HBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBB0","description":"ICD-NJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmi not documented and no reason is given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1314","description":"Bmi not documented and no reason is given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16072","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16072","description":"CPT-16072","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+ cell count >= 500 cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3496F","description":"Cd4+ cell count >= 500 cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rh ig minidose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90385","description":"Rh ig minidose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth pelvic organ surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84851","description":"Anesth pelvic organ surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Department of Veterans Affairs Whole Health Partner Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9004","description":"Department of Veterans Affairs Whole Health Partner Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENC0","description":"ICD-JENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee control condylar pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2810","description":"Knee control condylar pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEC0","description":"ICD-MGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0101","description":"HCPCS-A0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCB1","description":"ICD-FDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sent lymph node biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8878","description":"Sent lymph node biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ von Willebrand factor (recombinant)_ (Vonvendi)_ 1 IU VWF:RCo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7179","description":"Injection_ von Willebrand factor (recombinant)_ (Vonvendi)_ 1 IU VWF:RCo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPA0","description":"ICD-OHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTF1","description":"ICD-KHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRE0","description":"ICD-LCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRB1","description":"ICD-CIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFC0","description":"ICD-NKFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIF1","description":"ICD-FAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDC1","description":"ICD-MCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUB1","description":"ICD-MIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ elastic long stretch_ linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6597","description":"Gradient compression bandage roll_ elastic long stretch_ linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOE1","description":"ICD-DGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHC1","description":"ICD-NJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVE1","description":"ICD-OJVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPC1","description":"ICD-NBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMB0","description":"ICD-IAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom shape cover ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5705","description":"Custom shape cover ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair urethrovaginal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57310","description":"Repair urethrovaginal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUC1","description":"ICD-OIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDED1","description":"ICD-CDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIB0","description":"ICD-MCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97130","description":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILD1","description":"ICD-CILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Femoral endovas graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34813","description":"Femoral endovas graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXD0","description":"ICD-BCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARA1","description":"ICD-HARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGME1","description":"ICD-OGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC17","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNE0","description":"ICD-GGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMD1","description":"ICD-ECMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUD0","description":"ICD-MGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLD1","description":"ICD-BFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Helicoll_ per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4164","description":"Helicoll_ per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (b braun) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0136","description":"Injection_ acetaminophen (b braun) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANA1","description":"ICD-CANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no follow imag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9555","description":"Doc med reas no follow imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXA1","description":"ICD-JDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0027","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHB1","description":"ICD-FCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGC1","description":"ICD-BHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB52","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYA1","description":"ICD-PGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBC0","description":"ICD-GIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0574","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0574","description":"HCPCS-G0574","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA241","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBF1","description":"ICD-OBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUA1","description":"ICD-GHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYA0","description":"ICD-GCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSF0","description":"ICD-OLSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGC0","description":"ICD-KDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECID1","description":"ICD-ECID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUE0","description":"ICD-FGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25D","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAE0","description":"ICD-GHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No antibio w in 10d of sympt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9287","description":"No antibio w in 10d of sympt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvef mod/sever deprs syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3021F","description":"Lvef mod/sever deprs syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mnt subs tx for change dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0270","description":"Mnt subs tx for change dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trim skin lesions over 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11057","description":"Trim skin lesions over 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjustment gastric band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2083","description":"Adjustment gastric band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCF1","description":"ICD-MHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer water collec devic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7012","description":"Nebulizer water collec devic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab_ via intravitreal implant (Susvimo)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2779","description":"Injection_ ranibizumab_ via intravitreal implant (Susvimo)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Draw blood off venous device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36591","description":"Draw blood off venous device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALF1","description":"ICD-MALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAC0","description":"ICD-OBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPF0","description":"ICD-OGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYF1","description":"ICD-OIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic appliance half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0666","description":"Pneumatic appliance half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQD1","description":"ICD-DAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSC0","description":"ICD-KHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reusable oral thermometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4931","description":"Reusable oral thermometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0536","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","description":"HCPCS-G0536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWF0","description":"ICD-KAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIA1","description":"ICD-OKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patten bottom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2370","description":"Patten bottom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKD0","description":"ICD-GHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFB1","description":"ICD-JHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder harness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5699","description":"Shoulder harness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUC0","description":"ICD-FGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ovrsght xtrcorp liv asst pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0405T","description":"Ovrsght xtrcorp liv asst pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPF1","description":"ICD-JHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCB1","description":"ICD-OBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMA1","description":"ICD-KBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44144","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diphtheria_ tetanus toxoids_ and acellular pertussis vaccine andhemophilus influenza b vaccine (dtap-hib)_ for intramsucular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90721","description":"Diphtheria_ tetanus toxoids_ and acellular pertussis vaccine andhemophilus influenza b vaccine (dtap-hib)_ for intramsucular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastroenterology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91299","description":"Gastroenterology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFF1","description":"ICD-BFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8G","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete cbc w/auto diff wbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85025","description":"Complete cbc w/auto diff wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prior history of known cvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1256","description":"Prior history of known cvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKC1","description":"ICD-NBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJF1","description":"ICD-KCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVA0","description":"ICD-CAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8535","description":"Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYA1","description":"ICD-DDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit enteral grav diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9341","description":"Hit enteral grav diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHD1","description":"ICD-CDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCD1","description":"ICD-MJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC21","description":"ICD-4EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJME0","description":"ICD-MJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58976","description":"Transfer of embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWE1","description":"ICD-GHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAD0","description":"ICD-IBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXE0","description":"ICD-GCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTD0","description":"ICD-OBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iris support intraoclr lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2631","description":"Iris support intraoclr lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOB1","description":"ICD-KCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIF0","description":"ICD-NKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29405","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDE1","description":"ICD-KGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21B","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACA0","description":"ICD-IACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0799T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thrombin time titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85675","description":"Thrombin time titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Root surgery molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3425","description":"Root surgery molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXD1","description":"ICD-KDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lg vol nebulizer disposable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7007","description":"Lg vol nebulizer disposable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligate/divide/excise vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37785","description":"Ligate/divide/excise vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSE0","description":"ICD-CDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC113","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKA0","description":"ICD-CGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shldr disartic switch contro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6960","description":"Shldr disartic switch contro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ margetuximab-cmkb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9353","description":"Injection_ margetuximab-cmkb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44155","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eardrum revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69450","description":"Eardrum revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB206","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEE0","description":"ICD-CIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVB0","description":"ICD-BAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOB1","description":"ICD-CAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELD0","description":"ICD-AELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQC0","description":"ICD-CFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVE0","description":"ICD-CHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA25","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Statin presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9441","description":"Statin presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE235","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cocaine or metabolite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6044","description":"Cocaine or metabolite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx laryngoscopy excl nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31525","description":"Dx laryngoscopy excl nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orphenadrine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2360","description":"Orphenadrine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tb scrng done-interpd 6mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3455F","description":"Tb scrng done-interpd 6mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBF1","description":"ICD-NKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_Nivolumab_ 1mg (Opdivo)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9453","description":"Injection_Nivolumab_ 1mg (Opdivo)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCE0","description":"ICD-CHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supply/ext inf pump syr type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0552","description":"Supply/ext inf pump syr type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGF0","description":"ICD-OLGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD205","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 resin-based compos","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2712","description":"Crown 3/4 resin-based compos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autotransplant parathyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60512","description":"Autotransplant parathyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVD1","description":"ICD-NHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Back Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2138","description":"Back Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIE0","description":"ICD-OAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74247","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHE0","description":"ICD-CIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCE1","description":"ICD-ICCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Male condom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4267","description":"Male condom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of phenylketones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84035","description":"Assay of phenylketones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENF1","description":"ICD-CENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient in hospice at any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9758","description":"Patient in hospice at any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval aud status rehab add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92627","description":"Eval aud status rehab add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8G","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat penis lesion graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54112","description":"Treat penis lesion graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1046","description":"Functional status measurement with score was not obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cosyntropin cortrosyn inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0834","description":"Cosyntropin cortrosyn inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tyrosinemia type I monitoring by patient-collected blood card sample_ quantitative measurement of tyrosine_ phenylalanine_ methionine_ succinylacetone_ nitisinone_ liquid chro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0383U","description":"Tyrosinemia type I monitoring by patient-collected blood card sample_ quantitative measurement of tyrosine_ phenylalanine_ methionine_ succinylacetone_ nitisinone_ liquid chro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDID0","description":"ICD-KDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEE1","description":"ICD-EIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLB1","description":"ICD-BGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIF1","description":"ICD-NHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef blenderized foods","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4149","description":"Ef blenderized foods","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intradermal Cancer Immunotherapy; Preparation And Initial Injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0708T","description":"Intradermal Cancer Immunotherapy; Preparation And Initial Injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26478","description":"Lengthening of hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBA1","description":"ICD-ACBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18A","description":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETD0","description":"ICD-KETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAD0","description":"ICD-MGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESE0","description":"ICD-OESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB144","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Poliovirus vaccine_ (any type(s)) (opv)_ live_ for oral use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90712","description":"Poliovirus vaccine_ (any type(s)) (opv)_ live_ for oral use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGA1","description":"ICD-BAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9811","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9811","description":"HCPCS-C9811","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63272","description":"Excise intrspinl lesion lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKF0","description":"ICD-OAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOD1","description":"ICD-OKOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sphyg/bp app w cuff and stet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4660","description":"Sphyg/bp app w cuff and stet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUC0","description":"ICD-OJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCV2 3MCG TRS-SUCR 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0081A","description":"ADM SARSCV2 3MCG TRS-SUCR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNE0","description":"ICD-JDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88374","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYE0","description":"ICD-OFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSA0","description":"ICD-LDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extraction erupted tooth/exr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7140","description":"Extraction erupted tooth/exr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on external_ middle_ and inner ear including biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0117U","description":"Anesthesia for procedures on external_ middle_ and inner ear including biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Torsion ank & half solid sti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2375","description":"Torsion ank & half solid sti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ tubular protective absorption layer_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6607","description":"Gradient compression bandaging supply_ tubular protective absorption layer_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGND0","description":"ICD-GGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB11","description":"ICD-4DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quinupristin/dalfopristin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2770","description":"Quinupristin/dalfopristin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXA1","description":"ICD-CAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2099","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRA1","description":"ICD-HGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQD0","description":"ICD-HCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shorten/lengthen thighs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27468","description":"Shorten/lengthen thighs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHC0","description":"ICD-FDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Redo compl cardiac anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33622","description":"Redo compl cardiac anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVA1","description":"ICD-NLVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METC1","description":"ICD-METC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAA1","description":"ICD-AIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDC0","description":"ICD-CDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grp a strep test performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3210F","description":"Grp a strep test performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUE1","description":"ICD-GBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALB1","description":"ICD-KALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFED0","description":"ICD-NFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX23","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWE0","description":"ICD-LIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2109","description":"Spherocylinder 4.25d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNF0","description":"ICD-KFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee jnt ratchet lock ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2430","description":"Knee jnt ratchet lock ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75736","description":"Artery x-rays pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFC1","description":"ICD-NKFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of hand or finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29280","description":"Strapping of hand or finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKB1","description":"ICD-CBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWE0","description":"ICD-DHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVF0","description":"ICD-OJVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEF1","description":"ICD-AHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estriol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82677","description":"Assay of estriol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA213","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUE0","description":"ICD-NDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTB1","description":"ICD-MGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKB0","description":"ICD-JGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1104T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1104T","description":"CPT-1104T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOE1","description":"ICD-LDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOE0","description":"ICD-PCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB11","description":"ICD-4FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sialidase enzyme assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87905","description":"Sialidase enzyme assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTB0","description":"ICD-IDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient transferred directly from anesthetizing location to PACE or other non-ICU location","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9656","description":"Patient transferred directly from anesthetizing location to PACE or other non-ICU location","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEB1","description":"ICD-NHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure for percutaneous transhepatic cholangiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47500","description":"Injection procedure for percutaneous transhepatic cholangiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA11","description":"ICD-3JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDF0","description":"ICD-NCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUA1","description":"ICD-NBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67902","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUB1","description":"ICD-IAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive jaw surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21045","description":"Extensive jaw surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYD1","description":"ICD-GIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ casimersen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1426","description":"Injection_ casimersen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33840","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUF1","description":"ICD-IAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1942","description":"Injection_ aripiprazole lauroxil_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Review patient spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94016","description":"Review patient spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44800","description":"Excision of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trluml perip athrc renal art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0234T","description":"Trluml perip athrc renal art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSB0","description":"ICD-GBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABA0","description":"ICD-CABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBD1","description":"ICD-CFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"guided tissue regeneration_ edentulous area - non-resorbable barrier_ per site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7957","description":"guided tissue regeneration_ edentulous area - non-resorbable barrier_ per site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOF0","description":"ICD-LIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01682","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01682","description":"CPT-01682","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tymp memb motion examd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2035F","description":"Tymp memb motion examd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ace/arb thxpy not rxd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8475","description":"Ace/arb thxpy not rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOE0","description":"ICD-DGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWC0","description":"ICD-PEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion radioulnar jnt/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25830","description":"Fusion radioulnar jnt/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHD1","description":"ICD-EHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo pla sin up w/wo k/a cus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2034","description":"Kafo pla sin up w/wo k/a cus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0402","description":"HCPCS-B0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX45","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCF0","description":"ICD-MHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intrpulmnry percuss vent sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0481","description":"Intrpulmnry percuss vent sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIC1","description":"ICD-BHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB46","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10D","description":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Innovamatrix FS_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2013","description":"Innovamatrix FS_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ob us nuchal meas add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76814","description":"Ob us nuchal meas add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX44","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28B","description":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 11-20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99442","description":"Phone e/m phys/qhp 11-20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01270","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","description":"CPT-01270","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bupren/nal 6.1 to 10mg bupre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0574","description":"Bupren/nal 6.1 to 10mg bupre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imp/abut fixed dent part man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6117","description":"Imp/abut fixed dent part man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRA1","description":"ICD-OGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEB1","description":"ICD-NCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQB0","description":"ICD-KHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47051","description":"Anesth removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovas iliac a device addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34808","description":"Endovas iliac a device addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"5+ cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4209","description":"5+ cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSB0","description":"ICD-CGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13C","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cstm manual wheelchair/base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0008","description":"Cstm manual wheelchair/base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36563","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBD1","description":"ICD-NDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/endoscope us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45391","description":"Colonoscopy w/endoscope us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTC0","description":"ICD-OCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVC0","description":"ICD-NLVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nutrition class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9452","description":"Nutrition class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETA0","description":"ICD-OETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sinus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31299","description":"Sinus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18E","description":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0215T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUA1","description":"ICD-GAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incis w/discectomy cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22220","description":"Incis w/discectomy cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMD0","description":"ICD-IFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wc planar back cush wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2620","description":"Wc planar back cush wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flexhd/allopatchhd/matrixhd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4128","description":"Flexhd/allopatchhd/matrixhd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB42","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFD1","description":"ICD-JBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAC1","description":"ICD-OJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1 quant&revrse trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87536","description":"Hiv-1 quant&revrse trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNE1","description":"ICD-BCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPD1","description":"ICD-JDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTC1","description":"ICD-OBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1055T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1055T","description":"CPT-1055T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace chest compress vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7025","description":"Replace chest compress vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMA0","description":"ICD-JGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01770","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","description":"CPT-01770","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2D","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALA1","description":"ICD-BALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limb exercise test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95875","description":"Limb exercise test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX15","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBB0","description":"ICD-AFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estradiol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82670","description":"Assay of estradiol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEB0","description":"ICD-AEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIA0","description":"ICD-KBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Position back cush wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2614","description":"Position back cush wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGC1","description":"ICD-CDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antinomyces antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86602","description":"Antinomyces antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMD0","description":"ICD-KCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thiamine hcl 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3411","description":"Thiamine hcl 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00541","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","description":"CPT-00541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4047","description":"Cast sup sht leg splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23655","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deoxycortisol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82634","description":"Deoxycortisol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6072","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDA0","description":"ICD-JEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWA1","description":"ICD-OCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunosuppressive drug noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7599","description":"Immunosuppressive drug noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRE0","description":"ICD-HGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC111","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOA0","description":"ICD-LCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEB0","description":"ICD-GDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAB1","description":"ICD-CFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tone decay hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92563","description":"Tone decay hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIF0","description":"ICD-FDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove pelvis lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38770","description":"Remove pelvis lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVB0","description":"ICD-JIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01958","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","description":"CPT-01958","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31800","description":"Repair of windpipe injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARA1","description":"ICD-CARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA21","description":"ICD-2EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oseltamivir phosphate 75mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9019","description":"Oseltamivir phosphate 75mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALE1","description":"ICD-GALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXF0","description":"ICD-NHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mobility goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8979","description":"Mobility goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services given to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9740","description":"Hospice services given to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIE1","description":"ICD-JDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal Vaccine Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9991","description":"Pneumococcal Vaccine Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQF0","description":"ICD-DCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin polyc mch sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5816","description":"Endo knee-shin polyc mch sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nushield 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4160","description":"Nushield 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE106","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTC1","description":"ICD-ADTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYF0","description":"ICD-CEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNA0","description":"ICD-JHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diag bronchoscope/catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31643","description":"Diag bronchoscope/catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUB1","description":"ICD-ABUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Capecitabine_ oral_ 150 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8520","description":"Capecitabine_ oral_ 150 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9455","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Final refract +/- 1.0 in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9519","description":"Final refract +/- 1.0 in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQB0","description":"ICD-PGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHC0","description":"ICD-MDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nabilone oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8650","description":"Nabilone oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct angiography chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71275","description":"Ct angiography chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj sc/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96372","description":"Ther/proph/diag inj sc/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration popliteal artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35741","description":"Exploration popliteal artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUA1","description":"ICD-MLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXE0","description":"ICD-KFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iop down <15% of pre-svc lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3285F","description":"Iop down <15% of pre-svc lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-H0053","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","description":"HCPCS-H0053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAF1","description":"ICD-NFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure of valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33600","description":"Closure of valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMF0","description":"ICD-EDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGC0","description":"ICD-KIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-1 piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21145","description":"Lefort i-1 piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removable prosthodontic proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5899","description":"Removable prosthodontic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVB1","description":"ICD-BHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYB1","description":"ICD-CIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75651","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWA1","description":"ICD-CIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplant forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25312","description":"Transplant forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deluxe item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1001","description":"Deluxe item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fx rad intra-articul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25608","description":"Treat fx rad intra-articul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23150","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sirolimus protein-bound particles_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9331","description":"Injection_ sirolimus protein-bound particles_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAD1","description":"ICD-EFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73525","description":"Contrast x-ray of hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spine disk surgery thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63077","description":"Spine disk surgery thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD106","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJE0","description":"ICD-KDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHF1","description":"ICD-FDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQD0","description":"ICD-CGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAE1","description":"ICD-IDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLB1","description":"ICD-MHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECC1","description":"ICD-FECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PolyCyte_ for topical use only_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4241","description":"PolyCyte_ for topical use only_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0A","description":"High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch faceplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5053","description":"Clsd ostomy pouch faceplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCE1","description":"ICD-IFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct thorax w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71270","description":"Ct thorax w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Int therapeutic restoration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2941","description":"Int therapeutic restoration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCF1","description":"ICD-JDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA03","description":"Default_ /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht pharm per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9810","description":"Ht pharm per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWA1","description":"ICD-KCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPB1","description":"ICD-OHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99341","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC36","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAC1","description":"ICD-OHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUC1","description":"ICD-FDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI w/o fol w/cont_ breast_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8908","description":"MRI w/o fol w/cont_ breast_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIE0","description":"ICD-AAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELA1","description":"ICD-KELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zanamivir_inhalation pwd 10m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9018","description":"Zanamivir_inhalation pwd 10m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRA0","description":"ICD-CBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHB1","description":"ICD-EDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUA1","description":"ICD-GGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ plasma analysis of 388 proteins_ using aptamer-based proteomics technology_ predictive algorithm reported as clinical benefit from immune checkpoint inhibitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0436U","description":"Oncology (lung)_ plasma analysis of 388 proteins_ using aptamer-based proteomics technology_ predictive algorithm reported as clinical benefit from immune checkpoint inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-49189","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","description":"CPT-49189","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGD1","description":"ICD-BFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23552","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no pt cat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9429","description":"Doc med reas no pt cat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88012","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXC0","description":"ICD-ODXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHB1","description":"ICD-FAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCE0","description":"ICD-ODCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUA1","description":"ICD-KAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Init day hosp neonate care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99477","description":"Init day hosp neonate care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXE0","description":"ICD-GEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allergy immunology services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95199","description":"Allergy immunology services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-81354","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","description":"CPT-81354","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneuma compresor non-segment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0650","description":"Pneuma compresor non-segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA32","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWA0","description":"ICD-KFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHID1","description":"ICD-MHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVF1","description":"ICD-FBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sperm isolation complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89261","description":"Sperm isolation complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHF0","description":"ICD-JBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUB0","description":"ICD-JGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBD1","description":"ICD-NGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enterectomy w/o taper cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44126","description":"Enterectomy w/o taper cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTF1","description":"ICD-OFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWB1","description":"ICD-LGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impl/redo electrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43881","description":"Impl/redo electrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUE1","description":"ICD-FIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAE1","description":"ICD-MIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBD0","description":"ICD-CDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"DO GNOTYP ART4 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0184U","description":"DO GNOTYP ART4 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQE0","description":"ICD-OBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDF0","description":"ICD-ECDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0539","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","description":"HCPCS-G0539","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01830","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","description":"CPT-01830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMC0","description":"ICD-CGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMC0","description":"ICD-JFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA255","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shank ft w vert load pylon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5987","description":"Shank ft w vert load pylon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33417","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fem/popl revas w/tla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37224","description":"Fem/popl revas w/tla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPB0","description":"ICD-OHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXC0","description":"ICD-NLXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTB1","description":"ICD-MBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHE1","description":"ICD-NGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBA0","description":"ICD-OCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with ureteroscopy and/or pyeloscopy_ with lithotripsy (ureteral catheterization is included) and vacuum aspiration of the kidney_ collecting system and uret","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9761","description":"Cystourethroscopy_ with ureteroscopy and/or pyeloscopy_ with lithotripsy (ureteral catheterization is included) and vacuum aspiration of the kidney_ collecting system and uret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art or venous blood tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4750","description":"Art or venous blood tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zenith Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4253","description":"Zenith Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/4.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2209","description":"Lens sphcy bifocal 4.25-7/4.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETD1","description":"ICD-BETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay synovial fluid mucin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83872","description":"Assay synovial fluid mucin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEE1","description":"ICD-GEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVA1","description":"ICD-NHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36014","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUE1","description":"ICD-MCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQC1","description":"ICD-KFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUF1","description":"ICD-AGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBE0","description":"ICD-NCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHA0","description":"ICD-FCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0804","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0804","description":"CDT-D0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENF1","description":"ICD-NENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKA0","description":"ICD-NGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us guidance fetal reduct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8055","description":"Us guidance fetal reduct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKD1","description":"ICD-OFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVB1","description":"ICD-CGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPE0","description":"ICD-FAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJC1","description":"ICD-OKJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8D","description":"High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injectable poly-l-lactic acid_ restorative implant_ 1 ml_ face (deep dermis_ subcutaneous layers)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0196","description":"Injectable poly-l-lactic acid_ restorative implant_ 1 ml_ face (deep dermis_ subcutaneous layers)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36565","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRC1","description":"ICD-KHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD246","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of arm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24134","description":"Removal of arm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLA1","description":"ICD-JHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18I","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJE0","description":"ICD-GHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAB1","description":"ICD-GBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEB1","description":"ICD-FDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mycophenolate mofetil oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7517","description":"Mycophenolate mofetil oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25931","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc forearm les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25075","description":"Exc forearm les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX21","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEB0","description":"ICD-MCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Norsn no ct rpt to reg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9326","description":"Norsn no ct rpt to reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBE1","description":"ICD-GHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUA1","description":"ICD-MFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC235","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 81 Years And Older With A Diagnosis Of Frailty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2131","description":"Patients 81 Years And Older With A Diagnosis Of Frailty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-ss pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0457","description":"Tlso flex trnk sj-ss pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMB1","description":"ICD-IFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXB1","description":"ICD-OIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEC1","description":"ICD-BIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays adrenals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75733","description":"Artery x-rays adrenals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantation_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside of the mastoid and resulting in removal of greater","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69729","description":"Implantation_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside of the mastoid and resulting in removal of greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0670U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0670U","description":"CPT-0670U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAC1","description":"ICD-NIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Follow-up angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75898","description":"Follow-up angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove electrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43882","description":"Revise/remove electrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQD1","description":"ICD-HIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWC0","description":"ICD-DDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 10 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0446U","description":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 10 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIF0","description":"ICD-FHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"R hrt coronary artery angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93456","description":"R hrt coronary artery angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBD1","description":"ICD-KDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRD1","description":"ICD-OLRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEA1","description":"ICD-OJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20701","description":"Removal Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIF1","description":"ICD-AHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAA1","description":"ICD-NAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28190","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00910","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","description":"CPT-00910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOB0","description":"ICD-OFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvef <40% or dep lv sys fcn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8934","description":"Lvef <40% or dep lv sys fcn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of hip joint/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27036","description":"Excision of hip joint/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc rect tum transanal full","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45172","description":"Exc rect tum transanal full","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Free fascial flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15758","description":"Free fascial flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ or hematolymphoid neoplasm or disorder_ 51 or greater genes (eg_ ALK_ BRAF_ CDKN2A_ CEBPA_ DNMT3A_ EGFR_ ERBB2_ EZH2_ FLT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81456","description":"Targeted genomic sequence analysis panel_ solid organ or hematolymphoid neoplasm or disorder_ 51 or greater genes (eg_ ALK_ BRAF_ CDKN2A_ CEBPA_ DNMT3A_ EGFR_ ERBB2_ EZH2_ FLT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIC0","description":"ICD-CIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attendant care service /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5126","description":"Attendant care service /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJE0","description":"ICD-BCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUA0","description":"ICD-OEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj excisn of joint membrane","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7854","description":"Tmj excisn of joint membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tah rad dissect for debulk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58953","description":"Tah rad dissect for debulk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBD1","description":"ICD-ABBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITB1","description":"ICD-JITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAF1","description":"ICD-JEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXC1","description":"ICD-FGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec size w/ leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1224","description":"Wheelchair spec size w/ leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTB0","description":"ICD-EBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ nuclear magnetic resonance spectroscopy measurement of myo-inositol_ valine_ and creatinine_ algorithmically combined with cystatin C (by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0259U","description":"Nephrology (chronic kidney disease)_ nuclear magnetic resonance spectroscopy measurement of myo-inositol_ valine_ and creatinine_ algorithmically combined with cystatin C (by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fistula cannulation set_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4730","description":"Fistula cannulation set_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQB0","description":"ICD-OJQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phenylephrine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2370","description":"Phenylephrine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLE0","description":"ICD-CDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-S4024","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","description":"HCPCS-S4024","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWD0","description":"ICD-HFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of leg artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34203","description":"Removal of leg artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0604U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","description":"CPT-0604U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93971","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESC0","description":"ICD-PESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunohisto antibody slide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88344","description":"Immunohisto antibody slide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJE1","description":"ICD-KAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITC1","description":"ICD-IITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHF0","description":"ICD-JGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBA1","description":"ICD-MJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACC0","description":"ICD-KACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXC0","description":"ICD-NAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEA1","description":"ICD-OLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis volume measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81050","description":"Urinalysis volume measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ anifrolumab-fnia_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0491","description":"Injection_ anifrolumab-fnia_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAME0","description":"ICD-AAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCC0","description":"ICD-CFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place po breast cath for rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19296","description":"Place po breast cath for rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELE0","description":"ICD-AELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nondisposable nebulizer set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7005","description":"Nondisposable nebulizer set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFD1","description":"ICD-GBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB221","description":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIB0","description":"ICD-OCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Modification diabetic shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5507","description":"Modification diabetic shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SLCO1B1 (solute carrier organic anion transporter family_ member 1B1) (eg_ adverse drug reaction)_ gene analysis_ common variant(s) (eg_ *5)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81328","description":"SLCO1B1 (solute carrier organic anion transporter family_ member 1B1) (eg_ adverse drug reaction)_ gene analysis_ common variant(s) (eg_ *5)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJE1","description":"ICD-GCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXC0","description":"ICD-KIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Last Colonoscopy Incomplete_ Last Colonoscopy Had Inadequate Prep_ Pi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9998","description":"Documentation Of Medical Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Last Colonoscopy Incomplete_ Last Colonoscopy Had Inadequate Prep_ Pi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXF0","description":"ICD-OJXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24515","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTB0","description":"ICD-OFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXD0","description":"ICD-FAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES140","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUC1","description":"ICD-NAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUC0","description":"ICD-IIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGB0","description":"ICD-KFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0370T","description":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKA1","description":"ICD-CIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJD1","description":"ICD-OAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB106","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINC1","description":"ICD-OINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28C","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHD0","description":"ICD-OLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11622","description":"Exc s/n/h/f/g mal+mrg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Atten goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9166","description":"Atten goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA02","description":"Default_ /Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYB1","description":"ICD-KIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBD1","description":"ICD-OLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilated macular exam was not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9893","description":"Dilated macular exam was not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEF0","description":"ICD-EAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Set up port xray equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0092","description":"Set up port xray equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKE1","description":"ICD-OIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant (fresenius kabi) not therapeutically equivalent to j9395_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9394","description":"Injection_ fulvestrant (fresenius kabi) not therapeutically equivalent to j9395_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1471","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","description":"HCPCS-M1471","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYA0","description":"ICD-PHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKA1","description":"ICD-KCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBA0","description":"ICD-NGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUF0","description":"ICD-JDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIC0","description":"ICD-BDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stat lab home/nf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3601","description":"Stat lab home/nf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNB1","description":"ICD-FDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fee covid-19 vac 2 res","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014A","description":"Fee covid-19 vac 2 res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Portable liquid 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0434","description":"Portable liquid 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJC0","description":"ICD-BDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILD0","description":"ICD-AILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC145","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antibiotic not pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8708","description":"Antibiotic not pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRE0","description":"ICD-PLRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHE0","description":"ICD-IAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo_ colon_ retro imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1749","description":"Endo_ colon_ retro imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surg reduct osseoustuberosit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7485","description":"Surg reduct osseoustuberosit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xcm biologic tiss matrix 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4142","description":"Xcm biologic tiss matrix 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFE1","description":"ICD-OHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFB0","description":"ICD-OLFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSD0","description":"ICD-PGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLD1","description":"ICD-ABLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQF1","description":"ICD-HFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTC1","description":"ICD-MDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr s/a/l 10.1-30 sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14021","description":"Tis trnfr s/a/l 10.1-30 sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of carotene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82380","description":"Assay of carotene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLB0","description":"ICD-OJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFE1","description":"ICD-JDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg1a-b no pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9113","description":"Onc dx ovarian stg1a-b no pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDD1","description":"ICD-OEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTC1","description":"ICD-GFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCC1","description":"ICD-BHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOC0","description":"ICD-CHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cranial cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61001","description":"Remove cranial cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYA1","description":"ICD-KAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54318","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDA0","description":"ICD-GDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0519","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0519","description":"HCPCS-Q0519","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVF1","description":"ICD-KCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHE1","description":"ICD-EGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKA1","description":"ICD-CGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cannabinoids synthetic 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80351","description":"Cannabinoids synthetic 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44151","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg >4.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11406","description":"Exc tr-ext b9+marg >4.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDED1","description":"ICD-FDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEB0","description":"ICD-FEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTA1","description":"ICD-ECTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQC1","description":"ICD-LCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi_ antibody detection of 12 recombinant protein groups_ by immunoblot_ IgG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042U","description":"Borrelia burgdorferi_ antibody detection of 12 recombinant protein groups_ by immunoblot_ IgG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Topotecan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9351","description":"Topotecan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLD0","description":"ICD-EGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNA1","description":"ICD-BDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKD1","description":"ICD-GIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQB0","description":"ICD-GAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing patient serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86904","description":"Blood typing patient serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEC1","description":"ICD-JGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICB1","description":"ICD-FICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAC0","description":"ICD-MFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJC1","description":"ICD-BCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tension ring_ vac erect dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7902","description":"Tension ring_ vac erect dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBF1","description":"ICD-IIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33984","description":"Ecmo/ecls rmvl prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cadaver donor kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50300","description":"Remove cadaver donor kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain ovary abscess percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58822","description":"Drain ovary abscess percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Placement bile duct support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47801","description":"Placement bile duct support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stnd hemi (low seat) whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0002","description":"Stnd hemi (low seat) whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYE1","description":"ICD-HDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDA0","description":"ICD-AEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDB1","description":"ICD-GGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICF1","description":"ICD-FICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay chondroitin sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82485","description":"Assay chondroitin sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQF0","description":"ICD-HBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEC1","description":"ICD-MIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tooth splitting","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3920","description":"Tooth splitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect back tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21936","description":"Resect back tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1101","description":"HCPCS-B1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILF0","description":"ICD-KILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVE0","description":"ICD-JAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEA0","description":"ICD-FGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDF1","description":"ICD-GFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOA0","description":"ICD-HEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUE1","description":"ICD-KGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADB1","description":"ICD-MADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARA1","description":"ICD-DARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00770","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","description":"CPT-00770","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDA0","description":"ICD-CBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCE0","description":"ICD-NDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTA1","description":"ICD-NJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAF0","description":"ICD-ACAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHA0","description":"ICD-BCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit anti-hemophil diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9345","description":"Hit anti-hemophil diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUA0","description":"ICD-EDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECC1","description":"ICD-CECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHF1","description":"ICD-JDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ferritin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82728","description":"Assay of ferritin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAC0","description":"ICD-NGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAA0","description":"ICD-OLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAC0","description":"ICD-BHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDB0","description":"ICD-IEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOA1","description":"ICD-OGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEB0","description":"ICD-JGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAE0","description":"ICD-EHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKB1","description":"ICD-KCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42962","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMB1","description":"ICD-FFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC213","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth trach-bronch reconst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53951","description":"Anesth trach-bronch reconst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABD1","description":"ICD-MABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIF0","description":"ICD-MHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosth retina receive&gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0100T","description":"Prosth retina receive&gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBD0","description":"ICD-JGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEA1","description":"ICD-FGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMC0","description":"ICD-CAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACF0","description":"ICD-IACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMF1","description":"ICD-KFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anes spine tranthor w/o vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62551","description":"Anes spine tranthor w/o vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immed mand part dent metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5224","description":"Immed mand part dent metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPC0","description":"ICD-KAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sodium thiosulfate (hope)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0209","description":"Injection_ sodium thiosulfate (hope)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58400","description":"Suspension of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Silvr oxide batt glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4236","description":"Silvr oxide batt glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl/rplc nstim apnea pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0431T","description":"Rmvl/rplc nstim apnea pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77062","description":"Breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEE1","description":"ICD-ABEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITC0","description":"ICD-FITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD214","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEA0","description":"ICD-EDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald_ tv amplifier_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5270","description":"Ald_ tv amplifier_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Near-infrared spectroscopy studies of lower extremity wounds (eg_ for oxyhemoglobin measurement)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0493T","description":"Near-infrared spectroscopy studies of lower extremity wounds (eg_ for oxyhemoglobin measurement)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBA1","description":"ICD-CHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWC1","description":"ICD-PFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incomplete endodontic tx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3332","description":"Incomplete endodontic tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0211","description":"Injection_ sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pmkr_ dual_ rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1785","description":"Pmkr_ dual_ rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Str markers spec anal addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81266","description":"Str markers spec anal addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERB1","description":"ICD-DERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0005","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNF0","description":"ICD-CFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUF0","description":"ICD-MDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEF0","description":"ICD-CFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAED0","description":"ICD-KAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDE1","description":"ICD-GHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHC1","description":"ICD-BFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Full sole/heel wedge btween","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3420","description":"Full sole/heel wedge btween","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Ramucirumab_ 5 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9025","description":"Injection_ Ramucirumab_ 5 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB17","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25263","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABC0","description":"ICD-AABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Battery pneum vad replacemnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0503","description":"Battery pneum vad replacemnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHF0","description":"ICD-NKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWC0","description":"ICD-GDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"XWRAP_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4204","description":"XWRAP_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB43","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGB0","description":"ICD-NKGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHB1","description":"ICD-GGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4B","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath concentrate tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88108","description":"Cytopath concentrate tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDC1","description":"ICD-CFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADC1","description":"ICD-JADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0682","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","description":"HCPCS-G0682","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External bleaching home app","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9975","description":"External bleaching home app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36576","description":"Repair tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTD1","description":"ICD-AFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKE1","description":"ICD-FAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC114","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE220","description":"Reduced Physical Function _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVC0","description":"ICD-JFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAF0","description":"ICD-EEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDE1","description":"ICD-FBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBB1","description":"ICD-ICBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNC0","description":"ICD-JBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTD1","description":"ICD-KBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWA1","description":"ICD-DGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHD1","description":"ICD-KAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ copanlisib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9057","description":"Injection_ copanlisib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOE0","description":"ICD-OIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli_ Automated Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92650","description":"Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli_ Automated Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWC1","description":"ICD-LIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Derm autograft f/n/hf/g add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15136","description":"Derm autograft f/n/hf/g add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crutch forearm each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0111","description":"Crutch forearm each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB106","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78205","description":"Liver imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epsd bk pain for >12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1137F","description":"Epsd bk pain for >12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4395","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","description":"HCPCS-Q4395","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44160","description":"Removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDC0","description":"ICD-NFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01150","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","description":"CPT-01150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harvest Of Upper Extremity Artery_ 1 Segment_ For Coronary Artery Bypass Procedure_ Endoscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33509","description":"Harvest Of Upper Extremity Artery_ 1 Segment_ For Coronary Artery Bypass Procedure_ Endoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0539T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8F","description":"Very High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQB1","description":"ICD-HBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg cast chg wrst/elb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6380","description":"Postop dsg cast chg wrst/elb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assessment Of Salivary Flow By Measurement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0419","description":"Assessment Of Salivary Flow By Measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlamydia trachomatis ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87270","description":"Chlamydia trachomatis ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEB0","description":"ICD-GEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj foramen epidural add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64480","description":"Inj foramen epidural add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDC0","description":"ICD-KDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFA0","description":"ICD-OEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBC1","description":"ICD-AEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDB1","description":"ICD-IIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26608","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBB1","description":"ICD-JFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8I","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBC0","description":"ICD-BFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis a igm antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86709","description":"Hepatitis a igm antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMA0","description":"ICD-OAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRE1","description":"ICD-PBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ivf canc a stim case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4017","description":"Ivf canc a stim case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak 4 bar link w/fric swing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5611","description":"Ak 4 bar link w/fric swing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDB0","description":"ICD-KCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPB0","description":"ICD-KHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth sternal debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55051","description":"Anesth sternal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8F","description":"High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dressing change not for burn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15852","description":"Dressing change not for burn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electric stimulation therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97014","description":"Electric stimulation therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress fingers/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26037","description":"Decompress fingers/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","description":"HCPCS-M1392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEC0","description":"ICD-CFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41800","description":"Drainage of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVD1","description":"ICD-KDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ethylene glycol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82693","description":"Assay of ethylene glycol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep bk ptb laminated socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5540","description":"Prep bk ptb laminated socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOD0","description":"ICD-KCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLF1","description":"ICD-AFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFD0","description":"ICD-KIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDED0","description":"ICD-EDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Uvl sys panel 6 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0693","description":"Uvl sys panel 6 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor wght kininogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85293","description":"Clot factor wght kininogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spacer without mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8100","description":"Spacer without mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSC1","description":"ICD-CGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILB1","description":"ICD-BILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGF0","description":"ICD-FAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDE0","description":"ICD-MLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxaliplatin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9263","description":"Oxaliplatin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWC0","description":"ICD-PKWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIA0","description":"ICD-KAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXF0","description":"ICD-OFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWB0","description":"ICD-HFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHB0","description":"ICD-BCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOB0","description":"ICD-OJOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24101","description":"Explore/treat elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUC0","description":"ICD-GGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOD1","description":"ICD-LDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQF1","description":"ICD-GCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOD1","description":"ICD-PDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIC1","description":"ICD-MLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vestibuloplasty ridge extens","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7340","description":"Vestibuloplasty ridge extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLC1","description":"ICD-JDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOE1","description":"ICD-KGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIC1","description":"ICD-MDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22610","description":"Thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRC1","description":"ICD-OFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQA1","description":"ICD-KIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abdomen surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22999","description":"Abdomen surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit tpn total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9364","description":"Hit tpn total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of pregnenolone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84140","description":"Assay of pregnenolone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINA1","description":"ICD-FINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWD0","description":"ICD-CEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise/repair mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40812","description":"Excise/repair mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15A","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abatacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0129","description":"Abatacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp carotid-subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35606","description":"Art byp carotid-subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ labetalol hydrochloride (hikma) not therapeutically equivalent to j1820_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1921","description":"Injection_ labetalol hydrochloride (hikma) not therapeutically equivalent to j1820_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKC0","description":"ICD-JFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUF0","description":"ICD-GIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dose optimization auc - 5fu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3722","description":"Dose optimization auc - 5fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWF1","description":"ICD-PKWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRB1","description":"ICD-OIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychosocial rehabilitation services_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2017","description":"Psychosocial rehabilitation services_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDB0","description":"ICD-GCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLD0","description":"ICD-JGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIA0","description":"ICD-BHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair sternum/nuss w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21743","description":"Repair sternum/nuss w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELA0","description":"ICD-KELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orbit surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67599","description":"Orbit surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0947T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","description":"CPT-0947T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLD1","description":"ICD-NFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGID1","description":"ICD-AGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOB0","description":"ICD-GIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAC1","description":"ICD-KCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30410","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for bladder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51610","description":"Injection for bladder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOF0","description":"ICD-CGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFA0","description":"ICD-JDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWB1","description":"ICD-CAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scoliosis dna alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004M","description":"Scoliosis dna alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3mL dosage_ diluent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91300","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3mL dosage_ diluent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKC0","description":"ICD-CCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYE1","description":"ICD-DFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJE1","description":"ICD-CGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGID0","description":"ICD-MGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA32","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJD1","description":"ICD-JAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","description":"HCPCS-J3376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lamination collar w/ couplin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6629","description":"Lamination collar w/ couplin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ gene-drug interactions_ variant analysis of 16 genes_ including deletion/duplication an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0392U","description":"Drug metabolism (depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ gene-drug interactions_ variant analysis of 16 genes_ including deletion/duplication an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Yellow fever vaccine subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90717","description":"Yellow fever vaccine subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC240","description":"Reduced Physical Function _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAD1","description":"ICD-JAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAD0","description":"ICD-EBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMA1","description":"ICD-ICMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDF1","description":"ICD-CEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAC0","description":"ICD-GGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXF1","description":"ICD-BIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for ESRD on dialysis)_ 100 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5105","description":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for ESRD on dialysis)_ 100 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIC1","description":"ICD-BAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXC0","description":"ICD-NDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ftl cgen abnor two proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81508","description":"Ftl cgen abnor two proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDA0","description":"ICD-IEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28605","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stat lab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3600","description":"Stat lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEA1","description":"ICD-OKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed total elect w/o mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0297","description":"Hosp bed total elect w/o mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPC0","description":"ICD-NDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL21","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leads any type vad_ rep only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0487","description":"Leads any type vad_ rep only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVA0","description":"ICD-JAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26675","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bortezomib injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9041","description":"Bortezomib injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision malig lesion>1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7414","description":"Excision malig lesion>1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cell marker study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88182","description":"Cell marker study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","description":"HCPCS-M1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMA0","description":"ICD-BFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA21","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUA0","description":"ICD-KAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99484","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44372","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB111","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Uvl replacement bulb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4633","description":"Uvl replacement bulb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Voice current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9171","description":"Voice current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel-bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44660","description":"Repair bowel-bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 16 central carbon metabolites (ie_a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ succinat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0263U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 16 central carbon metabolites (ie_a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ succinat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX34","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBA1","description":"ICD-FGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCF1","description":"ICD-JCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLC0","description":"ICD-OBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3A","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAE0","description":"ICD-OGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocortisone acetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1700","description":"Hydrocortisone acetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAF0","description":"ICD-OIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec size w/ leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1222","description":"Wheelchair spec size w/ leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50393","description":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mapcp demo community","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9152","description":"Mapcp demo community","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESD0","description":"ICD-OESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19499","description":"Breast surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/repair chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32110","description":"Explore/repair chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAB0","description":"ICD-JEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Embryo hatching","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89253","description":"Embryo hatching","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20A","description":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla x-match noncytotoxc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86826","description":"Hla x-match noncytotoxc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPC1","description":"ICD-CFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1378","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","description":"HCPCS-M1378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGC1","description":"ICD-KCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grade 2 or above diarrhea and/or grade 2 or above colitis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1181","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADD0","description":"ICD-AADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE250","description":"Reduced Physical Function _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMB1","description":"ICD-KHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evoked auditory test limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92587","description":"Evoked auditory test limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDA1","description":"ICD-MHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33977","description":"Remove ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUD0","description":"ICD-JAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYB1","description":"ICD-KBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEE0","description":"ICD-BDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA21","description":"ICD-1KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVF1","description":"ICD-GEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMA0","description":"ICD-NKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITE1","description":"ICD-BITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKD1","description":"ICD-GCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of long arm cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29065","description":"Application of long arm cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQC0","description":"ICD-PEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla class ii high defin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86833","description":"Hla class ii high defin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8H","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILE1","description":"ICD-NILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of creatine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82540","description":"Assay of creatine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFD1","description":"ICD-FBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKB1","description":"ICD-OGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ amisulpride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9153","description":"Injection_ amisulpride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTC0","description":"ICD-ADTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOF1","description":"ICD-CHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy lymph node exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32674","description":"Thoracoscopy lymph node exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fabrication & fitting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2628","description":"Fabrication & fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRF1","description":"ICD-HDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA204","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27475","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with ablation or destruction of lesion(s) with laser_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31572","description":"Laryngoscopy_ flexible; with ablation or destruction of lesion(s) with laser_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEC1","description":"ICD-MCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTE1","description":"ICD-FHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Follow up care plan mdd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0545F","description":"Follow up care plan mdd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Sage Health Management Solutions_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1009","description":"Clinical Decision Support Mechanism Sage Health Management Solutions_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCF1","description":"ICD-OLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antiepileptics nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80340","description":"Antiepileptics nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8H","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAA0","description":"ICD-CHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEF0","description":"ICD-BIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACF1","description":"ICD-AACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apheresis rbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36512","description":"Apheresis rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGB1","description":"ICD-NJGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytomeg dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87497","description":"Cytomeg dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMD0","description":"ICD-BIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWB0","description":"ICD-DIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFA1","description":"ICD-KFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPE0","description":"ICD-OBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFB1","description":"ICD-FCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; Each Additional Le","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0630T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; Each Additional Le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mobilization of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44139","description":"Mobilization of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYB1","description":"ICD-OJYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA52","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12A","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJC1","description":"ICD-KEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No med visit in 24mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9246","description":"No med visit in 24mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHA1","description":"ICD-BDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient-specific_ assistive_ rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient_s tumor-specific cancer marker information obtained fr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0794T","description":"Patient-specific_ assistive_ rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient_s tumor-specific cancer marker information obtained fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot arch support remov prem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3030","description":"Foot arch support remov prem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFE1","description":"ICD-NLFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In Hospice Or Using Hospice Services During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2153","description":"In Hospice Or Using Hospice Services During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fungi identification mold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87107","description":"Fungi identification mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95927","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVF0","description":"ICD-FBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise hernia & sperm veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55540","description":"Revise hernia & sperm veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXF0","description":"ICD-BAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20B","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise anal ext tag/papilla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46220","description":"Excise anal ext tag/papilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ampho b cholesteryl sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0288","description":"Ampho b cholesteryl sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc active inj drug use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9518","description":"Doc active inj drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathogen(s) test for platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9100","description":"Pathogen(s) test for platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGD1","description":"ICD-FGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOB0","description":"ICD-OLOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00840","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","description":"CPT-00840","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKF0","description":"ICD-OLKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEA0","description":"ICD-FDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTE0","description":"ICD-EFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEF1","description":"ICD-IGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Radrite_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1024","description":"Clinical Decision Support Mechanism Radrite_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteopath manj 9-10 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98929","description":"Osteopath manj 9-10 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCB0","description":"ICD-MDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blooc clot factor v test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85220","description":"Blooc clot factor v test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQD0","description":"ICD-PFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37268","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","description":"CPT-37268","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Isoproterenol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7659","description":"Isoproterenol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0239","description":"Intravenous infusion_ bamlanivimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort ii anterior intrusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21150","description":"Lefort ii anterior intrusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Cutaneous Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81529","description":"Oncology (Cutaneous Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUD1","description":"ICD-GAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cyclophosphamide 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9070","description":"Cyclophosphamide 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25110","description":"Remove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resin three surfaces-anterio","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2332","description":"Resin three surfaces-anterio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pentobarbital sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2515","description":"Pentobarbital sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXE0","description":"ICD-OKXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBA1","description":"ICD-MCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHE1","description":"ICD-ECHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52000","description":"Cystoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAC1","description":"ICD-MHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYC0","description":"ICD-PEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBB1","description":"ICD-NGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNF1","description":"ICD-BGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate mets no cast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9132","description":"Onc dx prostate mets no cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRD1","description":"ICD-PGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB204","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4B","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB41","description":"Low Rehab_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28F","description":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc mel cnr stg 0 - iic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8944","description":"Ajcc mel cnr stg 0 - iic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intl custm cong/latyp insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5681","description":"Intl custm cong/latyp insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD226","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCF1","description":"ICD-NJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICE1","description":"ICD-NICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1385","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","description":"HCPCS-M1385","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTC1","description":"ICD-FDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27605","description":"Incision of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDF1","description":"ICD-EDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBD0","description":"ICD-OCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12A","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45120","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOD1","description":"ICD-HEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXE1","description":"ICD-NLXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA46","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBB0","description":"ICD-BDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETC0","description":"ICD-JETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKA1","description":"ICD-FBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85018","description":"Hemoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSA0","description":"ICD-OHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATE0","description":"ICD-FATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUB1","description":"ICD-OHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCE1","description":"ICD-MDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSD0","description":"ICD-CBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral antral fistula closure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7260","description":"Oral antral fistula closure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57220","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunotherapy injections","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95117","description":"Immunotherapy injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psa/t/glsc docd b/4 txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3268F","description":"Psa/t/glsc docd b/4 txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of arm nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64713","description":"Revision of arm nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt no dchg home postop day 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9602","description":"Pt no dchg home postop day 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUD0","description":"ICD-NKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC212","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcysteine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0132","description":"Acetylcysteine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWF0","description":"ICD-CAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Homaker service nos per 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5130","description":"Homaker service nos per 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit est age 5-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99393","description":"Prev visit est age 5-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHB0","description":"ICD-MFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHE0","description":"ICD-JAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBC1","description":"ICD-GBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQD0","description":"ICD-OLQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPC0","description":"ICD-FEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental gold foil three surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2430","description":"Dental gold foil three surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-83884","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","description":"CPT-83884","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Promethazine hcl 12.5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0169","description":"Promethazine hcl 12.5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Restorigin_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4192","description":"Restorigin_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUE1","description":"ICD-MHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75658","description":"Artery x-rays arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reas no adhere pos air pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8854","description":"Reas no adhere pos air pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endocervical curettage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57505","description":"Endocervical curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vessel injection procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36299","description":"Vessel injection procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asst oocyte fert case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4022","description":"Asst oocyte fert case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDC0","description":"ICD-NHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVA1","description":"ICD-KIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNF0","description":"ICD-NHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEF0","description":"ICD-MCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg arterial two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33534","description":"Cabg arterial two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect mediastinal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39220","description":"Resect mediastinal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35121","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKF0","description":"ICD-ODKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMF0","description":"ICD-GFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML34","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHF1","description":"ICD-CFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUA0","description":"ICD-FCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASD1","description":"ICD-OASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE140","description":"Special Care Low _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBF1","description":"ICD-KBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKE0","description":"ICD-OAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37606","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBA0","description":"ICD-ECBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJF0","description":"ICD-OFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFC1","description":"ICD-CCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial valve addl insert","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31651","description":"Bronchial valve addl insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWC1","description":"ICD-LGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 2.6-5.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12013","description":"Rpr f/e/e/n/l/m 2.6-5.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dxa ordered for osteo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8861","description":"Dxa ordered for osteo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKE0","description":"ICD-CFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRF0","description":"ICD-PJRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJC0","description":"ICD-GDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Disease_ Bacterial Vaginosis And Vaginitis_ Quantitative Real-Time Amplification Of Dna Markers For Gardnerella Vaginalis_ Atopobium Vaginae_ Megasphaera Type 1_ Ba","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81514","description":"Infectious Disease_ Bacterial Vaginosis And Vaginitis_ Quantitative Real-Time Amplification Of Dna Markers For Gardnerella Vaginalis_ Atopobium Vaginae_ Megasphaera Type 1_ Ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Creatine mb fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82553","description":"Creatine mb fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L5992","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","description":"HCPCS-L5992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJA1","description":"ICD-NJJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telescop/othr compound lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2615","description":"Telescop/othr compound lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA101","description":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRD1","description":"ICD-PHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAA1","description":"ICD-ODAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXC0","description":"ICD-KBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOB1","description":"ICD-HCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHD1","description":"ICD-ODHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC25","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Airway inhalation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94640","description":"Airway inhalation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUA0","description":"ICD-KDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lsh w/t/o uterus above 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58544","description":"Lsh w/t/o uterus above 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYB1","description":"ICD-DEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27536","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXC1","description":"ICD-CDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBC1","description":"ICD-CFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ gene expression profiling by RTqPCR_ <i>PRAME</i> and <i>LINC00518</i>_ superficial collection using adhesive patch(es)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0089U","description":"Oncology (melanoma)_ gene expression profiling by RTqPCR_ <i>PRAME</i> and <i>LINC00518</i>_ superficial collection using adhesive patch(es)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBF0","description":"ICD-EIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHE0","description":"ICD-BIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of bile duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47425","description":"Incision of bile duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMA1","description":"ICD-NCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93315","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurological procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95999","description":"Neurological procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMB0","description":"ICD-OIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/irrigate tear ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68840","description":"Explore/irrigate tear ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endocrine surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60699","description":"Endocrine surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28153","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJE1","description":"ICD-GDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous breast biopsies using stereotactic guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the biops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7501","description":"Percutaneous breast biopsies using stereotactic guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the biops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corticoster sparng thrpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4142F","description":"Corticoster sparng thrpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTA0","description":"ICD-CGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRE0","description":"ICD-GFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVD0","description":"ICD-ODVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBF1","description":"ICD-EBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPC1","description":"ICD-OEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc rspse chmotx rx motility cntrst tomography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0083U","description":"Onc rspse chmotx rx motility cntrst tomography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50600","description":"Exploration of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCF1","description":"ICD-IFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt dischg >2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9254","description":"Doc pt dischg >2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSC0","description":"ICD-HDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calibrator solution/chips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4256","description":"Calibrator solution/chips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove lung pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32440","description":"Remove lung pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHB0","description":"ICD-MHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray bile ducts/pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74300","description":"X-ray bile ducts/pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whirlpool therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97022","description":"Whirlpool therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJC0","description":"ICD-NCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOD0","description":"ICD-CDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOB1","description":"ICD-LDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5942","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5942","description":"CDT-D5942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Co/membane diffuse capacity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94729","description":"Co/membane diffuse capacity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHA0","description":"ICD-CBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB145","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl girdle milwaukee orth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4000","description":"Repl girdle milwaukee orth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCF0","description":"ICD-EBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJD0","description":"ICD-FCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD112","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVF0","description":"ICD-JFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQF0","description":"ICD-DIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ketorolac tromethamine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1885","description":"Ketorolac tromethamine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEME1","description":"ICD-MEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASA0","description":"ICD-DASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA03","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCD1","description":"ICD-AFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFID0","description":"ICD-CFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAA1","description":"ICD-JFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21720","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optx medial ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27766","description":"Optx medial ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3-d radiotherapy plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77295","description":"3-d radiotherapy plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJB1","description":"ICD-CBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iodine I-131_ Iobenguane_ 1 Millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9590","description":"Iodine I-131_ Iobenguane_ 1 Millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA21","description":"Low Rehab_ ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRB0","description":"ICD-CHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX01","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interim crown-further treatment or completion of diagnosis necessary prior to final impression","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2799","description":"Interim crown-further treatment or completion of diagnosis necessary prior to final impression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antihemophilic viii/vwf comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7186","description":"Antihemophilic viii/vwf comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2182","description":"Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA05","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYD0","description":"ICD-PJYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFE1","description":"ICD-GHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC160","description":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pinworm exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87172","description":"Pinworm exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj iron dextran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1750","description":"Inj iron dextran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXA1","description":"ICD-GBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ irinotecan liposome_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9205","description":"Injection_ irinotecan liposome_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Totazoline hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2670","description":"Totazoline hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Warfarin therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4012F","description":"Warfarin therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shdr fair lead cable direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6590","description":"Shdr fair lead cable direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOF1","description":"ICD-PKOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHA0","description":"ICD-MGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27831","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD260","description":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC135","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryoablate renal mass open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50250","description":"Cryoablate renal mass open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHF0","description":"ICD-FGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61156","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1304","description":"HCPCS-A1304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAF0","description":"ICD-JAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIC1","description":"ICD-MJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50437","description":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thromboplastin time partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85730","description":"Thromboplastin time partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERD0","description":"ICD-DERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing serologic rh(d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86901","description":"Blood typing serologic rh(d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47600","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDF1","description":"ICD-BFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6031","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","description":"HCPCS-L6031","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVE1","description":"ICD-GHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYA0","description":"ICD-OGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGED0","description":"ICD-OGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHA0","description":"ICD-KCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXD0","description":"ICD-GFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDC0","description":"ICD-EIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7519","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWA1","description":"ICD-LDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0554T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFD1","description":"ICD-NFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sewhfo cap desgn w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3977","description":"Sewhfo cap desgn w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOF0","description":"ICD-KIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHD0","description":"ICD-IHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEF0","description":"ICD-KDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL56","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6195","description":"Abutment Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXB1","description":"ICD-NHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOA0","description":"ICD-KCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGB0","description":"ICD-GDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAE0","description":"ICD-KGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXB1","description":"ICD-BGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44373","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81518","description":"Oncology (breast)_ mRNA_ gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25D","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA02","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDD0","description":"ICD-KHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPD0","description":"ICD-FAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDF1","description":"ICD-BCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHE1","description":"ICD-MCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC205","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1high risk med ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9365","description":"1high risk med ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD131","description":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","description":"CPT-01638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLC0","description":"ICD-EDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAE1","description":"ICD-BEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECD0","description":"ICD-AECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITE1","description":"ICD-GITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBB0","description":"ICD-NKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct angiography head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70496","description":"Ct angiography head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ DNA_ targeted sequencing of protein-coding exons of 468 cancer-associated genes_ including interrogation for somatic mutations and microsatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0048U","description":"Oncology (solid organ neoplasia)_ DNA_ targeted sequencing of protein-coding exons of 468 cancer-associated genes_ including interrogation for somatic mutations and microsatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Services performed by a occupational therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2169","description":"Services performed by a occupational therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Received At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2154","description":"Patient Received At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFC1","description":"ICD-JFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLD1","description":"ICD-FCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIC1","description":"ICD-IDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILB0","description":"ICD-AILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXB1","description":"ICD-CCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBC1","description":"ICD-GIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled carbon dioxide test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94770","description":"Exhaled carbon dioxide test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKB0","description":"ICD-NHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Axolotl Graft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4331","description":"Axolotl Graft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suction socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6686","description":"Suction socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla ii typing ag equiv lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81375","description":"Hla ii typing ag equiv lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXA0","description":"ICD-NJXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSB0","description":"ICD-PLSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUD1","description":"ICD-IEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGB0","description":"ICD-OJGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abrasion lesions add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15787","description":"Abrasion lesions add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11300","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablation Of Malignant Prostate Tissue_ Transrectal_ With High Intensity-Focused Ultrasound (Hifu)_ Including Ultrasound Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55880","description":"Ablation Of Malignant Prostate Tissue_ Transrectal_ With High Intensity-Focused Ultrasound (Hifu)_ Including Ultrasound Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5211","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cult skin grft t/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15150","description":"Cult skin grft t/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1125","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29845","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEE0","description":"ICD-BBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXF0","description":"ICD-CBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUA0","description":"ICD-CIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPA1","description":"ICD-OAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icm device interrogat remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93297","description":"Icm device interrogat remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVD0","description":"ICD-NLVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abd imag and followup rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9548","description":"Abd imag and followup rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUF1","description":"ICD-EBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Root surgery ea add root","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3426","description":"Root surgery ea add root","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES304","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESA1","description":"ICD-KESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8D","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urea injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3350","description":"Urea injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRB1","description":"ICD-HBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22852","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21B","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg artery-vein single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33517","description":"Cabg artery-vein single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVE1","description":"ICD-NDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetically controlled capsule endoscopy_ esophagus through stomach_ including intraprocedural positioning of capsule_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0651T","description":"Magnetically controlled capsule endoscopy_ esophagus through stomach_ including intraprocedural positioning of capsule_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14C","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2291","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","description":"HCPCS-J2291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQB0","description":"ICD-GGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory flow volume loop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94375","description":"Respiratory flow volume loop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Delivery comp imrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6016","description":"Delivery comp imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQD0","description":"ICD-PCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGB0","description":"ICD-OCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18X","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91451","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deep sedation/general anesthesia-each additional 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9221","description":"Deep sedation/general anesthesia-each additional 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0991T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","description":"CPT-0991T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEA1","description":"ICD-NJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of calcium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82330","description":"Assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUC1","description":"ICD-EGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTF1","description":"ICD-NDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suction lipectomy upr extrem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15878","description":"Suction lipectomy upr extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIA1","description":"ICD-OHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIA0","description":"ICD-GCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFE1","description":"ICD-NKFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLA0","description":"ICD-ABLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAD0","description":"ICD-IAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGC1","description":"ICD-KHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0525T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiologic study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93624","description":"Electrophysiologic study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ amiodarone hydrochloride (nexterone)_ 30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0283","description":"Injection_ amiodarone hydrochloride (nexterone)_ 30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Known Familial Variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81353","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Known Familial Variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOE1","description":"ICD-OJOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNB1","description":"ICD-NLNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disp fee inhal drugs/30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0513","description":"Disp fee inhal drugs/30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWF1","description":"ICD-CEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASA1","description":"ICD-CASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1828","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","description":"HCPCS-E1828","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBA0","description":"ICD-FCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUD1","description":"ICD-KDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADC0","description":"ICD-NADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC21","description":"ICD-1BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optic nerve head eval done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2027F","description":"Optic nerve head eval done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHE0","description":"ICD-JEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF)_ derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0900T","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF)_ derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGID0","description":"ICD-IGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB52","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNB0","description":"ICD-CCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC211","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62324","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive sternum surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21630","description":"Extensive sternum surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electric heat pad standard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0210","description":"Electric heat pad standard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFF1","description":"ICD-CGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10B","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBE1","description":"ICD-BFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB21","description":"Very High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATC1","description":"ICD-KATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISC0","description":"ICD-PISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACA1","description":"ICD-IACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA54","description":"Default_ /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long arm adult fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4006","description":"Cast sup long arm adult fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENE1","description":"ICD-JENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percut thrombect av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36870","description":"Percut thrombect av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge noble metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6212","description":"Bridge noble metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILF0","description":"ICD-JILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tonsils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42826","description":"Removal of tonsils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCC1","description":"ICD-JHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ micafungin sodium (par pharm) not thereapeutically equivalent to j2248_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2247","description":"Injection_ micafungin sodium (par pharm) not thereapeutically equivalent to j2248_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt counsld on exam for moles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5005F","description":"Pt counsld on exam for moles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPF0","description":"ICD-KIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHD0","description":"ICD-FFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYC1","description":"ICD-OLYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB160","description":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (sandoz)_ not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9297","description":"Injection_ pemetrexed (sandoz)_ not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary plastic pouch w fcpl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4379","description":"Urinary plastic pouch w fcpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alkaloids nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80323","description":"Alkaloids nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure of salivary fistula","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7983","description":"Closure of salivary fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inc thyr node <1.0 in rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9552","description":"Inc thyr node <1.0 in rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCB0","description":"ICD-ACCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLB1","description":"ICD-EDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDC1","description":"ICD-FBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYA1","description":"ICD-OBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Administering Pneumococcal Vaccine (E.G._ Adverse Reaction To Vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9989","description":"Documentation Of Medical Reason(S) For Not Administering Pneumococcal Vaccine (E.G._ Adverse Reaction To Vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemostatic agent_ gastrointestinal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1052","description":"Hemostatic agent_ gastrointestinal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQD1","description":"ICD-OIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIF1","description":"ICD-CCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE235","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC21","description":"ICD-4CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCA1","description":"ICD-IFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOA1","description":"ICD-DDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise thigh muscles/tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27400","description":"Revise thigh muscles/tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYF0","description":"ICD-PEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wedging of clubfoot cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29750","description":"Wedging of clubfoot cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSE1","description":"ICD-DGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0482U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","description":"CPT-0482U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33929","description":"Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr wc drivewheel motor repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2368","description":"Pwr wc drivewheel motor repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA21","description":"ICD-3DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELF0","description":"ICD-MELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUA1","description":"ICD-OGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCF0","description":"ICD-IDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hmes/trachvalve adhesivedisk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7506","description":"Hmes/trachvalve adhesivedisk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKA0","description":"ICD-JCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo femoral fx cast rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2136","description":"Kafo femoral fx cast rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEE0","description":"ICD-CDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAC1","description":"ICD-FBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDC0","description":"ICD-CBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUC1","description":"ICD-AHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTD1","description":"ICD-OJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trauma respons w/hosp criti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0390","description":"Trauma respons w/hosp criti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement impl pump cathet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0785","description":"Replacement impl pump cathet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALC1","description":"ICD-EALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYB1","description":"ICD-PBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31297","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20A","description":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo sng/dbl mechanical act","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2005","description":"Kafo sng/dbl mechanical act","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64822","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQC1","description":"ICD-GFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHE0","description":"ICD-OAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB31","description":"ICD-4JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAA0","description":"ICD-OAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise graft w/nonauto graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35883","description":"Revise graft w/nonauto graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Powered w/c cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2610","description":"Powered w/c cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression wrap with adjustable straps_ below knee_ 30-50 mmhg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6583","description":"Gradient compression wrap with adjustable straps_ below knee_ 30-50 mmhg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of vulva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56620","description":"Partial removal of vulva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Histoplasmosis skin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86510","description":"Histoplasmosis skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1502","description":"HCPCS-C1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYB1","description":"ICD-HGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFA0","description":"ICD-BEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCD0","description":"ICD-CDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supply allowance for adjunctive continuous glucose monitor (CGM)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4238","description":"Supply allowance for adjunctive continuous glucose monitor (CGM)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDC1","description":"ICD-GCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECC0","description":"ICD-FECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUA1","description":"ICD-CHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98000","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","description":"CPT-98000","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18H","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUD1","description":"ICD-EBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cellesta cord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4214","description":"Cellesta cord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJB0","description":"ICD-CDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAF0","description":"ICD-CGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMD1","description":"ICD-JHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVF0","description":"ICD-OKVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthesis_ penile_ inflatab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1813","description":"Prosthesis_ penile_ inflatab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYB1","description":"ICD-OGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain ostomy pouch w/flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5063","description":"Drain ostomy pouch w/flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction_ including interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9786","description":"Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction_ including interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multi-vitamin nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9153","description":"Multi-vitamin nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAF1","description":"ICD-AAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWE1","description":"ICD-LHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Matrl for vocal cord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1878","description":"Matrl for vocal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFF1","description":"ICD-FAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEE1","description":"ICD-KDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEB0","description":"ICD-NKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDF1","description":"ICD-MJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALF1","description":"ICD-EALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9738","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXB1","description":"ICD-KFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTE0","description":"ICD-MJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethro w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52441","description":"Cystourethro w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHB1","description":"ICD-JBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without contrast material; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77046","description":"Magnetic resonance imaging_ breast_ without contrast material; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heredtry nurondcrn tum dsrdr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81438","description":"Heredtry nurondcrn tum dsrdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC21","description":"ICD-1JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTA0","description":"ICD-EFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk back check","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5686","description":"Bk back check","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANB0","description":"ICD-GANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOF1","description":"ICD-PBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/control bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45382","description":"Colonoscopy w/control bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0205","description":"HCPCS-C0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPA0","description":"ICD-BDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHC1","description":"ICD-MBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vaporizer room type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0605","description":"Vaporizer room type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50700","description":"Revision of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD156","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLA1","description":"ICD-KDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ emicizumab-kxwh_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7170","description":"Injection_ emicizumab-kxwh_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMF1","description":"ICD-BHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCB1","description":"ICD-AGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch w/flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5054","description":"Clsd ostomy pouch w/flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programmer for transient_ orally ingested capsule","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9268","description":"Programmer for transient_ orally ingested capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mattress innerspring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0271","description":"Mattress innerspring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient receives hcv antibody test with reactive result","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1232","description":"Patient receives hcv antibody test with reactive result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOA0","description":"ICD-OEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTF0","description":"ICD-MGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASD1","description":"ICD-PASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBD1","description":"ICD-MGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42226","description":"Lengthening of palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doppler flow testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93990","description":"Doppler flow testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEA0","description":"ICD-IFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carmustine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9050","description":"Carmustine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism LogicNets_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1019","description":"Clinical decision support mechanism LogicNets_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIA1","description":"ICD-ACIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myelography thoracic spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72255","description":"Myelography thoracic spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXD1","description":"ICD-JFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKC0","description":"ICD-JHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic resorbable wound dressing_ sterile_ pad size more than 16 sq in but less than or equal to 48 sq in_ without adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6461","description":"Synthetic resorbable wound dressing_ sterile_ pad size more than 16 sq in but less than or equal to 48 sq in_ without adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEF1","description":"ICD-OLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28D","description":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX12","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLC0","description":"ICD-MBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRF0","description":"ICD-DIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24B","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPF1","description":"ICD-KHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral busulfan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8510","description":"Oral busulfan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJB0","description":"ICD-CIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair stomach opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43870","description":"Repair stomach opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVA0","description":"ICD-GAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCA0","description":"ICD-OKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel pad removable for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3485","description":"Shoe heel pad removable for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80438","description":"Trh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0451T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGA1","description":"ICD-GCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6564","description":"Gradient compression stocking_ waist length_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEE0","description":"ICD-KIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDE1","description":"ICD-FEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Battery chrgr 12 volt utah/e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7366","description":"Battery chrgr 12 volt utah/e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGC1","description":"ICD-NGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fungi identification yeast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87106","description":"Fungi identification yeast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPD0","description":"ICD-GDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSB1","description":"ICD-LDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ polyvalent_ intramuscular_ for children from five years to nine years of age who have not previously received the vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0195","description":"Pneumococcal conjugate vaccine_ polyvalent_ intramuscular_ for children from five years to nine years of age who have not previously received the vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVD0","description":"ICD-KGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHC1","description":"ICD-OHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESA0","description":"ICD-OESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20B","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVF1","description":"ICD-NAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFF1","description":"ICD-GDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy finger joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26110","description":"Biopsy finger joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQF1","description":"ICD-KAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTC0","description":"ICD-JHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sup fee antiem_antica_immuno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0511","description":"Sup fee antiem_antica_immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home environment assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1028","description":"Home environment assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Each addtnl cast post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2953","description":"Each addtnl cast post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay secretory type ii pla2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0423T","description":"Assay secretory type ii pla2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pan-cancer)_ analysis of minimal residual disease (MRD) from plasma_ with assays personalized to each patient based on prior next-generation sequencing of the patien","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0340U","description":"Oncology (pan-cancer)_ analysis of minimal residual disease (MRD) from plasma_ with assays personalized to each patient based on prior next-generation sequencing of the patien","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma_ sessile serrated polyp_ or sessile serrated adenoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9934","description":"Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma_ sessile serrated polyp_ or sessile serrated adenoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24620","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8C","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDB0","description":"ICD-JFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE131","description":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt recvd inhal anesthetic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4554F","description":"Pt recvd inhal anesthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKC1","description":"ICD-JDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0304U","description":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2699","description":"Brachytx_ non-stranded_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20692","description":"Apply bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ortho shoe add full sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3540","description":"Ortho shoe add full sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSF0","description":"ICD-KDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8014","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8014","description":"HCPCS-C8014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB36","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4023","description":"Pathology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIA0","description":"ICD-IFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no offer eol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9381","description":"Doc med reas no offer eol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA130","description":"Reduced Physical Function _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIB1","description":"ICD-JHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE211","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Power operated vehicle noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0812","description":"Power operated vehicle noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGA0","description":"ICD-FIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 1 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0815","description":"Pwc gp 1 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem mntr pulm flu mntr setup","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0607T","description":"Rem mntr pulm flu mntr setup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRF0","description":"ICD-GHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGB1","description":"ICD-CDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 5999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4726","description":"Dialys sol fld vol > 5999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ ablation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1886","description":"Catheter_ ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMB0","description":"ICD-CAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJE1","description":"ICD-OBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHC1","description":"ICD-JGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam si joints 3/> vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72202","description":"X-ray exam si joints 3/> vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECD1","description":"ICD-OECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWB0","description":"ICD-CEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTE0","description":"ICD-JCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBE0","description":"ICD-CGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABE1","description":"ICD-MABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOE1","description":"ICD-DDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14D","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMF0","description":"ICD-OIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray of mammary ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77054","description":"X-ray of mammary ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB21","description":"ICD-1AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQD0","description":"ICD-LDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANA0","description":"ICD-CANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epoprostenol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1325","description":"Epoprostenol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9948","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28110","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Feeding aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5951","description":"Feeding aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCC1","description":"ICD-NCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC224","description":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX55","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKC0","description":"ICD-JBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBE0","description":"ICD-OIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bowel lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44111","description":"Excision of bowel lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDED0","description":"ICD-CDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLF0","description":"ICD-GHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periodontal maint procedures","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4910","description":"Periodontal maint procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Integra bmwd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4104","description":"Integra bmwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJE1","description":"ICD-BBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysterectomy/revise vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58280","description":"Hysterectomy/revise vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMB1","description":"ICD-IAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYF1","description":"ICD-OBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYB1","description":"ICD-PFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDC1","description":"ICD-JCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERB0","description":"ICD-LERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3398","description":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0647U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0647U","description":"CPT-0647U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Propranolol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1800","description":"Propranolol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43122","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFE0","description":"ICD-KGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPA0","description":"ICD-JDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath therapeutic irrig agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4321","description":"Cath therapeutic irrig agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunodiffusion nes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86329","description":"Immunodiffusion nes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement bulb th lightbox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4634","description":"Replacement bulb th lightbox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMB1","description":"ICD-GIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18I","description":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUA0","description":"ICD-ADUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1393","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","description":"HCPCS-M1393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear diagnostic exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78999","description":"Nuclear diagnostic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval laryngoscopy sense tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92615","description":"Eval laryngoscopy sense tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB21","description":"ICD-2HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB230","description":"Special Care High _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALC0","description":"ICD-NALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKC1","description":"ICD-NHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDC1","description":"ICD-NLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOA0","description":"ICD-CBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMB0","description":"ICD-NHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of leg at hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27290","description":"Amputation of leg at hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNC1","description":"ICD-JGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","description":"CPT-90635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTE1","description":"ICD-OJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYC0","description":"ICD-KDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQE1","description":"ICD-LDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy vulva lesions sim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56501","description":"Destroy vulva lesions sim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILD0","description":"ICD-EILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC155","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDD0","description":"ICD-GGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJC0","description":"ICD-KGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCF0","description":"ICD-IBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWD0","description":"ICD-OLWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray assay calculus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82370","description":"X-ray assay calculus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Survey not complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0914","description":"Survey not complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RHD&RHCE GNTYP RHD1-10&RHCE5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0198U","description":"RHD&RHCE GNTYP RHD1-10&RHCE5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUB0","description":"ICD-ADUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj midazolam hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2250","description":"Inj midazolam hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ca tx e-stim electr/transduc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4555","description":"Ca tx e-stim electr/transduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Graft hand or finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26416","description":"Graft hand or finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22D","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cvd risk assessment not performed or incomplete (e.g._ cvd risk assessment was not documented)_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1257","description":"Cvd risk assessment not performed or incomplete (e.g._ cvd risk assessment was not documented)_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CT/MRI brain done 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3112F","description":"CT/MRI brain done 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSF0","description":"ICD-LCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUE1","description":"ICD-ECUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCE1","description":"ICD-CGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1822","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","description":"HCPCS-E1822","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64466","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","description":"CPT-64466","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWF0","description":"ICD-OLWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAD0","description":"ICD-OGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intend rpt mult chr msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9669","description":"Intend rpt mult chr msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remov vertbr dcmprn thrclmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63087","description":"Remov vertbr dcmprn thrclmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVC1","description":"ICD-OCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42180","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATC1","description":"ICD-BATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQE1","description":"ICD-PBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYF0","description":"ICD-LDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1397","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","description":"HCPCS-M1397","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAA0","description":"ICD-EFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHD0","description":"ICD-CIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJC1","description":"ICD-CCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place cath vertebral art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36226","description":"Place cath vertebral art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLA0","description":"ICD-EBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUA1","description":"ICD-NGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBB0","description":"ICD-BBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUC1","description":"ICD-CGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hocm 300-349mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9962","description":"Hocm 300-349mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTE1","description":"ICD-BDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLF0","description":"ICD-IGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCA0","description":"ICD-EHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB113","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWA1","description":"ICD-GAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0130U","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOB1","description":"ICD-PLOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFF0","description":"ICD-FCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESA1","description":"ICD-DESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBB1","description":"ICD-IIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAD1","description":"ICD-MHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMF0","description":"ICD-MHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHB1","description":"ICD-NKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRD1","description":"ICD-LBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ non-coa/non-cov w/del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1876","description":"Stent_ non-coa/non-cov w/del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of transferrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84466","description":"Assay of transferrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNE1","description":"ICD-FFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1413","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","description":"HCPCS-M1413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLC0","description":"ICD-OHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECF0","description":"ICD-NECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKE0","description":"ICD-CBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXF0","description":"ICD-CCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole_ (Abilify Asimtufii)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9152","description":"Injection_ aripiprazole_ (Abilify Asimtufii)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVF1","description":"ICD-BFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRD1","description":"ICD-LCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYC0","description":"ICD-GHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJE0","description":"ICD-OEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto tissue graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4283","description":"Auto tissue graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPD1","description":"ICD-NLPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary artery graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33504","description":"Coronary artery graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKC0","description":"ICD-JGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAC1","description":"ICD-JDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVA1","description":"ICD-GCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUC0","description":"ICD-AHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCID1","description":"ICD-MCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9583","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7530","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64565","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNE0","description":"ICD-GDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUE0","description":"ICD-KEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBC1","description":"ICD-AIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGND0","description":"ICD-KGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPF1","description":"ICD-NBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0930T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","description":"CPT-0930T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10D","description":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66155","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25675","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYF1","description":"ICD-OEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLA1","description":"ICD-OCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6069","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKA0","description":"ICD-OLKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRA0","description":"ICD-GGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEB0","description":"ICD-EGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ing hernia init blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49501","description":"Rpr ing hernia init blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31086","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No reas_ no ret or w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9515","description":"No reas_ no ret or w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit cont insulin diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9353","description":"Hit cont insulin diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFA1","description":"ICD-KEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUF0","description":"ICD-BAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA150","description":"Clinically Complex _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWE0","description":"ICD-CAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmoscopy_ Extended; With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease (Eg_ For Retinal Tear_ Retinal Detachment_ Retinal Tumor) With Interpretati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92201","description":"Ophthalmoscopy_ Extended; With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease (Eg_ For Retinal Tear_ Retinal Detachment_ Retinal Tumor) With Interpretati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC07","description":"High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQA1","description":"ICD-OBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA134","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNF0","description":"ICD-FBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTA1","description":"ICD-AHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADF0","description":"ICD-CADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPB0","description":"ICD-GAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVB0","description":"ICD-KAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool withi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1045","description":"Functional status measurement with score was obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool withi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHE1","description":"ICD-MHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC21","description":"ICD-1CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40651","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular disease (acute coronary syndrome [ACS])_ IL-16_ FAS_ FASLigand_ HGF_ CTACK_ EOTAXIN_ and MCP-3 by immunoassay combined with age_ sex_ family history_ and person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0415U","description":"Cardiovascular disease (acute coronary syndrome [ACS])_ IL-16_ FAS_ FASLigand_ HGF_ CTACK_ EOTAXIN_ and MCP-3 by immunoassay combined with age_ sex_ family history_ and person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Octreotide injection_ depot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2353","description":"Octreotide injection_ depot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAC1","description":"ICD-CEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYE0","description":"ICD-PHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVC0","description":"ICD-FBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGF0","description":"ICD-NLGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95709","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIE0","description":"ICD-JCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caloric vstblr test w/rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92537","description":"Caloric vstblr test w/rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSC0","description":"ICD-PJSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHB1","description":"ICD-IBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADA0","description":"ICD-GADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAB1","description":"ICD-AIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caloric vestibular test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92533","description":"Caloric vestibular test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with thepower source and control electronics unit_ controlled by hardw","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0491","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with thepower source and control electronics unit_ controlled by hardw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIE0","description":"ICD-GBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flecainide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80181","description":"Flecainide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temp anchorage dev w flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7293","description":"Temp anchorage dev w flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27240","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43420","description":"Repair esophagus opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWF0","description":"ICD-HGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARC1","description":"ICD-DARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYC0","description":"ICD-PIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRA0","description":"ICD-DCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAF0","description":"ICD-GGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQF1","description":"ICD-PIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDA0","description":"ICD-AHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15C","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPD1","description":"ICD-GIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHA0","description":"ICD-EDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOA1","description":"ICD-CDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treated water per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4714","description":"Treated water per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No dxa no med hx no rv sx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9472","description":"No dxa no med hx no rv sx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explr/decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67445","description":"Explr/decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDC1","description":"ICD-ADDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB112","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cerliponase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0567","description":"Injection_ cerliponase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3-Dimensional Volumetric Imaging And Reconstruction Of Breast Or Axillary Lymph Node Tissue_ Each Excised Specimen_ 3-Dimensional Automatic Specimen Reorientation_ Interpretat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0694T","description":"3-Dimensional Volumetric Imaging And Reconstruction Of Breast Or Axillary Lymph Node Tissue_ Each Excised Specimen_ 3-Dimensional Automatic Specimen Reorientation_ Interpretat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSD0","description":"ICD-GHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHA0","description":"ICD-OEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIE0","description":"ICD-AFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBF0","description":"ICD-CDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ret dev_ insertable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1773","description":"Ret dev_ insertable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tetanus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86774","description":"Tetanus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGD1","description":"ICD-NGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIA1","description":"ICD-CBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBC1","description":"ICD-NIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLC0","description":"ICD-EBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPE0","description":"ICD-NGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBID0","description":"ICD-MBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDA0","description":"ICD-GFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Death did not occur during the index acute care hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9815","description":"Death did not occur during the index acute care hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUF0","description":"ICD-JGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cran surg hemotoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21152","description":"Anesth cran surg hemotoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFC1","description":"ICD-FFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGF1","description":"ICD-BAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRA0","description":"ICD-OGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBD1","description":"ICD-CCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIE0","description":"ICD-NJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ brachytx seed adm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1728","description":"Cath_ brachytx seed adm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB146","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTD1","description":"ICD-NGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPC0","description":"ICD-KHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISE0","description":"ICD-GISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANA0","description":"ICD-BANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69705","description":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chronic Care Management Services_ Each Additional 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional_ Per Calendar Month (Li","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2058","description":"Chronic Care Management Services_ Each Additional 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional_ Per Calendar Month (Li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22B","description":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIC0","description":"ICD-IFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJD1","description":"ICD-FDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGE1","description":"ICD-OHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAD1","description":"ICD-CFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCND0","description":"ICD-NCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAB1","description":"ICD-MAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWA0","description":"ICD-GHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEF1","description":"ICD-NEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34711","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza immunization was not administered for reasons documented by clinician (e.g._ patient allergy or other medical reasons_ patient declined or other patient reasons_ vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1300","description":"Influenza immunization was not administered for reasons documented by clinician (e.g._ patient allergy or other medical reasons_ patient declined or other patient reasons_ vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBC0","description":"ICD-OCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES212","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of scleral staphyloma; without graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66220","description":"Repair of scleral staphyloma; without graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81284","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with transendoscopic endobronchial ultrasound (ebus)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7512","description":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with transendoscopic endobronchial ultrasound (ebus)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of torus palatinus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7472","description":"Removal of torus palatinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWA1","description":"ICD-LGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDD0","description":"ICD-OKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med reas no perf foot exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9502","description":"Med reas no perf foot exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA30","description":"Medium Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLF0","description":"ICD-MLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBA0","description":"ICD-FEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABB1","description":"ICD-AABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66225","description":"Repair/graft eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWB0","description":"ICD-KHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOE1","description":"ICD-KHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA21","description":"ICD-4GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Friction dampening arm supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2629","description":"Friction dampening arm supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA104","description":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neox 100 or Clarix 100_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4156","description":"Neox 100 or Clarix 100_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33031","description":"Partial removal of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFA1","description":"ICD-GCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ptrsn no gc chl syp test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9229","description":"Ptrsn no gc chl syp test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA31","description":"ICD-3CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXB0","description":"ICD-JEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPA1","description":"ICD-KDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAE1","description":"ICD-EEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWF1","description":"ICD-GAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology work-up evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9050","description":"Oncology work-up evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Islet cell antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86341","description":"Islet cell antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0485","description":"Oral device/appliance prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABA1","description":"ICD-OABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cid ext speech process repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8627","description":"Cid ext speech process repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect tarsal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28171","description":"Resect tarsal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromogenic substrate assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85130","description":"Chromogenic substrate assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRE1","description":"ICD-GCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHE1","description":"ICD-IHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63016","description":"Remove spine lamina >2 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCF1","description":"ICD-IHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQE1","description":"ICD-PHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corticorelin ovine triflutal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0795","description":"Corticorelin ovine triflutal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHD1","description":"ICD-KHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRC1","description":"ICD-DHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHF1","description":"ICD-ACHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABD0","description":"ICD-JABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQE1","description":"ICD-GGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chronic care management services_ provided personally by a physician or other qualified health care professional_ at least 30 minutes of physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99491","description":"Chronic care management services_ provided personally by a physician or other qualified health care professional_ at least 30 minutes of physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPD0","description":"ICD-GBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAF0","description":"ICD-JBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLF1","description":"ICD-FCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGC0","description":"ICD-FDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMF1","description":"ICD-IDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTF0","description":"ICD-MCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematocrit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85014","description":"Hematocrit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNC1","description":"ICD-OKNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESC1","description":"ICD-CESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph balloon distension tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91040","description":"Esoph balloon distension tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9062","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9062","description":"HCPCS-J9062","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0497U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","description":"CPT-0497U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES324","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOA0","description":"ICD-HHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of anti-infective_ pain management_ chelation_ pulmonary hypertension_ inotropic_ or other intravenous infusion dr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0088","description":"Professional services_ initial visit_ for the administration of anti-infective_ pain management_ chelation_ pulmonary hypertension_ inotropic_ or other intravenous infusion dr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRB1","description":"ICD-HGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICE1","description":"ICD-OICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWE1","description":"ICD-PAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5139","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5139","description":"HCPCS-Q5139","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TERT (telomerase reverse transcriptase) (eg_ thyroid carcinoma_ glioblastoma multiforme) gene analysis_ targeted sequence analysis (eg_ promoter region)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81345","description":"TERT (telomerase reverse transcriptase) (eg_ thyroid carcinoma_ glioblastoma multiforme) gene analysis_ targeted sequence analysis (eg_ promoter region)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect arm/elbow tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24077","description":"Resect arm/elbow tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bumetanide 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0171","description":"Bumetanide 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76826","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sio flex pelvisacral custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0622","description":"Sio flex pelvisacral custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0681","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","description":"HCPCS-J0681","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVA0","description":"ICD-BBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43840","description":"Repair of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOE1","description":"ICD-GIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEA0","description":"ICD-GIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWF1","description":"ICD-DIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBA0","description":"ICD-KBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA10","description":"Default_ /5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67346","description":"Biopsy eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERC0","description":"ICD-OERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped home apnea rec hk-up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94775","description":"Ped home apnea rec hk-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14C","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAC1","description":"ICD-JIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home infusion each addtl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99602","description":"Home infusion each addtl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00561","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","description":"CPT-00561","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUF1","description":"ICD-JFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat tail bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27202","description":"Treat tail bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXF1","description":"ICD-NAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited dental tx adolescent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8030","description":"Limited dental tx adolescent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64681","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Air pressure pad for mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0197","description":"Air pressure pad for mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADD1","description":"ICD-CADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL21","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0237","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","description":"HCPCS-M0237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge porcelain high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6240","description":"Bridge porcelain high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult size pull-on med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4526","description":"Adult size pull-on med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmprs burngarment foot-thigh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6508","description":"Cmprs burngarment foot-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKA1","description":"ICD-OAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 25MCG/0.25ML1ST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111A","description":"ADM SARSCOV2 25MCG/0.25ML1ST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18G","description":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko w/adj jt rot cntrl molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1844","description":"Ko w/adj jt rot cntrl molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Etonogestrel implant system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7307","description":"Etonogestrel implant system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone diacetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3302","description":"Triamcinolone diacetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spec sit not prim tumor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8723","description":"Spec sit not prim tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of haptoglobin quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83010","description":"Assay of haptoglobin quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetics 25-99","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88274","description":"Cytogenetics 25-99","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBB1","description":"ICD-OFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIB1","description":"ICD-MDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD211","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBE0","description":"ICD-JIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50620","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWE0","description":"ICD-CCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETF1","description":"ICD-EETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUC1","description":"ICD-FFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPC1","description":"ICD-BEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUB0","description":"ICD-GDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETE1","description":"ICD-JETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYC1","description":"ICD-DFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERC0","description":"ICD-CERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBC0","description":"ICD-NKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66030","description":"Injection treatment of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPD0","description":"ICD-NCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPC0","description":"ICD-CEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBB1","description":"ICD-MJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYF1","description":"ICD-KGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTB0","description":"ICD-FCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place rt device/marker pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55876","description":"Place rt device/marker pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUB1","description":"ICD-NBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADA1","description":"ICD-GADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1341","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGND1","description":"ICD-KGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replc tth&acrlc mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5671","description":"Replc tth&acrlc mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC226","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45113","description":"Partial proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of chloramphenicol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82415","description":"Assay of chloramphenicol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFD0","description":"ICD-CCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGB1","description":"ICD-OAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiesse injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2026","description":"Radiesse injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whfo nontorsion joint prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3931","description":"Whfo nontorsion joint prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAE0","description":"ICD-EAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAND1","description":"ICD-OAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDF0","description":"ICD-OFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert levonorgestrel ius","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4981","description":"Insert levonorgestrel ius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIC0","description":"ICD-IDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGF1","description":"ICD-NLGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGD1","description":"ICD-FHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCME1","description":"ICD-JCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ue not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8670","description":"Fun stat score ue not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBB1","description":"ICD-KDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multi-axial knee/shin system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5840","description":"Multi-axial knee/shin system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47480","description":"Incision of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins vag brachytx device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57156","description":"Ins vag brachytx device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ortho shoe add leather insol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3500","description":"Ortho shoe add leather insol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Furnsh initial orthosis only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1200","description":"Furnsh initial orthosis only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0577","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0577","description":"HCPCS-G0577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ efgartigimod alfa-fcab_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9332","description":"Injection_ efgartigimod alfa-fcab_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home infusion/visit 2 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99601","description":"Home infusion/visit 2 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBC1","description":"ICD-KHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion 29-31 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2266","description":"Induced abortion 29-31 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m fanolesomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9566","description":"Tc99m fanolesomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oth resp proc_ group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0239","description":"Oth resp proc_ group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35276","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUD0","description":"ICD-MBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJB0","description":"ICD-BGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOA1","description":"ICD-OCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBC1","description":"ICD-OIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dark adaptation eye exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92284","description":"Dark adaptation eye exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA16","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC216","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMD1","description":"ICD-CBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYC0","description":"ICD-LEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJA1","description":"ICD-BAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab-abbs_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5115","description":"Injection_ rituximab-abbs_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFID1","description":"ICD-CFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration for testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54550","description":"Exploration for testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ which may include simultaneous direction of tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97155","description":"Adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ which may include simultaneous direction of tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUD1","description":"ICD-BHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther xcl hrvst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0264T","description":"Im b1 mrw cel ther xcl hrvst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRD1","description":"ICD-GFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ATXN10 (ataxin 10) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81183","description":"ATXN10 (ataxin 10) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAF0","description":"ICD-EGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Av fistula revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36833","description":"Av fistula revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBC0","description":"ICD-CFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNC0","description":"ICD-GFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PuraPly_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4195","description":"PuraPly_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of foot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28020","description":"Exploration of foot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDD0","description":"ICD-CEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14451","description":"Anesth corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair tcat mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33418","description":"Repair tcat mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lactoferrin fecal (quant)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83631","description":"Lactoferrin fecal (quant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interv hlth/behav fam w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96154","description":"Interv hlth/behav fam w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m medronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9503","description":"Tc99m medronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise & treat bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51030","description":"Incise & treat bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls daily mgmt artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33949","description":"Ecmo/ecls daily mgmt artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC113","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALA0","description":"ICD-EALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMC1","description":"ICD-JGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45327","description":"Proctosigmoidoscopy w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDD0","description":"ICD-JBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB21","description":"ICD-3FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meperidine/promethazine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2180","description":"Meperidine/promethazine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBC0","description":"ICD-AGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVF1","description":"ICD-BDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonmed family planning ed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1010","description":"Nonmed family planning ed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary cath anchor device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4333","description":"Urinary cath anchor device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUE1","description":"ICD-CAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer w/ compressor & he","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0585","description":"Nebulizer w/ compressor & he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of corticosteroids 17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83491","description":"Assay of corticosteroids 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEF1","description":"ICD-FDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Has Any Emergency Department Encounter During The Performance Period With Place Of Service Indicator 23","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0035","description":"Patient Has Any Emergency Department Encounter During The Performance Period With Place Of Service Indicator 23","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANF1","description":"ICD-JANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAF0","description":"ICD-MBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMF0","description":"ICD-ADMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYF1","description":"ICD-PFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ria nonantibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83519","description":"Ria nonantibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICC0","description":"ICD-NICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical home_ maintenance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0281","description":"Medical home_ maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAF1","description":"ICD-OKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1 antibody testing of or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3645","description":"Hiv-1 antibody testing of or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10B","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITA1","description":"ICD-MITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMB0","description":"ICD-BHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIB1","description":"ICD-NBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUE1","description":"ICD-NGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHF1","description":"ICD-OAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARB1","description":"ICD-HARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of amikacin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80150","description":"Assay of amikacin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve (Monarch external Trigeminal Nerve Stimulation (eTNS) System.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1016","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve (Monarch external Trigeminal Nerve Stimulation (eTNS) System.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYE1","description":"ICD-OLYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breathing capacity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94010","description":"Breathing capacity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair mouth laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40831","description":"Repair mouth laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult day center_ 8-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0530","description":"Adult day center_ 8-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB111","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos back post/lat wdth>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2616","description":"Pos back post/lat wdth>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27530","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWE0","description":"ICD-OHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHD0","description":"ICD-EIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18H","description":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIB1","description":"ICD-FEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBE0","description":"ICD-ECBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGED0","description":"ICD-MGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMA1","description":"ICD-JEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow molded w/ expand inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6205","description":"Elbow molded w/ expand inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQC0","description":"ICD-HDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWA1","description":"ICD-DFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBA0","description":"ICD-EGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cases in which an inhalational anesthetic is used only for induction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9955","description":"Cases in which an inhalational anesthetic is used only for induction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29886","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hocm 200-249mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9960","description":"Hocm 200-249mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHC0","description":"ICD-MGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE220","description":"Clinically Complex _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cognitive skills development","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97532","description":"Cognitive skills development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYB0","description":"ICD-DGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPA0","description":"ICD-GEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBE1","description":"ICD-FIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBB0","description":"ICD-CBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVC1","description":"ICD-KDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical nutrition indiv in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97802","description":"Medical nutrition indiv in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODID0","description":"ICD-ODID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB21","description":"ICD-1GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharm rx agent noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9699","description":"Radiopharm rx agent noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHC0","description":"ICD-CDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSE0","description":"ICD-PGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBND1","description":"ICD-JBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove implant of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65920","description":"Remove implant of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGF0","description":"ICD-BHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQF1","description":"ICD-PGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYB1","description":"ICD-KDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain shoulder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23030","description":"Drain shoulder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPB1","description":"ICD-JEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42665","description":"Ligation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECED1","description":"ICD-ECED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bile duct revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47701","description":"Bile duct revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHC0","description":"ICD-GAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPC0","description":"ICD-KGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHF0","description":"ICD-IAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX26","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPD1","description":"ICD-KHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Terbutaline sulf comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7681","description":"Terbutaline sulf comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Create new tubal opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58770","description":"Create new tubal opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRD0","description":"ICD-CBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92311","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0510","description":"Non-prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTB1","description":"ICD-IHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVD1","description":"ICD-KAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reguard_ for topical use only_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4255","description":"Reguard_ for topical use only_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHD1","description":"ICD-NHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB11","description":"ICD-2FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anticonv thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4230F","description":"Anticonv thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert cath pleura w/ image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32557","description":"Insert cath pleura w/ image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVB1","description":"ICD-CHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7521","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","description":"HCPCS-J7521","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vertebral body tethering_ anterior; up to 7 vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0656T","description":"Vertebral body tethering_ anterior; up to 7 vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adj cmo not pres rsn not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8929","description":"Adj cmo not pres rsn not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMB1","description":"ICD-NHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUE0","description":"ICD-BCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heavyduty/wide commode chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0168","description":"Heavyduty/wide commode chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty tricuspid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33464","description":"Valvuloplasty tricuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture anaerobe ident each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87076","description":"Culture anaerobe ident each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMC1","description":"ICD-OHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Irinotecan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9206","description":"Irinotecan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNF1","description":"ICD-BHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWC0","description":"ICD-PIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01120","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","description":"CPT-01120","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3B","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIE0","description":"ICD-BCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34704","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11B","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMB0","description":"ICD-GFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIC0","description":"ICD-OAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHB0","description":"ICD-KBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAND1","description":"ICD-FAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1415","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","description":"HCPCS-M1415","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRA0","description":"ICD-LHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7050","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC55","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of sweat sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84302","description":"Assay of sweat sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGME0","description":"ICD-CGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTE1","description":"ICD-KGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB11","description":"ICD-3GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21B","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD101","description":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGID1","description":"ICD-OGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKC0","description":"ICD-JIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTA1","description":"ICD-CGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft kneecap tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27381","description":"Repair/graft kneecap tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWC0","description":"ICD-KFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCC0","description":"ICD-FGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBC0","description":"ICD-CEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUF1","description":"ICD-NJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTE0","description":"ICD-MLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCF1","description":"ICD-FBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Particle agglut antbdy scrn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86403","description":"Particle agglut antbdy scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAB1","description":"ICD-BCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQF0","description":"ICD-CEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB30","description":"Medium Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Budesonide comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7627","description":"Budesonide comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB11","description":"ICD-2JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc 2x re-assess filt remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9543","description":"Doc 2x re-assess filt remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMA1","description":"ICD-MLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKA1","description":"ICD-GHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85097","description":"Bone marrow interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFE1","description":"ICD-BHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYF1","description":"ICD-CBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive sternum surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21632","description":"Extensive sternum surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAB0","description":"ICD-IGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening pap smear by phys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P3001","description":"Screening pap smear by phys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDD0","description":"ICD-BEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk mold socket sach ft endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5301","description":"Bk mold socket sach ft endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBE0","description":"ICD-NGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJF0","description":"ICD-OLJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMC0","description":"ICD-KFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1B","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of lip fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40806","description":"Incision of lip fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACE1","description":"ICD-IACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFA0","description":"ICD-BFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB126","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIA0","description":"ICD-FCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67808","description":"Remove eyelid lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPE1","description":"ICD-BCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHF0","description":"ICD-KDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology colorectal scr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81528","description":"Oncology colorectal scr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01430","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","description":"CPT-01430","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNE1","description":"ICD-OKNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBD1","description":"ICD-KFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlorpromazine hcl 5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0161","description":"Chlorpromazine hcl 5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYA0","description":"ICD-HHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy tube collar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7526","description":"Tracheostomy tube collar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFF1","description":"ICD-ODFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99283","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA231","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBF0","description":"ICD-OKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of toe tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28232","description":"Incision of toe tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap w/omentopexy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49326","description":"Lap w/omentopexy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; system_ including pulse generat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33278","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; system_ including pulse generat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fremanezumab-vfrm_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9040","description":"Injection_ fremanezumab-vfrm_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48155","description":"Removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair dura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61618","description":"Repair dura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28080","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve palsy muscle graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15841","description":"Nerve palsy muscle graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auricular electrostimulation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8930","description":"Auricular electrostimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVF0","description":"ICD-FDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMF0","description":"ICD-KGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0247","description":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC31","description":"ICD-4HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress forearm 2 spaces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25025","description":"Decompress forearm 2 spaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXE1","description":"ICD-BDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFB1","description":"ICD-OJFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2596","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","description":"HCPCS-J2596","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLF0","description":"ICD-EFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv adjuvant vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90653","description":"Iiv adjuvant vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAF1","description":"ICD-ABAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB241","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ intravas ultrasound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1753","description":"Cath_ intravas ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16375","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16375","description":"CPT-16375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tech other than surfc cultr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4261F","description":"Tech other than surfc cultr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLB1","description":"ICD-MLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval risk vte card 30d prior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9298","description":"Eval risk vte card 30d prior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture groin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35132","description":"Repair artery rupture groin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral med adm direct observe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0033","description":"Oral med adm direct observe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHE0","description":"ICD-KEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penile injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54235","description":"Penile injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calc bmi out nrm param nof/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8419","description":"Calc bmi out nrm param nof/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1235","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9808","description":"HCPCS-C9808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2361","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2361","description":"HCPCS-J2361","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJE0","description":"ICD-BAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tr retinal les preterm inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67229","description":"Tr retinal les preterm inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRE1","description":"ICD-GBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHD1","description":"ICD-OAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj follitropin beta 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0128","description":"Inj follitropin beta 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test for acetone/ketones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82009","description":"Test for acetone/ketones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hair trnspl >15 punch grafts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15776","description":"Hair trnspl >15 punch grafts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA21","description":"Very High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWF0","description":"ICD-PAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No bone scn b/4 txmnt/aftrdx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3270F","description":"No bone scn b/4 txmnt/aftrdx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ circulating tumor cell selection_ identification_ morphological characterization_ detection and enumeration based on differential EpCAM_ cytokeratins 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0338U","description":"Oncology (solid tumor)_ circulating tumor cell selection_ identification_ morphological characterization_ detection and enumeration based on differential EpCAM_ cytokeratins 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWB1","description":"ICD-LIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMC0","description":"ICD-EGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTA1","description":"ICD-KBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE256","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUC1","description":"ICD-AIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Guidance for radiaj tx dlvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77387","description":"Guidance for radiaj tx dlvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXE0","description":"ICD-BIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOA0","description":"ICD-KIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB31","description":"ICD-3EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAB0","description":"ICD-CHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIC0","description":"ICD-NKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25A","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1408","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","description":"HCPCS-M1408","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVB0","description":"ICD-NIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJA1","description":"ICD-OFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPF0","description":"ICD-JDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHE0","description":"ICD-OIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDD1","description":"ICD-JDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay nephelometry not spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83883","description":"Assay nephelometry not spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUA0","description":"ICD-NFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIID0","description":"ICD-KIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telavancin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3095","description":"Telavancin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Augmentative AI-based facial phenotype analysis with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0731T","description":"Augmentative AI-based facial phenotype analysis with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUD0","description":"ICD-AIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Longevity And Mortality Risk_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 18 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0294U","description":"Longevity And Mortality Risk_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 18 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epifix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4186","description":"Epifix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal foreign body gum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41805","description":"Removal foreign body gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove lung catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32552","description":"Remove lung catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITB0","description":"ICD-IITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQB0","description":"ICD-DHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFE0","description":"ICD-BIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJA1","description":"ICD-GEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33966","description":"Ecmo/ecls rmvl prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBA1","description":"ICD-FHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHD1","description":"ICD-OIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE201","description":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJF0","description":"ICD-FEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-molded lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2320","description":"Non-molded lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nivolumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9299","description":"Injection_ nivolumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+cell cnt/% docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3500F","description":"Cd4+cell cnt/% docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPB0","description":"ICD-ODPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUB1","description":"ICD-EHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFE0","description":"ICD-NHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB01","description":"Low Rehab_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUC0","description":"ICD-KEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHC0","description":"ICD-JDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monthly supplies for use of device coded at e0733","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4541","description":"Monthly supplies for use of device coded at e0733","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDB1","description":"ICD-EBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDA1","description":"ICD-BCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zrsr2 (Zinc Finger Ccch-Type_ Rna Binding Motif And Serine/Arginine-Rich 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variant(S) (Eg_ E65Fs_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81360","description":"Zrsr2 (Zinc Finger Ccch-Type_ Rna Binding Motif And Serine/Arginine-Rich 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variant(S) (Eg_ E65Fs_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTE1","description":"ICD-NCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLB1","description":"ICD-IDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD204","description":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISE0","description":"ICD-KISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJE1","description":"ICD-KBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64553","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVB1","description":"ICD-KAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Init eval for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1119F","description":"Init eval for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhc pt maint ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0159","description":"Hhc pt maint ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAID1","description":"ICD-CAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMA1","description":"ICD-OKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXB0","description":"ICD-GFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRF0","description":"ICD-CGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCF0","description":"ICD-MGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCE1","description":"ICD-FGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3C","description":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immune globulin_ powder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1566","description":"Immune globulin_ powder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection Factor IX_ (antihemophilic factor_ recombinant)_ glycopegylated_ (Rebinyn)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7203","description":"Injection Factor IX_ (antihemophilic factor_ recombinant)_ glycopegylated_ (Rebinyn)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDA0","description":"ICD-BGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOA1","description":"ICD-HEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood pressure reading not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1281","description":"Blood pressure reading not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVB0","description":"ICD-NHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28F","description":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOD0","description":"ICD-KGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital call","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9420","description":"Hospital call","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX23","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srs cran les simple addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61797","description":"Srs cran les simple addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC11","description":"ICD-1AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKC0","description":"ICD-GDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mlh1 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81292","description":"Mlh1 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88025","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUC0","description":"ICD-BEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUE0","description":"ICD-MCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUC1","description":"ICD-ABUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD144","description":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electromagnetic therapy onc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0295","description":"Electromagnetic therapy onc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPC0","description":"ICD-BAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TAG_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4261","description":"TAG_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGB1","description":"ICD-KCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYB1","description":"ICD-OLYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable catheter tips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4860","description":"Disposable catheter tips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDB1","description":"ICD-GHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electron microscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88348","description":"Electron microscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJC1","description":"ICD-KBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5154","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","description":"HCPCS-Q5154","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWC1","description":"ICD-LBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23D","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain aneurysm repr simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61700","description":"Brain aneurysm repr simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice in snf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5004","description":"Hospice in snf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dstrj neurofibromata xtnsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0419T","description":"Dstrj neurofibromata xtnsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUD0","description":"ICD-IEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVE1","description":"ICD-CFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of leg veins/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37735","description":"Removal of leg veins/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTF0","description":"ICD-OKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01482","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","description":"CPT-01482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Azacitidine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9025","description":"Azacitidine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo transthoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93304","description":"Echo transthoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLE0","description":"ICD-GDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHC0","description":"ICD-AIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFND0","description":"ICD-NFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWB0","description":"ICD-LHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNF0","description":"ICD-ODNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0495U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","description":"CPT-0495U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63090","description":"Remove vert body dcmprn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACD0","description":"ICD-GACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTB0","description":"ICD-OKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAB1","description":"ICD-BGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIA0","description":"ICD-BDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB231","description":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv unsure baby of hiv+moms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3491F","description":"Hiv unsure baby of hiv+moms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLC0","description":"ICD-CFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE134","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETD1","description":"ICD-JETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVB1","description":"ICD-NKVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEED1","description":"ICD-AEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJE0","description":"ICD-KEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX07","description":"Low Rehab plus Extensive _ ADL Index 2-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKF0","description":"ICD-OFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Abnormal Native Connecti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93594","description":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Abnormal Native Connecti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mast mod rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19307","description":"Mast mod rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML15","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43855","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65810","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVC1","description":"ICD-NKVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q9996","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","description":"HCPCS-Q9996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCC1","description":"ICD-MDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99343","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXD1","description":"ICD-OIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLD1","description":"ICD-FGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAD0","description":"ICD-FBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBB0","description":"ICD-FGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUE1","description":"ICD-CDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLF0","description":"ICD-FHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHF1","description":"ICD-CIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB226","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBE1","description":"ICD-BBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLF1","description":"ICD-BCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74480","description":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYC0","description":"ICD-PHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0577U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","description":"CPT-0577U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34421","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCC0","description":"ICD-JGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLE1","description":"ICD-AHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aorcel/aormesen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35531","description":"Art byp grft aorcel/aormesen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28X","description":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABID1","description":"ICD-ABID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-27713","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","description":"CPT-27713","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHED1","description":"ICD-CHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQD1","description":"ICD-LEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLD0","description":"ICD-NJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB105","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo ablate renal mass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50542","description":"Laparo ablate renal mass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4361","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","description":"HCPCS-Q4361","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Idursulfase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1743","description":"Idursulfase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEC1","description":"ICD-FEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHD0","description":"ICD-FCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPD1","description":"ICD-FIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Already Receiving Physical/Occupational/Speech/Recreational Therapy During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0040","description":"Patient Already Receiving Physical/Occupational/Speech/Recreational Therapy During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ ha_ i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2634","description":"Brachytx_ non-str_ ha_ i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADF1","description":"ICD-JADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Accession of brush biopsy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0486","description":"Accession of brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath w/o bag 2-way silicone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4312","description":"Cath w/o bag 2-way silicone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Etidronate disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1436","description":"Etidronate disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ ns_ non-hdrir-192","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1719","description":"Brachytx_ ns_ non-hdrir-192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLC0","description":"ICD-IFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTC0","description":"ICD-ICTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20C","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFF0","description":"ICD-NBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1802","description":"HCPCS-B1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59409","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLE0","description":"ICD-KDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBA1","description":"ICD-FFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ famotidine_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0028","description":"Injection_ famotidine_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJE0","description":"ICD-FBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIC0","description":"ICD-NIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9875","description":"Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ophth us quant a only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76511","description":"Ophth us quant a only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFB0","description":"ICD-BAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit hydra over 3l diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9377","description":"Hit hydra over 3l diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient was in hospice or receiving palliative care at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1059","description":"Patient was in hospice or receiving palliative care at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIF1","description":"ICD-ADIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-rad contrast materialnoc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9698","description":"Non-rad contrast materialnoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remis 12m phq-9 score <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9509","description":"Remis 12m phq-9 score <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBC1","description":"ICD-CEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-77439","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","description":"CPT-77439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNC0","description":"ICD-OJNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral - occlusal radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0706","description":"Intraoral - occlusal radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder/create pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51596","description":"Remove bladder/create pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUC0","description":"ICD-NEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-35602","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","description":"CPT-35602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHC1","description":"ICD-MHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No urtr inj at surg/1ms post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9633","description":"No urtr inj at surg/1ms post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQA0","description":"ICD-OFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANA0","description":"ICD-GANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGB0","description":"ICD-FHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrin degradj d-dimer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85380","description":"Fibrin degradj d-dimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPB1","description":"ICD-CDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWB1","description":"ICD-HFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8I","description":"High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOB1","description":"ICD-GGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXD1","description":"ICD-FCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFA1","description":"ICD-JCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDB1","description":"ICD-MJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart first pass multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78483","description":"Heart first pass multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBF0","description":"ICD-MHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venous pressure clamp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4918","description":"Venous pressure clamp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1134","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDC1","description":"ICD-AFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","description":"HCPCS-J1414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiograph head w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70546","description":"Mr angiograph head w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAA0","description":"ICD-EIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGA0","description":"ICD-BHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYA1","description":"ICD-PEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA31","description":"ICD-4HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBE1","description":"ICD-NIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21600","description":"Partial removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKC1","description":"ICD-NKKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41850","description":"Treatment of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy abdominal mass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49180","description":"Biopsy abdominal mass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLE0","description":"ICD-NGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJA1","description":"ICD-FFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77285","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular Venous Arterialization_ Tibial Or Peroneal Vein_ With Transcatheter Placement Of Intravascular Stent Graft(S) And Closure By Any Method_ Including Percutaneous Or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0620T","description":"Endovascular Venous Arterialization_ Tibial Or Peroneal Vein_ With Transcatheter Placement Of Intravascular Stent Graft(S) And Closure By Any Method_ Including Percutaneous Or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-62331","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","description":"CPT-62331","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOE0","description":"ICD-GFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXB1","description":"ICD-FBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQB0","description":"ICD-KDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autologous blood process","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86890","description":"Autologous blood process","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50240","description":"Partial removal of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65110","description":"Removal of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42210","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOB1","description":"ICD-GHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCB1","description":"ICD-EFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anticoagulant management for a patient taking warfarin_ must include review and interpretation of a new home_ office_ or lab international normalized ratio (INR) test result_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93793","description":"Anticoagulant management for a patient taking warfarin_ must include review and interpretation of a new home_ office_ or lab international normalized ratio (INR) test result_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Benesch boot pair junior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3214","description":"Benesch boot pair junior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam abdo back wall lim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76775","description":"Us exam abdo back wall lim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acesso tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4300","description":"Acesso tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQC0","description":"ICD-PGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16051","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy cerv/thor facet jnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64633","description":"Destroy cerv/thor facet jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWF0","description":"ICD-CDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc no daily aspirin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9278","description":"Doc no daily aspirin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient spent less than three days in hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9860","description":"Patient spent less than three days in hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVA1","description":"ICD-BIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHD0","description":"ICD-OHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXA1","description":"ICD-CFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34702","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gauze > 48 sq in water/salne","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6230","description":"Gauze > 48 sq in water/salne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTB0","description":"ICD-AGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINC0","description":"ICD-JINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAE0","description":"ICD-CEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFE1","description":"ICD-JGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWB0","description":"ICD-GAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTA1","description":"ICD-FDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients With Mechanical Prosthetic Heart Valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0043","description":"Patients With Mechanical Prosthetic Heart Valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx isodose intermed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77317","description":"Brachytx isodose intermed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18A","description":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTD1","description":"ICD-IFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL36","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUC0","description":"ICD-NKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ankle joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27625","description":"Remove ankle joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ga67 gallium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9556","description":"Ga67 gallium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCD1","description":"ICD-KDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVF0","description":"ICD-OLVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIA0","description":"ICD-CHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPA1","description":"ICD-JFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDD1","description":"ICD-OCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28575","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of nucleotidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83915","description":"Assay of nucleotidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post-operative body jacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1310","description":"Post-operative body jacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB135","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDD1","description":"ICD-GIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77407","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBD1","description":"ICD-MIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMB0","description":"ICD-NIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55175","description":"Revision of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9738","description":"Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKE1","description":"ICD-OAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (hematolymphoid neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood or bone marrow_ report of specific gene rearra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014U","description":"Hematology (hematolymphoid neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood or bone marrow_ report of specific gene rearra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/orogastric w/tube plmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43752","description":"Nasal/orogastric w/tube plmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9482","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colectomy w/neo-rectum pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44158","description":"Colectomy w/neo-rectum pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHA1","description":"ICD-KAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermapure 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4152","description":"Dermapure 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66740","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQA1","description":"ICD-DAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTF1","description":"ICD-MGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interest escort in non er","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0090","description":"Interest escort in non er","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDC1","description":"ICD-AGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00752","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","description":"CPT-00752","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHF0","description":"ICD-FAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCC1","description":"ICD-AGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; each additional 30 minutes of technician time (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0365T","description":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; each additional 30 minutes of technician time (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Site no lung or lung cx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9424","description":"Site no lung or lung cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abscess imaging ltd area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78805","description":"Abscess imaging ltd area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB244","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBD1","description":"ICD-BFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath impl vasc access portal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4300","description":"Cath impl vasc access portal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDB1","description":"ICD-ECDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20A","description":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEB0","description":"ICD-OCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB104","description":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of skull lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61500","description":"Removal of skull lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Beta-bloc rx pt w/abn lvef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8450","description":"Beta-bloc rx pt w/abn lvef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXF1","description":"ICD-CIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOB1","description":"ICD-DBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUB1","description":"ICD-MEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69605","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Msh6 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81300","description":"Msh6 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA21","description":"Medium Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (high-grade prostate cancer)_ biochemical assay of four proteins (Total PSA_ Free PSA_ Intact PSA_ and human kallikrein-2 [hK2])_ utilizing plasma or serum_ prognosti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81539","description":"Oncology (high-grade prostate cancer)_ biochemical assay of four proteins (Total PSA_ Free PSA_ Intact PSA_ and human kallikrein-2 [hK2])_ utilizing plasma or serum_ prognosti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEE0","description":"ICD-NBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj olanzapine 2.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0166","description":"Inj olanzapine 2.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBF1","description":"ICD-KFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraop oct brst/node spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0351T","description":"Intraop oct brst/node spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIF0","description":"ICD-JDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-2 piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21146","description":"Lefort i-2 piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCB1","description":"ICD-OKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Otolaryngology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4022","description":"Otolaryngology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colistimethate inh sol mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0142","description":"Colistimethate inh sol mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55810","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB204","description":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27246","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCF0","description":"ICD-NBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPE0","description":"ICD-NBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSA0","description":"ICD-GDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject for spine disk x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62290","description":"Inject for spine disk x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYD0","description":"ICD-LCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTF0","description":"ICD-KCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvas resp support talk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4550F","description":"Noninvas resp support talk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES126","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med rsn scope pt >85y","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9660","description":"Doc med rsn scope pt >85y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy ligate perf veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37500","description":"Endoscopy ligate perf veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIF0","description":"ICD-IFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBB0","description":"ICD-MCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea stm ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0426T","description":"Insj/rplc nstim apnea stm ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52277","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGF1","description":"ICD-CAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALD1","description":"ICD-IALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB156","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSC1","description":"ICD-PGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUA1","description":"ICD-OJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFB0","description":"ICD-CIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0548U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","description":"CPT-0548U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Fixed Bilateral Space Maintainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1558","description":"Removal Of Fixed Bilateral Space Maintainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUF1","description":"ICD-BEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMC0","description":"ICD-BGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epoprostenol dilutant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0155","description":"Epoprostenol dilutant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHD1","description":"ICD-BBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair major blood vessel(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33320","description":"Repair major blood vessel(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC125","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pet image ltd area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78811","description":"Pet image ltd area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAD0","description":"ICD-JEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYA0","description":"ICD-GAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ edaravone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1301","description":"Injection_ edaravone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sodium fluoride f-18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9580","description":"Sodium fluoride f-18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coccidioides antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86635","description":"Coccidioides antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDD0","description":"ICD-BGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVF1","description":"ICD-CGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); diagnostic_ including collection of specimen(s) by brushing or washing when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6027","description":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); diagnostic_ including collection of specimen(s) by brushing or washing when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level III_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0752T","description":"Digitization of glass microscope slides for level III_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGD0","description":"ICD-NCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE221","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCE0","description":"ICD-IGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCC1","description":"ICD-KHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE154","description":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMC0","description":"ICD-JBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDID0","description":"ICD-EDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10C","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26742","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYE0","description":"ICD-OBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMB0","description":"ICD-KHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCE0","description":"ICD-NJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAE1","description":"ICD-BGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOE0","description":"ICD-HBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVB0","description":"ICD-NEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultraviolet light therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96900","description":"Ultraviolet light therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVB0","description":"ICD-KGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alternating pressure pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4640","description":"Alternating pressure pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pacemaker monitr digital/vis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0615","description":"Pacemaker monitr digital/vis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIB1","description":"ICD-BHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Childbirth refresher class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9437","description":"Childbirth refresher class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of silver diamine fluoride 38%_ by a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0792T","description":"Application of silver diamine fluoride 38%_ by a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vendaje_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4252","description":"Vendaje_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reusable enema bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4458","description":"Reusable enema bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7527","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOB1","description":"ICD-KIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBA0","description":"ICD-BGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95720","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEE1","description":"ICD-CGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carcinoembryonic antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82378","description":"Carcinoembryonic antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLC0","description":"ICD-JDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB11","description":"ICD-4CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB151","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enrollment**","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0009","description":"Enrollment**","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Offset/lat rocker arm w/ela","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2632","description":"Offset/lat rocker arm w/ela","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ilr device interrogat remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93298","description":"Ilr device interrogat remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2B","description":"Medium Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of total testosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84403","description":"Assay of total testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen system gas portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0430","description":"Oxygen system gas portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARD1","description":"ICD-CARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8H","description":"High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALD1","description":"ICD-JALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDD1","description":"ICD-CGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33470","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSD1","description":"ICD-HCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abd imag and followup no rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9550","description":"Abd imag and followup no rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQE0","description":"ICD-KEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse liver duct & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47802","description":"Fuse liver duct & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB241","description":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQD1","description":"ICD-KAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBB1","description":"ICD-GCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise flexor carpi radialis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25001","description":"Incise flexor carpi radialis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ (dr. reddy_s)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9072","description":"Injection_ cyclophosphamide_ (dr. reddy_s)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQB1","description":"ICD-PGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQB1","description":"ICD-DFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXA1","description":"ICD-OCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITB0","description":"ICD-JITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tacrol astagraf ex rel oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7508","description":"Tacrol astagraf ex rel oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients Under Hospice Care In The Current Reporting Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0051","description":"Patients Under Hospice Care In The Current Reporting Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth pacemaker insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53051","description":"Anesth pacemaker insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECC1","description":"ICD-EECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEID0","description":"ICD-MEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Admin influenza virus vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0008","description":"Admin influenza virus vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ metronidazole_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1836","description":"Injection_ metronidazole_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHA0","description":"ICD-AIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise & treat bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51020","description":"Incise & treat bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAF1","description":"ICD-KDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peg interferon alfa-2a/180","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0145","description":"Peg interferon alfa-2a/180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5153","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","description":"HCPCS-Q5153","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ guiding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1887","description":"Catheter_ guiding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81403","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRE1","description":"ICD-LIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of percutaneous transhepatic stent for internal and external biliary drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47511","description":"Introduction of percutaneous transhepatic stent for internal and external biliary drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chloramphenicol sodium injec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0720","description":"Chloramphenicol sodium injec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMF1","description":"ICD-JHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGA1","description":"ICD-NEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUE1","description":"ICD-IBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25685","description":"Treat wrist fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLE1","description":"ICD-GCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBA1","description":"ICD-BFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD130","description":"Special Care High _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEC1","description":"ICD-IFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFE0","description":"ICD-CAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCD1","description":"ICD-CDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine infusion device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62360","description":"Insert spine infusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXF1","description":"ICD-BBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCE1","description":"ICD-NDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58800","description":"Drainage of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11401","description":"Exc tr-ext b9+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45123","description":"Partial proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ankle joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27626","description":"Remove ankle joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10A","description":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcysteine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7608","description":"Acetylcysteine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neostigmine methylslfte inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2710","description":"Neostigmine methylslfte inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heparin-protamine tolerance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85530","description":"Heparin-protamine tolerance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJA1","description":"ICD-OGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEA1","description":"ICD-CGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA12","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMC0","description":"ICD-BBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61870","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin protect wc cus wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2603","description":"Skin protect wc cus wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXF1","description":"ICD-GIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOB1","description":"ICD-KDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay c-d transfer measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82373","description":"Assay c-d transfer measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKA0","description":"ICD-NFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of prealbumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84134","description":"Assay of prealbumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture type immunofluoresc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87140","description":"Culture type immunofluoresc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37232","description":"Tib/per revasc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nicardipine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2404","description":"Injection_ nicardipine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTE1","description":"ICD-NGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRB0","description":"ICD-OIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIB0","description":"ICD-GFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repos prev impltbl subq dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33273","description":"Repos prev impltbl subq dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRB1","description":"ICD-KBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc lack perm&cont&parox fib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1061F","description":"Doc lack perm&cont&parox fib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1012","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMC1","description":"ICD-GIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen quant gabapentin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80171","description":"Drug screen quant gabapentin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test urine for lactose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83633","description":"Test urine for lactose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFF0","description":"ICD-KFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSE0","description":"ICD-DDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43130","description":"Removal of esophagus pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epcoritamab-bysp_ 0.16 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9321","description":"Injection_ epcoritamab-bysp_ 0.16 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKD0","description":"ICD-BBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJD1","description":"ICD-NDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUF0","description":"ICD-NLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAD1","description":"ICD-NFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amino acid single qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82127","description":"Amino acid single qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vesiculobullous disease carr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5991","description":"Vesiculobullous disease carr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHE0","description":"ICD-EDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clin node stgng docdb/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3323F","description":"Clin node stgng docdb/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impact tooth remov part bony","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7230","description":"Impact tooth remov part bony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEF1","description":"ICD-FBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt lithium 3.6 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0604","description":"Repl batt lithium 3.6 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPC1","description":"ICD-CEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEF1","description":"ICD-IBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCC0","description":"ICD-CHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01960","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","description":"CPT-01960","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKD1","description":"ICD-OGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy stone removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52325","description":"Cystoscopy stone removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXC0","description":"ICD-BFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHA0","description":"ICD-OGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFE1","description":"ICD-KEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB31","description":"ICD-3IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infusion pump_non-prog_ perm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1891","description":"Infusion pump_non-prog_ perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMA1","description":"ICD-EIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIA1","description":"ICD-MHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLB0","description":"ICD-MGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clonidine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0735","description":"Clonidine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1079","description":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/excise tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52355","description":"Cystouretero w/excise tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMD1","description":"ICD-FGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8H","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cholangiography and/or pancreatography; through existing catheter_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74305","description":"Cholangiography and/or pancreatography; through existing catheter_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICE0","description":"ICD-MICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBD1","description":"ICD-NLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFE1","description":"ICD-NGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of nasal vestibular lateral wall stenosis with implant(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9749","description":"Repair of nasal vestibular lateral wall stenosis with implant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEF0","description":"ICD-AHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ing hernia baby reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49495","description":"Rpr ing hernia baby reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWF1","description":"ICD-LIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKD1","description":"ICD-CAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAF1","description":"ICD-OGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28A","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical conference by physic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0220","description":"Medical conference by physic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12D","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC214","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical dress holder reuse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4463","description":"Surgical dress holder reuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC31","description":"ICD-3JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE213","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mercaptopurine 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0108","description":"Mercaptopurine 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYB1","description":"ICD-PKYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35321","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINB0","description":"ICD-NINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells_ including leukapheresis and dose preparation procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9098","description":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells_ including leukapheresis and dose preparation procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0553U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","description":"CPT-0553U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVD1","description":"ICD-FAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOA1","description":"ICD-PBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUB0","description":"ICD-IHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXB1","description":"ICD-CGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJA1","description":"ICD-OHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUC0","description":"ICD-KCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTB0","description":"ICD-JCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGE0","description":"ICD-NDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILE1","description":"ICD-AILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOD1","description":"ICD-DGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILA1","description":"ICD-NILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerv flex n/adj foam pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0120","description":"Cerv flex n/adj foam pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLC1","description":"ICD-ABLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEME0","description":"ICD-KEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTD1","description":"ICD-ABTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trabeculostomy Ab Interno By Laser;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0621T","description":"Trabeculostomy Ab Interno By Laser;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFC1","description":"ICD-NJFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQE1","description":"ICD-PAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVC0","description":"ICD-NAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31294","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRF0","description":"ICD-GBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Placement of seton","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46020","description":"Placement of seton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHC0","description":"ICD-AGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMF0","description":"ICD-MJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gauze <= 16 sq in water/sal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6228","description":"Gauze <= 16 sq in water/sal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFME1","description":"ICD-AFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj intercost mlt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64421","description":"N block inj intercost mlt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQD0","description":"ICD-LEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCA1","description":"ICD-EFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRD1","description":"ICD-DFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSC1","description":"ICD-CFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC216","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6554","description":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKD0","description":"ICD-NEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCE1","description":"ICD-NHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcath stent cca w/eps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37215","description":"Transcath stent cca w/eps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electro-uroflowmetry first","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51741","description":"Electro-uroflowmetry first","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Image test ref carot diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3100F","description":"Image test ref carot diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA11","description":"ICD-1DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDD1","description":"ICD-IFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLA0","description":"ICD-NJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","description":"HCPCS-J2428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERC0","description":"ICD-HERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDF0","description":"ICD-JEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30320","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDED0","description":"ICD-IDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIED0","description":"ICD-GIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap revise/remv eltrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43648","description":"Lap revise/remv eltrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1601","description":"HCPCS-B1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVE0","description":"ICD-OLVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXE0","description":"ICD-NBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWB0","description":"ICD-KIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEB0","description":"ICD-GBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRD1","description":"ICD-PBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00600","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","description":"CPT-00600","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEC0","description":"ICD-NGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special casting material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4590","description":"Special casting material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKB1","description":"ICD-BDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVA1","description":"ICD-NEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPC1","description":"ICD-NAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artacent wound_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4169","description":"Artacent wound_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCE0","description":"ICD-EBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc visit unspecified nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9055","description":"Onc visit unspecified nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJE1","description":"ICD-KIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psych diag eval w/med srvcs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90792","description":"Psych diag eval w/med srvcs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vacc 4 dose immunsup im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90747","description":"Hepb vacc 4 dose immunsup im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0902","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0902","description":"CDT-D0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ foot_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6587","description":"Gradient pressure wrap with adjustable straps_ foot_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64834","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24470","description":"Revision of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTC0","description":"ICD-CHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSE0","description":"ICD-CBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC31","description":"ICD-2IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFC0","description":"ICD-KFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDA0","description":"ICD-GHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44145","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temp obturator prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5936","description":"Temp obturator prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGB1","description":"ICD-JFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMC0","description":"ICD-ADMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINE1","description":"ICD-JINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYE1","description":"ICD-CDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32601","description":"Thoracoscopy diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pectin based ostomy paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4406","description":"Pectin based ostomy paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFF1","description":"ICD-KHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3D Echocardiographic Imaging And Postprocessing During Transesophageal Echocardiography_ Or During Transthoracic Echocardiography For Congenital Cardiac Anomalies_ For The Ass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93319","description":"3D Echocardiographic Imaging And Postprocessing During Transesophageal Echocardiography_ Or During Transthoracic Echocardiography For Congenital Cardiac Anomalies_ For The Ass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEF1","description":"ICD-FFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Csit lowrisk surg pts preop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8961","description":"Csit lowrisk surg pts preop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE241","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLC0","description":"ICD-FFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Galectin-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82777","description":"Galectin-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pain assessment not documented as being performed_ documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8442","description":"Pain assessment not documented as being performed_ documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15934","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glucarpidase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9293","description":"Injection_ glucarpidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNF0","description":"ICD-NGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEB1","description":"ICD-KBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA245","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHB1","description":"ICD-NEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQC1","description":"ICD-KHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXC1","description":"ICD-GIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA31","description":"ICD-3HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation stating the patient has received or is currently receiving palliative or hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1307","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Csit perf sx or high chd rsk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8966","description":"Csit perf sx or high chd rsk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of pylorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43800","description":"Reconstruction of pylorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDA1","description":"ICD-MIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFB0","description":"ICD-FGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24145","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy & polypectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45333","description":"Sigmoidoscopy & polypectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSF1","description":"ICD-OHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBC1","description":"ICD-FBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen system liquid portabl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0435","description":"Oxygen system liquid portabl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med reas antibiotic pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8709","description":"Med reas antibiotic pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAF1","description":"ICD-JFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACA0","description":"ICD-MACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC53","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEA0","description":"ICD-OHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd endoscopic stent place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43266","description":"Egd endoscopic stent place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Implantation Or Replacement Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0587T","description":"Percutaneous Implantation Or Replacement Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extraosseous joint stblztion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0335T","description":"Extraosseous joint stblztion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVE1","description":"ICD-NHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1596","description":"Injection_ glycopyrrolate_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXD0","description":"ICD-OAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUA0","description":"ICD-BDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ synojoynt_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7331","description":"Hyaluronan or derivative_ synojoynt_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEC0","description":"ICD-BDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAD0","description":"ICD-JHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone_ lacrimal ophthalmic insert_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1096","description":"Dexamethasone_ lacrimal ophthalmic insert_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13B","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental inlay metallic 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2520","description":"Dental inlay metallic 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB136","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC52","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2A","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPE0","description":"ICD-FDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18A","description":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63271","description":"Excise intrspinl lesion thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen crosslinking cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0402T","description":"Collagen crosslinking cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNF0","description":"ICD-NBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral)_ biochemical assays_ tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)_ interferon gamma-induced protein-10 (IP-10)_ and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0351U","description":"Infectious disease (bacterial or viral)_ biochemical assays_ tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)_ interferon gamma-induced protein-10 (IP-10)_ and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUD0","description":"ICD-FEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Chlamydia trachomatis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87810","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Chlamydia trachomatis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOB0","description":"ICD-LCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAC0","description":"ICD-NDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88154","description":"Cytopath c/v select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMF0","description":"ICD-KIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUB1","description":"ICD-KIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9809","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGE0","description":"ICD-CCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ticarcillin disod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0040","description":"Injection_ ticarcillin disod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8762","description":"Pd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dtap-ipv/hib vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90698","description":"Dtap-ipv/hib vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLE0","description":"ICD-CFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWF1","description":"ICD-CFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEE0","description":"ICD-CGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8X","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJA0","description":"ICD-CGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intragastric hypothermia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0100","description":"Intragastric hypothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disease management program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0315","description":"Disease management program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWC1","description":"ICD-PKWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILC1","description":"ICD-BILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEF1","description":"ICD-NIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct capture limited","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0380","description":"Cone beam ct capture limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10B","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair leg fascia defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27656","description":"Repair leg fascia defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAE0","description":"ICD-MHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Graphite crucible for preparation of Technetium Tc 99m-labeled carbon aerosol_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9506","description":"Graphite crucible for preparation of Technetium Tc 99m-labeled carbon aerosol_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUA1","description":"ICD-ICUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0675","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","description":"HCPCS-J0675","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1829","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","description":"HCPCS-E1829","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNF1","description":"ICD-OJNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKF0","description":"ICD-CDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIA1","description":"ICD-KGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial prenatal care visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0500F","description":"Initial prenatal care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegcetacoplan_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9151","description":"Injection_ pegcetacoplan_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anti rheum drugthxpyrxd/gvn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4187F","description":"Anti rheum drugthxpyrxd/gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen supplies stand/rack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1355","description":"Oxygen supplies stand/rack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEC0","description":"ICD-KHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAF0","description":"ICD-BHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair webbed toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28345","description":"Repair webbed toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTC1","description":"ICD-MFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTA1","description":"ICD-FHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINA0","description":"ICD-FINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJF0","description":"ICD-KFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Cranberry Peak_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1008","description":"Clinical Decision Support Mechanism Cranberry Peak_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncoprotein her-2/neu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83950","description":"Oncoprotein her-2/neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYA0","description":"ICD-HDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gated heart multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78473","description":"Gated heart multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMC0","description":"ICD-EHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBND1","description":"ICD-FBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital bed var ht w/ mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0255","description":"Hospital bed var ht w/ mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft contral carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35509","description":"Art byp grft contral carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20D","description":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQB1","description":"ICD-GAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLE0","description":"ICD-NFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIB1","description":"ICD-FGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIA0","description":"ICD-NKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWB1","description":"ICD-PHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEA0","description":"ICD-NLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSC1","description":"ICD-OHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sgd prerec msg >8min <=20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2502","description":"Sgd prerec msg >8min <=20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removable partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5281","description":"Removable partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTE1","description":"ICD-MJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYD1","description":"ICD-LEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQA0","description":"ICD-DBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98979","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","description":"CPT-98979","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFB1","description":"ICD-GGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQB0","description":"ICD-PJQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMC1","description":"ICD-FBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76497","description":"Ct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCB1","description":"ICD-OLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients on peritoneal dialysis for any portion of the reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0052","description":"Patients on peritoneal dialysis for any portion of the reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVD0","description":"ICD-NCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCB1","description":"ICD-AHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSF1","description":"ICD-CBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBF0","description":"ICD-FGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFC1","description":"ICD-KAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPC1","description":"ICD-NLPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45499","description":"Laparoscope proc rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20B","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEED1","description":"ICD-MEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC11","description":"ICD-4EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLA0","description":"ICD-EDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sialoendoscopy capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0371","description":"Sialoendoscopy capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1412","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","description":"HCPCS-M1412","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hmes or trach valve housing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7505","description":"Hmes or trach valve housing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGB0","description":"ICD-CBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESB1","description":"ICD-LESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth larynx/trach < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32651","description":"Anesth larynx/trach < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEC1","description":"ICD-JAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNB1","description":"ICD-NKNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Expandable controller_ initl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2377","description":"Expandable controller_ initl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ibutilide fumarate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1742","description":"Ibutilide fumarate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQF1","description":"ICD-KDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBD1","description":"ICD-MFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWB0","description":"ICD-LFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lomustine 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0178","description":"Lomustine 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFD0","description":"ICD-CHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETD1","description":"ICD-OETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin and muscle repair face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15845","description":"Skin and muscle repair face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65135","description":"Insert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD234","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXA1","description":"ICD-BCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1B","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGA0","description":"ICD-FDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Palliative Care Services Used By Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9992","description":"Palliative Care Services Used By Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVB0","description":"ICD-FDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNC1","description":"ICD-GCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFC0","description":"ICD-KDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNB0","description":"ICD-JCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALB0","description":"ICD-GALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXF1","description":"ICD-BGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy adrenalectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60650","description":"Laparoscopy adrenalectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOC1","description":"ICD-GFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX44","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization counseling by a physician or other qualified health care professional for COVID-19_ ages under 21_ 5-15 minutes time (This code is used for the Medicaid EPSDT)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0315","description":"Immunization counseling by a physician or other qualified health care professional for COVID-19_ ages under 21_ 5-15 minutes time (This code is used for the Medicaid EPSDT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amino acids single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82131","description":"Amino acids single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC31","description":"ICD-2BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove lung artery emboli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33915","description":"Remove lung artery emboli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43453","description":"Dilate esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAD0","description":"ICD-EEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIE0","description":"ICD-BAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1303","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELC1","description":"ICD-GELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUB0","description":"ICD-MFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endocerv curettage w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57456","description":"Endocerv curettage w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWA0","description":"ICD-GDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine; scoliosis study_ including supine and erect studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72090","description":"Radiologic examination_ spine; scoliosis study_ including supine and erect studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0961T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","description":"CPT-0961T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHD1","description":"ICD-FGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEF0","description":"ICD-FIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCA0","description":"ICD-NFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCC1","description":"ICD-IHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited dental tx primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8010","description":"Limited dental tx primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder universal joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6650","description":"Shoulder universal joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18C","description":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ casimersen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9075","description":"Injection_ casimersen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep ak ischial direct form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5570","description":"Prep ak ischial direct form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVA1","description":"ICD-BEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIA0","description":"ICD-BCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lengthen metacarpal/finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26568","description":"Lengthen metacarpal/finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGC1","description":"ICD-FFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low frequency non-thermal us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97610","description":"Low frequency non-thermal us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin w/base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6721","description":"Crown resin w/base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Holster elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0498","description":"Holster elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIA1","description":"ICD-JCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHF0","description":"ICD-AFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pos elder mal scrn plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8733","description":"Doc pos elder mal scrn plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38500","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIB1","description":"ICD-FAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHND1","description":"ICD-CHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUD1","description":"ICD-JGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADE1","description":"ICD-BADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 3 piece rigid shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0492","description":"Tlso 3 piece rigid shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mental status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2014F","description":"Mental status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVA0","description":"ICD-BAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDC0","description":"ICD-KHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00836","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","description":"CPT-00836","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLD1","description":"ICD-FFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental inlay resin 3/mre sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2652","description":"Dental inlay resin 3/mre sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digoxin thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4220F","description":"Digoxin thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJB0","description":"ICD-JHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLC0","description":"ICD-FDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytotoxic antibody screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86808","description":"Cytotoxic antibody screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDF0","description":"ICD-AIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthroscopy_ shoulder_ surgi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2300","description":"Arthroscopy_ shoulder_ surgi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXD0","description":"ICD-ODXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24D","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ factor IX_ albumin fusion protein_ (recombinant)_ Idelvion_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7202","description":"Injection_ factor IX_ albumin fusion protein_ (recombinant)_ Idelvion_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clean out mastoid cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69222","description":"Clean out mastoid cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHF0","description":"ICD-IFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJD1","description":"ICD-JDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Follow up home visit/prental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1004","description":"Follow up home visit/prental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDA1","description":"ICD-KDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMA1","description":"ICD-NAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBC0","description":"ICD-CDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTE0","description":"ICD-IFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult size brief/diaper sm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4521","description":"Adult size brief/diaper sm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient enrolled in hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9858","description":"Patient enrolled in hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC11","description":"ICD-3CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB21","description":"Medium Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Barrera sl or barrera dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4281","description":"Barrera sl or barrera dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLA0","description":"ICD-BCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytp fna eval ea addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88177","description":"Cytp fna eval ea addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDF1","description":"ICD-JIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTF1","description":"ICD-OGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXD1","description":"ICD-BEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21453","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24A","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); modulating antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86043","description":"Acetylcholine receptor (AChR); modulating antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj filgrastim gcsf biosimil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5101","description":"Inj filgrastim gcsf biosimil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUA0","description":"ICD-NBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1493","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","description":"HCPCS-M1493","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBF1","description":"ICD-OCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transabdom amnioinfus w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59070","description":"Transabdom amnioinfus w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27740","description":"Repair of leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human Health Factor 10 Amniotic Patch (HHF10-P)_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4224","description":"Human Health Factor 10 Amniotic Patch (HHF10-P)_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSF1","description":"ICD-PDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAF1","description":"ICD-IAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8I","description":"Very High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"2vhpv vaccine 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90650","description":"2vhpv vaccine 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC12","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDD0","description":"ICD-KDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQE1","description":"ICD-CFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32120","description":"Re-exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cefoxitin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0694","description":"Cefoxitin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9176","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9176","description":"HCPCS-C9176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACB1","description":"ICD-MACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUE0","description":"ICD-ACUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"2 pc drainable ost pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4413","description":"2 pc drainable ost pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLC1","description":"ICD-KBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCE0","description":"ICD-OBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolong e&m/psyctx serv o/p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99355","description":"Prolong e&m/psyctx serv o/p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBC1","description":"ICD-NCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLE1","description":"ICD-NGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAD0","description":"ICD-OLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5145","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","description":"HCPCS-Q5145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYA0","description":"ICD-DFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVE0","description":"ICD-BEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0D","description":"High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINA1","description":"ICD-OINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDE0","description":"ICD-EIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cyclophosphamide oral 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8530","description":"Cyclophosphamide oral 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVB0","description":"ICD-FIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of skin tags <w/15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11200","description":"Removal of skin tags <w/15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 7 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP07","description":"Auto.test pane pricing code_ 7 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed xtra hvy dty x wide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0304","description":"Hosp bed xtra hvy dty x wide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYC1","description":"ICD-CGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTE1","description":"ICD-CDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAE0","description":"ICD-NLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAD1","description":"ICD-IFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC101","description":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHB0","description":"ICD-KEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25120","description":"Removal of forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastroplasty duodenal switch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43845","description":"Gastroplasty duodenal switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMA1","description":"ICD-GIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUF0","description":"ICD-NKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inlay repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2981","description":"Inlay repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of skin wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15829","description":"Removal of skin wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTE1","description":"ICD-MLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Delay flap f/c/c/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15620","description":"Delay flap f/c/c/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neostim tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4265","description":"Neostim tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscop w/esoph musc exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32665","description":"Thoracoscop w/esoph musc exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diaper serv reusable diaper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4538","description":"Diaper serv reusable diaper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70015","description":"Contrast x-ray of brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDB0","description":"ICD-AIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0592U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","description":"CPT-0592U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOE0","description":"ICD-DEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Candida dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87481","description":"Candida dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Jak2 (Janus Kinase 2) (Eg_ Myeloproliferative Disorder) Targeted Sequence Analysis (Eg_ Exons 12 And 13)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81279","description":"Jak2 (Janus Kinase 2) (Eg_ Myeloproliferative Disorder) Targeted Sequence Analysis (Eg_ Exons 12 And 13)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBC0","description":"ICD-CHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco use txmnt counseling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4000F","description":"Tobacco use txmnt counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2198","description":"Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9244","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9244","description":"CDT-D9244","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPF1","description":"ICD-OHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVB1","description":"ICD-BCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNB0","description":"ICD-NGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUC0","description":"ICD-BCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUE0","description":"ICD-OJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61521","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGD0","description":"ICD-NLGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB33","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITB0","description":"ICD-EITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clsd red comp malar/zygma fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7760","description":"Clsd red comp malar/zygma fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Door to punc time >2hr_ nrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9582","description":"Door to punc time >2hr_ nrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVE1","description":"ICD-OKVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAA0","description":"ICD-AFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDC0","description":"ICD-IDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHF0","description":"ICD-FFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOD0","description":"ICD-DFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ behind the ear (BTE)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5181","description":"Hearing aid_ contralateral routing device_ monaural_ behind the ear (BTE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATD0","description":"ICD-CATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0910T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","description":"CPT-0910T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frame typ sock interscap-tho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6690","description":"Frame typ sock interscap-tho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0427T","description":"Insj/rplc nstim apnea pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PuraPly XT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4197","description":"PuraPly XT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputate hand at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25922","description":"Amputate hand at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSF0","description":"ICD-OHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIF0","description":"ICD-JBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMB1","description":"ICD-OGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0603U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","description":"CPT-0603U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAED0","description":"ICD-FAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering influenza vaccine (e.g._ prior anaphylaxis due to the influenza vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1169","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g._ prior anaphylaxis due to the influenza vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD226","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ human papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0500T","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ human papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTF1","description":"ICD-KFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indium in-111 pentetreotide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9572","description":"Indium in-111 pentetreotide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1019","description":"Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diethylstilbestrol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9165","description":"Diethylstilbestrol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24366","description":"Reconstruct head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraop cyto path consult 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88334","description":"Intraop cyto path consult 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect prox humerus tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23220","description":"Resect prox humerus tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAB0","description":"ICD-NJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBD0","description":"ICD-BGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEE1","description":"ICD-FAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVD0","description":"ICD-OEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leuprolide acetate implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9219","description":"Leuprolide acetate implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay resin 4/mre sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2664","description":"Dental onlay resin 4/mre sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlh w/t/o uterus over 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58573","description":"Tlh w/t/o uterus over 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eo rigid w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3762","description":"Eo rigid w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKE0","description":"ICD-BEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRE1","description":"ICD-KIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung cx bx rpt no doc class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9421","description":"Lung cx bx rpt no doc class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGID1","description":"ICD-NGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX43","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVB1","description":"ICD-GAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programmable_ transient_ orally ingested capsule_ for use with external programmer_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9269","description":"Programmable_ transient_ orally ingested capsule_ for use with external programmer_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXF0","description":"ICD-CGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digoxin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1160","description":"Digoxin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPC1","description":"ICD-BHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged Office Or Other Outpatient Evaluation And Management Service(S) Beyond The Minimum Required Time Of The Primary Procedure Which Has Been Selected Using Total Time_ R","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99417","description":"Prolonged Office Or Other Outpatient Evaluation And Management Service(S) Beyond The Minimum Required Time Of The Primary Procedure Which Has Been Selected Using Total Time_ R","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gr34 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2359","description":"Gr34 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOD1","description":"ICD-PIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio abdominal arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75635","description":"Ct angio abdominal arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC131","description":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYD0","description":"ICD-CFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHD0","description":"ICD-ICHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFE0","description":"ICD-KCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained with diagnostic magnetic reso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0724T","description":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained with diagnostic magnetic reso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1072","description":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB211","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tongue mouth jaw surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41150","description":"Tongue mouth jaw surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0563U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","description":"CPT-0563U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI orbit/face/neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70542","description":"MRI orbit/face/neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymph choriomeningitis ab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86727","description":"Lymph choriomeningitis ab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHB0","description":"ICD-IDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interface_ cough stim device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7020","description":"Interface_ cough stim device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOF0","description":"ICD-LBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATA1","description":"ICD-AATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve repair; with nerve allograft_ each nerve_ first strand (cable)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64912","description":"Nerve repair; with nerve allograft_ each nerve_ first strand (cable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWE0","description":"ICD-DFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release eye tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67343","description":"Release eye tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBB0","description":"ICD-OHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icar ischm mntr interr eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0306T","description":"Icar ischm mntr interr eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Singl prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0504","description":"Singl prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I&d absc intraoral soft tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7510","description":"I&d absc intraoral soft tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDC Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0001","description":"CDC Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8I","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESA1","description":"ICD-HESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0462","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","description":"HCPCS-J0462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBC0","description":"ICD-GHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pvb thoracic cont infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64463","description":"Pvb thoracic cont infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAD0","description":"ICD-NEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00796","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","description":"CPT-00796","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLD0","description":"ICD-ABLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLF1","description":"ICD-KBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSD1","description":"ICD-PKSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplcmt defib w/lead(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33249","description":"Insj/rplcmt defib w/lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHF0","description":"ICD-BAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVF1","description":"ICD-NJVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMF0","description":"ICD-NKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj perflexane lip micros_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9955","description":"Inj perflexane lip micros_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDA0","description":"ICD-OIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No impr vis acuit w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9517","description":"No impr vis acuit w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQB1","description":"ICD-PDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Staph a dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87640","description":"Staph a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAE0","description":"ICD-JAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit chemo per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9329","description":"Hit chemo per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infrared heating pad system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0221","description":"Infrared heating pad system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFF0","description":"ICD-NHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATC1","description":"ICD-OATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Safety concerns screen provided and negative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9923","description":"Safety concerns screen provided and negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHB1","description":"ICD-NBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJF1","description":"ICD-NEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD204","description":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASE1","description":"ICD-HASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDC0","description":"ICD-OIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDF0","description":"ICD-OKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10A","description":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUA1","description":"ICD-CAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50576","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ amplified probe techniq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0005","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ amplified probe techniq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental bitewings four films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0274","description":"Dental bitewings four films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No postop ren fail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8576","description":"No postop ren fail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVD0","description":"ICD-GDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation vad in person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93750","description":"Interrogation vad in person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC224","description":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove stent via transureth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50386","description":"Remove stent via transureth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57000","description":"Exploration of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla class i semiquant panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86834","description":"Hla class i semiquant panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBD1","description":"ICD-OCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEE1","description":"ICD-FEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYE0","description":"ICD-PEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair standard w/ leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1150","description":"Wheelchair standard w/ leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0957T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","description":"CPT-0957T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOC0","description":"ICD-PHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMA0","description":"ICD-MCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary Disease (Idiopathic Pulmonary Fibrosis [Ipf])_ Mrna_ Gene Expression Analysis Of 190 Genes_ Utilizing Transbronchial Biopsies_ Diagnostic Algorithm Reported As Categ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81554","description":"Pulmonary Disease (Idiopathic Pulmonary Fibrosis [Ipf])_ Mrna_ Gene Expression Analysis Of 190 Genes_ Utilizing Transbronchial Biopsies_ Diagnostic Algorithm Reported As Categ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33771","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove digit nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64776","description":"Remove digit nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELA1","description":"ICD-MELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRF0","description":"ICD-KDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electric breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0603","description":"Electric breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shingrix vaccine documented as administered or previously received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1064","description":"Shingrix vaccine documented as administered or previously received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Desoxycorticosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82633","description":"Desoxycorticosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78599","description":"Respiratory nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pediatrics Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4024","description":"Pediatrics Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHE1","description":"ICD-OHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMB1","description":"ICD-CAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABF0","description":"ICD-EABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIB0","description":"ICD-KFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9485","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBA0","description":"ICD-CBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso trnk sj-t9 pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0454","description":"Tlso trnk sj-t9 pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","description":"HCPCS-J9174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ra tracer id of sentinl node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38792","description":"Ra tracer id of sentinl node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXC0","description":"ICD-GHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AJCC Breast Cancer Stage I: T1mic_ T1a or T1b (tumor size <= 1 cm) documented (ONC)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3372F","description":"AJCC Breast Cancer Stage I: T1mic_ T1a or T1b (tumor size <= 1 cm) documented (ONC)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRA0","description":"ICD-DFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEE0","description":"ICD-GIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELC0","description":"ICD-NELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYA1","description":"ICD-HCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB220","description":"Reduced Physical Function _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMA0","description":"ICD-GAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMB0","description":"ICD-CFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNF1","description":"ICD-OKNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQD0","description":"ICD-LFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHB0","description":"ICD-FAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHE1","description":"ICD-NFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ring flange plas/leather mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1110","description":"Ring flange plas/leather mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHF0","description":"ICD-NHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1440","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","description":"HCPCS-M1440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0426","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0426","description":"CDT-D0426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECA1","description":"ICD-KECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGA1","description":"ICD-CCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/abn lvef inelig b-bloc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8451","description":"Pt w/abn lvef inelig b-bloc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJA1","description":"ICD-FDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCB0","description":"ICD-FHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trach-esoph voice pros md in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8509","description":"Trach-esoph voice pros md in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAF1","description":"ICD-ODAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC26","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Io rad tx deliver by elctrns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77425","description":"Io rad tx deliver by elctrns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXB0","description":"ICD-OEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHF1","description":"ICD-KHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Facial augmentation implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5925","description":"Facial augmentation implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; column (eg_ gas liquid or hplc)_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82486","description":"Chromatography_ qualitative; column (eg_ gas liquid or hplc)_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITD0","description":"ICD-CITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCC0","description":"ICD-BFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc sed rate nonautomated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85651","description":"Rbc sed rate nonautomated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX36","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPD1","description":"ICD-BEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73590","description":"X-ray exam of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOB1","description":"ICD-PDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASF0","description":"ICD-GASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUE0","description":"ICD-OAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below knee sus/seal sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5685","description":"Below knee sus/seal sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","description":"HCPCS-M1405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAA1","description":"ICD-OAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWD1","description":"ICD-PLWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary leg bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5112","description":"Urinary leg bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unspec maxillofacial prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8048","description":"Unspec maxillofacial prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCE0","description":"ICD-MDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEED0","description":"ICD-IEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUA0","description":"ICD-FIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPD1","description":"ICD-CAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMB0","description":"ICD-AIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1120","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXA0","description":"ICD-FCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOB1","description":"ICD-OBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Potassium hydroxide preps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0112","description":"Potassium hydroxide preps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODME0","description":"ICD-ODME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home care supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99339","description":"Domicil/r-home care supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRD0","description":"ICD-OCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCE1","description":"ICD-FBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWF1","description":"ICD-DCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOF1","description":"ICD-KEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGE0","description":"ICD-NBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24565","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reshaping bone orthognathic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7940","description":"Reshaping bone orthognathic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLB1","description":"ICD-ABLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX24","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEB0","description":"ICD-EEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31786","description":"Remove windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPB1","description":"ICD-CFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed_ arterial approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0643T","description":"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed_ arterial approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pacemaker_ leadless_ dual chamber (right atrial and right ventricular implantable components)_ rate-responsive_ including all necessary components for implantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1605","description":"Pacemaker_ leadless_ dual chamber (right atrial and right ventricular implantable components)_ rate-responsive_ including all necessary components for implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAA1","description":"ICD-MGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC03","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVB0","description":"ICD-OKVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytomegalovirus dfa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87271","description":"Cytomegalovirus dfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDA0","description":"ICD-MJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25101","description":"Explore/treat wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC160","description":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXA0","description":"ICD-OLXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBID1","description":"ICD-NBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOE0","description":"ICD-OCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWF1","description":"ICD-KDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methyldopate hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0210","description":"Methyldopate hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPC1","description":"ICD-FCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBE0","description":"ICD-OLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Combo pegintf/rib rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4153F","description":"Combo pegintf/rib rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACC1","description":"ICD-BACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQC1","description":"ICD-LEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0B","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJE1","description":"ICD-GEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9734","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resuscitation bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8999","description":"Resuscitation bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWC1","description":"ICD-CIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red cell mass multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78121","description":"Red cell mass multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJB1","description":"ICD-KGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINA0","description":"ICD-BINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10B","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy infusion method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96425","description":"Chemotherapy infusion method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shldr disartic myoelectronic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6965","description":"Shldr disartic myoelectronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVB1","description":"ICD-FGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRB0","description":"ICD-PGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB212","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-3/> piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21147","description":"Lefort i-3/> piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOC0","description":"ICD-HHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo spiral prefabricated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1951","description":"Afo spiral prefabricated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALE0","description":"ICD-CALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound srfc culturetech used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4260F","description":"Wound srfc culturetech used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNB0","description":"ICD-OBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUF0","description":"ICD-ODUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nk cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86357","description":"Nk cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Haloperidol decanoate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1631","description":"Haloperidol decanoate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7515","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJID1","description":"ICD-MJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRE1","description":"ICD-DGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fosaprepitant injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1453","description":"Fosaprepitant injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJD0","description":"ICD-JGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAA0","description":"ICD-OKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAE0","description":"ICD-JCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLA0","description":"ICD-CBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iv hanger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0105","description":"Iv hanger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60521","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0305","description":"HCPCS-B0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software_ data collection_ transmission_ and storage_ each 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0741T","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software_ data collection_ transmission_ and storage_ each 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein access cutdown < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36420","description":"Vein access cutdown < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recement inlay onlay or part","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2910","description":"Recement inlay onlay or part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAF0","description":"ICD-OHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXF0","description":"ICD-BHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVB1","description":"ICD-CIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ spheroid cell culture_ poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib_ olaparib_ rucaparib_ velparib)_ tumor response prediction for each drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0325U","description":"Oncology (ovarian)_ spheroid cell culture_ poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib_ olaparib_ rucaparib_ velparib)_ tumor response prediction for each drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEB1","description":"ICD-EGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood smear interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85060","description":"Blood smear interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cognit impairment assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3720F","description":"Cognit impairment assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBE1","description":"ICD-EEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval opioid use instr/pt int","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9584","description":"Eval opioid use instr/pt int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ezderm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4136","description":"Ezderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with biopsy(ies) with adjuctive blue light cystoscopy with fluorescent imaging agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7550","description":"Cystourethroscopy_ with biopsy(ies) with adjuctive blue light cystoscopy with fluorescent imaging agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adhere pos air press therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8851","description":"Adhere pos air press therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Goserelin acetate implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9202","description":"Goserelin acetate implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFD0","description":"ICD-NGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18D","description":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYB0","description":"ICD-PBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5A","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc surveillance for disease","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9052","description":"Onc surveillance for disease","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBF1","description":"ICD-MDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQA1","description":"ICD-CDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDB1","description":"ICD-MFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBB0","description":"ICD-NIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKD1","description":"ICD-FHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXE0","description":"ICD-NAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCB0","description":"ICD-MGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJA0","description":"ICD-CBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHB1","description":"ICD-KHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXC1","description":"ICD-NJXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46924","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imaging of the head (CT or MRI) was not obtained_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1029","description":"Imaging of the head (CT or MRI) was not obtained_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUD0","description":"ICD-MIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00944","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","description":"CPT-00944","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCA1","description":"ICD-IGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEC1","description":"ICD-CHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUF1","description":"ICD-OFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC204","description":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILC0","description":"ICD-IILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHC1","description":"ICD-NEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0221","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUE1","description":"ICD-BHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD160","description":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthroflex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4125","description":"Arthroflex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mumps virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90704","description":"Mumps virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heinz bodies induced","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85445","description":"Heinz bodies induced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSE0","description":"ICD-CFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOB0","description":"ICD-PHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23A","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28050","description":"Biopsy of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted misc prosthetic ser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8499","description":"Unlisted misc prosthetic ser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colorectal scrn; hi risk ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0105","description":"Colorectal scrn; hi risk ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJF1","description":"ICD-FHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMC0","description":"ICD-FFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of sexual activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9818","description":"Documentation of sexual activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00812","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","description":"CPT-00812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUF0","description":"ICD-EHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast exam thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75605","description":"Contrast exam thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMF1","description":"ICD-ADMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBME1","description":"ICD-KBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAF0","description":"ICD-MGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Betamethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7624","description":"Betamethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCD0","description":"ICD-FHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res W/Chf Billd Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9680","description":"Onsite Ac C Tx Nsg Fac Res W/Chf Billd Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Empiric antibiotic rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4045F","description":"Empiric antibiotic rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00148","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","description":"CPT-00148","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28740","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MSH6 (mutS homolog 6) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0160U","description":"MSH6 (mutS homolog 6) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1297","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCE1","description":"ICD-GGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blastomyces antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86612","description":"Blastomyces antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOC0","description":"ICD-HEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB217","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carry goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8985","description":"Carry goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0B","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUB0","description":"ICD-BEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1C","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Care after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59430","description":"Care after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOC1","description":"ICD-KAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg_ DiGeorge syndrome_ Cri-du-chat syndrome)_ circulating cell-free fetal DNA in maternal blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81422","description":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg_ DiGeorge syndrome_ Cri-du-chat syndrome)_ circulating cell-free fetal DNA in maternal blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICF0","description":"ICD-GICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWD1","description":"ICD-GDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB141","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXB1","description":"ICD-GIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infect control supplies nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8301","description":"Infect control supplies nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFE1","description":"ICD-FIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enterovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86658","description":"Enterovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33405","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Renal function panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80069","description":"Renal function panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRD0","description":"ICD-HFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOC1","description":"ICD-KBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test sock wrist disart/bel e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6680","description":"Test sock wrist disart/bel e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mohs addl stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17312","description":"Mohs addl stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBB0","description":"ICD-AGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8D","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levofloxacin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1956","description":"Levofloxacin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2101","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC40","description":"Ultra High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMB1","description":"ICD-MBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB24","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWA0","description":"ICD-KEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXE0","description":"ICD-NDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAE1","description":"ICD-NHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALF1","description":"ICD-AALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE256","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sulfamethoxazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0039","description":"Injection_ sulfamethoxazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIED1","description":"ICD-KIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLB1","description":"ICD-MFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fracture frame dual w cross","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0946","description":"Fracture frame dual w cross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Residential Habilitation 4-8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0102","description":"Residential Habilitation 4-8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPB1","description":"ICD-BEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMA1","description":"ICD-NFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWA1","description":"ICD-GCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLC0","description":"ICD-MFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCD0","description":"ICD-FDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSD0","description":"ICD-GCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pressure pneum appl half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0673","description":"Pressure pneum appl half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSE0","description":"ICD-ODSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTC1","description":"ICD-ODTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANB0","description":"ICD-KANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA53","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cyclosporine oral 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7502","description":"Cyclosporine oral 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLD1","description":"ICD-NHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYB1","description":"ICD-CGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQB1","description":"ICD-HIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correct skin color 6.0 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11920","description":"Correct skin color 6.0 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rna tstng hepc vir ord/docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3265F","description":"Rna tstng hepc vir ord/docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emtricitabine 200mg and tenofovir alafenamide 25mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0751","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No pt category on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9293","description":"No pt category on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess susp docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3344F","description":"Mammo assess susp docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHD0","description":"ICD-AEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHD0","description":"ICD-BHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFME1","description":"ICD-KFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolong serv w/o contact add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99359","description":"Prolong serv w/o contact add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIF1","description":"ICD-MDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPA1","description":"ICD-NBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYC0","description":"ICD-GEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87469","description":"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30300","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVC0","description":"ICD-JBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBF1","description":"ICD-EGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12C","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVE0","description":"ICD-FGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBE1","description":"ICD-BCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCF1","description":"ICD-FCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCD0","description":"ICD-IBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Image cath fluid trns/vgnl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49407","description":"Image cath fluid trns/vgnl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1705","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1705","description":"HCPCS-B1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAA0","description":"ICD-KEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"repair cast partial framework_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5621","description":"repair cast partial framework_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull & explore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61250","description":"Pierce skull & explore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0091A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAE1","description":"ICD-MCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUA0","description":"ICD-EGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHE1","description":"ICD-JEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCD1","description":"ICD-NHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNB1","description":"ICD-FHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cane adjust/fixed with tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0100","description":"Cane adjust/fixed with tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBB0","description":"ICD-NCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOE0","description":"ICD-GIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cocoon membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4264","description":"Cocoon membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFF0","description":"ICD-JGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated-aucl_ (Jivi)_ 1U","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7208","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated-aucl_ (Jivi)_ 1U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic ring fx treat int fix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0414","description":"Pelvic ring fx treat int fix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGB1","description":"ICD-OIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of knee cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27345","description":"Removal of knee cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8A","description":"High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOE0","description":"ICD-PBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt reas no pneumococcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8866","description":"Doc pt reas no pneumococcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELC1","description":"ICD-MELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAD0","description":"ICD-BFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKE0","description":"ICD-BFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein four","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33513","description":"Cabg vein four","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of hymen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56700","description":"Partial removal of hymen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNF1","description":"ICD-NJNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEB1","description":"ICD-NGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXC0","description":"ICD-BAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ suprapubic/cystoscopic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2627","description":"Cath_ suprapubic/cystoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEF1","description":"ICD-MGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTB1","description":"ICD-JGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of eye prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2626","description":"Reduction of eye prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKA0","description":"ICD-JAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1196","description":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81425","description":"Genome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLA1","description":"ICD-JFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENF1","description":"ICD-OENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA31","description":"ICD-3IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0593U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","description":"CPT-0593U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDA0","description":"ICD-MIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33824","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUA1","description":"ICD-ADUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARD0","description":"ICD-KARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOD0","description":"ICD-CEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01404","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","description":"CPT-01404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5C","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVE0","description":"ICD-JFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIB0","description":"ICD-CFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJE1","description":"ICD-NLJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSE0","description":"ICD-OFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Consultation with a medical health care professional","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9311","description":"Consultation with a medical health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair fem hernia blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49557","description":"Rerepair fem hernia blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIF1","description":"ICD-BBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRB1","description":"ICD-PKRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adj chem not pres rsn spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8928","description":"Adj chem not pres rsn spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vaginectomy w/nodes compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57112","description":"Vaginectomy w/nodes compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy forearm soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25066","description":"Biopsy forearm soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDA1","description":"ICD-MBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIID0","description":"ICD-OIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPF0","description":"ICD-NJPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 15 genotyping (HPA-15)_ CD109 (CD109 molecule) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion purpura)_ gene analysis_ common varian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81112","description":"Human Platelet Antigen 15 genotyping (HPA-15)_ CD109 (CD109 molecule) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion purpura)_ gene analysis_ common varian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0220","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSD1","description":"ICD-OLSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKA0","description":"ICD-BBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace/irrigate catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62225","description":"Replace/irrigate catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Outrigger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1080","description":"Outrigger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABB1","description":"ICD-OABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWC0","description":"ICD-KGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ingest challenge addl 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95079","description":"Ingest challenge addl 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUD0","description":"ICD-JIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exfoliative cytolog collect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7287","description":"Exfoliative cytolog collect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28D","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBED1","description":"ICD-MBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trach suction cath close sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4605","description":"Trach suction cath close sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert needle cath bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44015","description":"Insert needle cath bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc app","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44979","description":"Laparoscope proc app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA21","description":"ICD-3EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69740","description":"Repair facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xyntha inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7185","description":"Xyntha inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGF0","description":"ICD-CEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUF0","description":"ICD-OFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGA0","description":"ICD-NAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Md inr test revie inter mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0250","description":"Md inr test revie inter mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINB1","description":"ICD-JINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBE0","description":"ICD-GGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGD1","description":"ICD-CEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"After cataract laser surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66821","description":"After cataract laser surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFED0","description":"ICD-IFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAB1","description":"ICD-GHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onlay porc/crmc >=3 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6609","description":"Onlay porc/crmc >=3 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24615","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNA0","description":"ICD-CGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYA0","description":"ICD-CDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEA0","description":"ICD-CBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLE0","description":"ICD-OBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","description":"CPT-01930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKF1","description":"ICD-OGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCC1","description":"ICD-FFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc taa repr incl subcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33880","description":"Endovasc taa repr incl subcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88000","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOB0","description":"ICD-OGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1462","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","description":"HCPCS-M1462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEB0","description":"ICD-MBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asthma kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8097","description":"Asthma kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whirlpool non-portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1310","description":"Whirlpool non-portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYE1","description":"ICD-GDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Slitting of prepuce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54001","description":"Slitting of prepuce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee disart_ sach ft_ endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5312","description":"Knee disart_ sach ft_ endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIF1","description":"ICD-JGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWA0","description":"ICD-HAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLD0","description":"ICD-IGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aortoiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35637","description":"Art byp aortoiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tob non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9459","description":"Tob non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1106","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"LW GNOTYP ICAM4 EXON 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0197U","description":"LW GNOTYP ICAM4 EXON 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXA1","description":"ICD-FEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12A","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chap services at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9473","description":"Chap services at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcyte_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4182","description":"Transcyte_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATB1","description":"ICD-GATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWD1","description":"ICD-PFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I & d vag hematoma non-ob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57023","description":"I & d vag hematoma non-ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Novosorb Synpath Dermal Matrix_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2006","description":"Novosorb Synpath Dermal Matrix_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTF0","description":"ICD-EFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHA1","description":"ICD-AIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEID0","description":"ICD-OEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28H","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIC0","description":"ICD-IHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIF1","description":"ICD-OGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg_CT studies performed for radiation treatment planning)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9320","description":"Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg_CT studies performed for radiation treatment planning)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXE1","description":"ICD-CHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA41","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGA1","description":"ICD-BHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath ren art 2nd+ bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36254","description":"Ins cath ren art 2nd+ bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC12","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whfo w/o joints pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3807","description":"Whfo w/o joints pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe sole wedge outside sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3360","description":"Shoe sole wedge outside sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct thorax w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71250","description":"Ct thorax w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMD0","description":"ICD-ODMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture bacteria anaerobic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87073","description":"Culture bacteria anaerobic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGD0","description":"ICD-CAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXD1","description":"ICD-JEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6090","description":"Repair implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGF1","description":"ICD-KFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAE1","description":"ICD-GAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9691","description":"Patient had hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21255","description":"Reconstruct lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEF1","description":"ICD-AFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHC0","description":"ICD-KEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Soft interface material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1820","description":"Soft interface material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83719","description":"Assay of blood lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNF1","description":"ICD-NHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free DNA_ analysis of 311 or more genes_ interrogation for sequence variants_ including substitutions_ ins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0239U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free DNA_ analysis of 311 or more genes_ interrogation for sequence variants_ including substitutions_ ins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETA1","description":"ICD-KETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWF1","description":"ICD-LAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of toe joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28054","description":"Biopsy of toe joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCA0","description":"ICD-KFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Infinx_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1018","description":"Clinical decision support mechanism Infinx_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxacillin sodium injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2700","description":"Oxacillin sodium injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of inner eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66770","description":"Removal of inner eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay nonendocrine receptor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84238","description":"Assay nonendocrine receptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Guided tiss regen resorble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4266","description":"Guided tiss regen resorble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYF1","description":"ICD-PKYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIF0","description":"ICD-JIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12B","description":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIB0","description":"ICD-NGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Barbiturates_ not elsewhere specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6043","description":"Barbiturates_ not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRD1","description":"ICD-DBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enterostomal therapy by a re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9474","description":"Enterostomal therapy by a re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous electrical nerve field stimulation_ cranial nerves_ without implantation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0720T","description":"Percutaneous electrical nerve field stimulation_ cranial nerves_ without implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part removal of ankle/heel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28120","description":"Part removal of ankle/heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJC1","description":"ICD-OEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHD1","description":"ICD-JDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vasc graft into carpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25430","description":"Vasc graft into carpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ faricimab-svoa_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9097","description":"Injection_ faricimab-svoa_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calc bmi norm parameters","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8420","description":"Calc bmi norm parameters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA11","description":"ICD-4FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29046","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18H","description":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLD0","description":"ICD-NGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMF1","description":"ICD-MLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXC1","description":"ICD-OEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHF0","description":"ICD-GAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHB1","description":"ICD-CEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB206","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recon_ cta for surg plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0288","description":"Recon_ cta for surg plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28307","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKE0","description":"ICD-NKKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93531","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBD0","description":"ICD-ADBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBF1","description":"ICD-EIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMB0","description":"ICD-GBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVD1","description":"ICD-FIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIC0","description":"ICD-EHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXB1","description":"ICD-GFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9985","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJD1","description":"ICD-NGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITE1","description":"ICD-FITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Japanese encephalitis virus vaccine_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90735","description":"Japanese encephalitis virus vaccine_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66020","description":"Injection treatment of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKB1","description":"ICD-JIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29821","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amniotext patch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4247","description":"Amniotext patch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ chloroprocaine hydrochloride_  per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2401","description":"Injection_ chloroprocaine hydrochloride_  per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA35","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEE0","description":"ICD-BEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29240","description":"Strapping of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fda approved prescription drug_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0799","description":"Fda approved prescription drug_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Internal eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92286","description":"Internal eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFC0","description":"ICD-KEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWC0","description":"ICD-OKWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0978T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","description":"CPT-0978T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Was Provided Pallative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9993","description":"Patient Was Provided Pallative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair special seat heig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1296","description":"Wheelchair special seat heig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXD1","description":"ICD-FAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDF1","description":"ICD-BEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKC0","description":"ICD-GAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRB0","description":"ICD-PCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43310","description":"Repair of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEC0","description":"ICD-GDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC50","description":"Medium Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Approp digoxin tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4189F","description":"Approp digoxin tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin (lyumjev)_ per 5 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1814","description":"Insulin (lyumjev)_ per 5 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ trans atherectomy_ dir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1714","description":"Cath_ trans atherectomy_ dir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBF1","description":"ICD-JGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUD1","description":"ICD-EGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prfrmnc docd 2 wks b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3328F","description":"Prfrmnc docd 2 wks b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPF1","description":"ICD-NAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKD1","description":"ICD-KHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYF0","description":"ICD-HIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC21","description":"ICD-2KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUD1","description":"ICD-JCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0402","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0402","description":"CDT-D0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDD1","description":"ICD-OGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0221","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear rx iv admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79101","description":"Nuclear rx iv admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYB1","description":"ICD-DFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFB1","description":"ICD-KHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20D","description":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Integrated keratoprosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1818","description":"Integrated keratoprosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDF1","description":"ICD-IIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBF0","description":"ICD-CIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSE1","description":"ICD-GBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Construction of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57291","description":"Construction of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 5.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4172","description":"Parenteral sol amino acid 5.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27194","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE255","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49617","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tte w or wo fol wcon_doppler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8929","description":"Tte w or wo fol wcon_doppler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMA1","description":"ICD-OLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr s/a/l 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14020","description":"Tis trnfr s/a/l 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9877","description":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient does not have a caregiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2184","description":"Patient does not have a caregiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18C","description":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUF1","description":"ICD-GGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFE1","description":"ICD-NEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tooth transplantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7272","description":"Tooth transplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27745","description":"Reinforce tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC54","description":"Very High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18G","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQE1","description":"ICD-PDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit inj interferon diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9559","description":"Hit inj interferon diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis repeated eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90937","description":"Hemodialysis repeated eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA01","description":"Very High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18G","description":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of esophagus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43100","description":"Excision of esophagus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opps service_sched team conf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0175","description":"Opps service_sched team conf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETF1","description":"ICD-BETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIA1","description":"ICD-OGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt reas no hospice refer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9525","description":"Doc pt reas no hospice refer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMD0","description":"ICD-ACMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2A","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB156","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60225","description":"Partial removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ileoscopy_through stoma; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6018","description":"Ileoscopy_through stoma; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESD1","description":"ICD-PESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal t1-2 no progr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9090","description":"Onc dx rectal t1-2 no progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25B","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHB0","description":"ICD-ODHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL44","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEA0","description":"ICD-FAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47140","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closd rductn splint alveolus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7670","description":"Closd rductn splint alveolus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKC1","description":"ICD-OCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECD0","description":"ICD-FECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTF1","description":"ICD-EDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOE1","description":"ICD-ODOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo total proctocolectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44210","description":"Laparo total proctocolectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screen c/v thin layer by md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0124","description":"Screen c/v thin layer by md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace non-molded calf lace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4055","description":"Replace non-molded calf lace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q12h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9501","description":"Hit antibiotic q12h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2082","description":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENB0","description":"ICD-GENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Copy number (EG_ intellectual disability_ dysmorphology)_ sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0156U","description":"Copy number (EG_ intellectual disability_ dysmorphology)_ sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; each additional electr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64597","description":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; each additional electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINF0","description":"ICD-GINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESD0","description":"ICD-PESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGME1","description":"ICD-JGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMB1","description":"ICD-JEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEC0","description":"ICD-FCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXD1","description":"ICD-BHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUD1","description":"ICD-EEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37145","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC21","description":"ICD-3FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sugars multiple quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84379","description":"Sugars multiple quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA220","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMB0","description":"ICD-MAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEED1","description":"ICD-IEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18G","description":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Who w/nontorsion jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3905","description":"Who w/nontorsion jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sclerotx fluid collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49185","description":"Sclerotx fluid collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCD1","description":"ICD-OHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQB1","description":"ICD-DCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYC1","description":"ICD-OIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQC0","description":"ICD-GIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95925","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBC1","description":"ICD-IFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA11","description":"ICD-4LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/revise male sling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53442","description":"Remove/revise male sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEF0","description":"ICD-NIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILF0","description":"ICD-AILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24D","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAID0","description":"ICD-IAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOD1","description":"ICD-OBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCD1","description":"ICD-CCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00830","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","description":"CPT-00830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWA1","description":"ICD-OLWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHC0","description":"ICD-EIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24430","description":"Repair of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCME1","description":"ICD-FCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAE1","description":"ICD-IHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKF0","description":"ICD-GGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQB1","description":"ICD-GDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anticoag clinic per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9401","description":"Anticoag clinic per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFD0","description":"ICD-BHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSA1","description":"ICD-CDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit midline cath insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5521","description":"Hit midline cath insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPC1","description":"ICD-JFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44970","description":"Laparoscopy appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDE0","description":"ICD-GFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Robotic surgical system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2900","description":"Robotic surgical system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA60","description":"Very High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJA0","description":"ICD-KBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroconvulsive therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90870","description":"Electroconvulsive therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHB0","description":"ICD-FCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore wound extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20103","description":"Explore wound extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11C","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDC1","description":"ICD-JGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18H","description":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Euflexxa inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7323","description":"Euflexxa inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYF1","description":"ICD-HIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTC0","description":"ICD-BGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUC1","description":"ICD-IBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXF0","description":"ICD-FGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWA0","description":"ICD-DCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYB0","description":"ICD-CAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOE1","description":"ICD-LEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25350","description":"Revision of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93226","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAF0","description":"ICD-BGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject r ventr/atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93566","description":"Inject r ventr/atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deb musc/fascia 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11043","description":"Deb musc/fascia 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Protamine sulfate per 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4802","description":"Protamine sulfate per 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29000","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44385","description":"Endoscopy of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93533","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVF1","description":"ICD-JAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0402","description":"HCPCS-A0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr fe/e/en/l/m 12.6-20.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12016","description":"Rpr fe/e/en/l/m 12.6-20.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSB1","description":"ICD-LHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep bk ptb plaster molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5510","description":"Prep bk ptb plaster molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSD1","description":"ICD-PFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOA0","description":"ICD-KHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plague vaccine_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90727","description":"Plague vaccine_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGD1","description":"ICD-CIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30901","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB145","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPD0","description":"ICD-GFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC21","description":"ICD-4BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAA0","description":"ICD-NEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHC1","description":"ICD-GDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27394","description":"Lengthening of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightweight leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1270","description":"Wheelchair lightweight leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28C","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Space maintainer_ removable bilateral_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1526","description":"Space maintainer_ removable bilateral_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJE1","description":"ICD-NIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDF0","description":"ICD-MHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAB1","description":"ICD-FHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44188","description":"Lap colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroguide for spine inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77003","description":"Fluoroguide for spine inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQD1","description":"ICD-PAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSF1","description":"ICD-DGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE216","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQA1","description":"ICD-GIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB240","description":"Special Care Low _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg ordered rvwd reqstd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3650F","description":"Eeg ordered rvwd reqstd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFD0","description":"ICD-NCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor x stuart-power","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85260","description":"Clot factor x stuart-power","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45400","description":"Laparoscopic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBA0","description":"ICD-IFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHC1","description":"ICD-GIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEA0","description":"ICD-ECEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYF0","description":"ICD-PBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHC1","description":"ICD-EDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBB1","description":"ICD-NFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8X","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLB0","description":"ICD-EBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s)_ and atherectomy_ includ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9775","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s)_ and atherectomy_ includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plastic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4027","description":"Plastic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHED0","description":"ICD-MHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIC1","description":"ICD-JGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVC1","description":"ICD-JBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCE1","description":"ICD-NBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDF1","description":"ICD-FIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27832","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBE1","description":"ICD-IFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUA1","description":"ICD-MBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pd catheter anchor belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4653","description":"Pd catheter anchor belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 5/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73523","description":"X-ray exam hips bi 5/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAF0","description":"ICD-CDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epidural lysis mult sessions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62263","description":"Epidural lysis mult sessions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXF0","description":"ICD-OKXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUD1","description":"ICD-MFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJD1","description":"ICD-CIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLD0","description":"ICD-JFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J8502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","description":"HCPCS-J8502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPF0","description":"ICD-OLPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWF1","description":"ICD-HIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bp sys>=140 and/or dias >=90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8477","description":"Bp sys>=140 and/or dias >=90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD146","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documented medical reasons for not performing intraoperative cystoscopy (e.g._ urethral pathology precluding cystoscopy_ any patient who has a congenital or acquired absence o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9607","description":"Documented medical reasons for not performing intraoperative cystoscopy (e.g._ urethral pathology precluding cystoscopy_ any patient who has a congenital or acquired absence o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11451","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRB1","description":"ICD-LHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heavy duty wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0006","description":"Heavy duty wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFB1","description":"ICD-JIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVD0","description":"ICD-OFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHE0","description":"ICD-NIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64840","description":"Repair of leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genetic counsel 15 mins","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0265","description":"Genetic counsel 15 mins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQB0","description":"ICD-CFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYC1","description":"ICD-KAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXC1","description":"ICD-FAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJC1","description":"ICD-NAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBF1","description":"ICD-NEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25230","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHD1","description":"ICD-BIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELF0","description":"ICD-NELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPA0","description":"ICD-CHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEC1","description":"ICD-GBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11463","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE241","description":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQB1","description":"ICD-DAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ ziv-aflibercept_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9400","description":"Inj_ ziv-aflibercept_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOB1","description":"ICD-OHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES321","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92992","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental panoramic film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0330","description":"Dental panoramic film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQC0","description":"ICD-DFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pan-solid tumor)_ analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA_ biomarker comparison to a previous baseline pre-treatmen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0422U","description":"Oncology (pan-solid tumor)_ analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA_ biomarker comparison to a previous baseline pre-treatmen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-rays bone survey complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77075","description":"X-rays bone survey complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC24","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proposed Adopting Best Practices And Promoting Patient Safety Within Emergency Medicine Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0057","description":"Proposed Adopting Best Practices And Promoting Patient Safety Within Emergency Medicine Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBB1","description":"ICD-KEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUD0","description":"ICD-GAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8D","description":"Low Rehab_ ADL Index 0-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maxilla open reduct simple","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7610","description":"Maxilla open reduct simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAF0","description":"ICD-FGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neg press wound tx >50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97606","description":"Neg press wound tx >50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryptosporidium ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87272","description":"Cryptosporidium ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXE0","description":"ICD-CFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA112","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIE0","description":"ICD-BFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDD1","description":"ICD-EHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRA1","description":"ICD-CDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Toe joint transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26556","description":"Toe joint transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraventricular pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93612","description":"Intraventricular pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ionm in operatng room 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95940","description":"Ionm in operatng room 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1040","description":"Patients with a diagnosis of lumbar idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of protein urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84156","description":"Assay of protein urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aldosterone suppression eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80408","description":"Aldosterone suppression eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0626T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBC1","description":"ICD-IIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGF0","description":"ICD-NFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVF0","description":"ICD-BGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC11","description":"ICD-1BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKD0","description":"ICD-JAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAB1","description":"ICD-FBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (fresenius kabi)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9048","description":"Injection_ bortezomib (fresenius kabi)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFA0","description":"ICD-CGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOC1","description":"ICD-PDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD114","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB215","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13D","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE216","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOB0","description":"ICD-KBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUA1","description":"ICD-FEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUB1","description":"ICD-FHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXF0","description":"ICD-JBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screw retained plate","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7292","description":"Screw retained plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colpopexy intraperitoneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57283","description":"Colpopexy intraperitoneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCA1","description":"ICD-GCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe styled positioning dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3160","description":"Shoe styled positioning dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQF1","description":"ICD-CGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFE0","description":"ICD-BGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot and ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28262","description":"Revision of foot and ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspir/inj thyroid cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60300","description":"Aspir/inj thyroid cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUE1","description":"ICD-JIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology gynecologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81535","description":"Oncology gynecologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYF0","description":"ICD-LGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHB0","description":"ICD-OGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sympathectomy digital artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64820","description":"Sympathectomy digital artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB21","description":"ICD-4BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAA1","description":"ICD-JAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYF1","description":"ICD-DIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGA1","description":"ICD-CEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth amniocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84251","description":"Anesth amniocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1032","description":"Nonpneumatic sequential compression garment_ full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGND0","description":"ICD-BGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJB1","description":"ICD-JHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSA0","description":"ICD-KGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of bile duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47420","description":"Incision of bile duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIC0","description":"ICD-NBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRE0","description":"ICD-PIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4354","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","description":"HCPCS-Q4354","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bifoc prscp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0506","description":"Bifoc prscp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla typing a b or c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86813","description":"Hla typing a b or c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAE1","description":"ICD-MFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAA0","description":"ICD-MDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYD0","description":"ICD-KAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65815","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOD0","description":"ICD-LAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFID1","description":"ICD-AFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOA0","description":"ICD-OJOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder passive restor cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6320","description":"Shoulder passive restor cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACC1","description":"ICD-JACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLD1","description":"ICD-CCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLC1","description":"ICD-ICLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWF1","description":"ICD-DFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Als defibrillation supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0392","description":"Als defibrillation supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFC1","description":"ICD-CGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAD0","description":"ICD-KFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01634","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","description":"CPT-01634","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNF0","description":"ICD-NCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNC1","description":"ICD-BCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spin/brain pump refil & main","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95991","description":"Spin/brain pump refil & main","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX11","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam ribs uni 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71100","description":"X-ray exam ribs uni 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/ove","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2206","description":"Lens sphcy bifocal 4.00d/ove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sign lang/oral interpreter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1013","description":"Sign lang/oral interpreter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj cladribine per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9065","description":"Inj cladribine per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDA1","description":"ICD-JBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Budesonide non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7633","description":"Budesonide non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAB1","description":"ICD-NJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEE1","description":"ICD-MLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXB0","description":"ICD-CDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation (In-Person) With Analysis_ Review And Report By A Physician Or Other Qualified Health Care Professional_ Including Connection_ Recording And Di","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0685T","description":"Interrogation Device Evaluation (In-Person) With Analysis_ Review And Report By A Physician Or Other Qualified Health Care Professional_ Including Connection_ Recording And Di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUB1","description":"ICD-FEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort iii w/fhdw/o lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21159","description":"Lefort iii w/fhdw/o lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSB1","description":"ICD-LFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen specific nucleic acid (DNA or RNA)_ 33 targets_ real-time semi-quantitative PCR_ bronchoalveolar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0151U","description":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen specific nucleic acid (DNA or RNA)_ 33 targets_ real-time semi-quantitative PCR_ bronchoalveolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOB0","description":"ICD-PFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRD1","description":"ICD-HBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision and/or reinsertion of transhepatic tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47530","description":"Revision and/or reinsertion of transhepatic tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB51","description":"Very High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSE0","description":"ICD-KGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spinal Puncture_ Lumbar_ Diagnostic; With Fluoroscopic Or Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62328","description":"Spinal Puncture_ Lumbar_ Diagnostic; With Fluoroscopic Or Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57200","description":"Repair of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYA1","description":"ICD-GEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPD0","description":"ICD-NGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L7406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","description":"HCPCS-L7406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDD1","description":"ICD-MKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ BICROS_ behind the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5220","description":"Hearing aid_ BICROS_ behind the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal mucosal integrity testing by electrical impedance_ transoral (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9777","description":"Esophageal mucosal integrity testing by electrical impedance_ transoral (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATE1","description":"ICD-AATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADF0","description":"ICD-NADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDD1","description":"ICD-MJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOA1","description":"ICD-CBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Atropine comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7635","description":"Atropine comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMA1","description":"ICD-OAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAE1","description":"ICD-GHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA03","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCF1","description":"ICD-EFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKD0","description":"ICD-NGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADID1","description":"ICD-ADID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTD1","description":"ICD-OCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUF0","description":"ICD-JIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDF0","description":"ICD-BEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLD1","description":"ICD-MKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70010","description":"Contrast x-ray of brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAD0","description":"ICD-ICAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81248","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUB0","description":"ICD-MHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6534","description":"Gc stocking thighlngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTE1","description":"ICD-KBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCE0","description":"ICD-MJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amniocentesis diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59000","description":"Amniocentesis diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph imped funct test > 1hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91038","description":"Esoph imped funct test > 1hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAE0","description":"ICD-IEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARB0","description":"ICD-GARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTA0","description":"ICD-BFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFC1","description":"ICD-BFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74445","description":"X-ray exam of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMD1","description":"ICD-EIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPD0","description":"ICD-JGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulp cap indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3120","description":"Pulp cap indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRB1","description":"ICD-DDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILB1","description":"ICD-MILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIB0","description":"ICD-IHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJF0","description":"ICD-BEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRE0","description":"ICD-OBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cervix repair bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57556","description":"Remove cervix repair bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAD0","description":"ICD-GHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg >16 <=48 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6252","description":"Absorpt drg >16 <=48 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXC0","description":"ICD-JBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pelvis contents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58240","description":"Removal of pelvis contents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXF0","description":"ICD-JFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement nasal cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7032","description":"Replacement nasal cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam breastbone 2/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71120","description":"X-ray exam breastbone 2/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 80 or more drugs or metabolites_ urine_ by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0146U","description":"Drug assay_ definitive_ 80 or more drugs or metabolites_ urine_ by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXB0","description":"ICD-KHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1204","description":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMD1","description":"ICD-EFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOC0","description":"ICD-LAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PermeaDerm glove_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2017","description":"PermeaDerm glove_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam abdo back wall comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76770","description":"Us exam abdo back wall comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVA0","description":"ICD-OBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1071T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1071T","description":"CPT-1071T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harvest cultured skin graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15040","description":"Harvest cultured skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair valve femoral vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34501","description":"Repair valve femoral vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX52","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert mesh/pelvic flr addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57267","description":"Insert mesh/pelvic flr addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLD1","description":"ICD-FHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXB1","description":"ICD-JCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUB1","description":"ICD-BEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cannabinoid synthetic 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80352","description":"Cannabinoid synthetic 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVC1","description":"ICD-CHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVB0","description":"ICD-NJVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27752","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFED1","description":"ICD-MFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRB1","description":"ICD-KFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFB1","description":"ICD-GDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJC0","description":"ICD-OIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIC0","description":"ICD-MIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound char size etc docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2050F","description":"Wound char size etc docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBE0","description":"ICD-BBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDA1","description":"ICD-BBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRD0","description":"ICD-CDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIA0","description":"ICD-OFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gi endoscopic ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76975","description":"Gi endoscopic ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SC GNOTYP ERMAP EXONS 4 12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0199U","description":"SC GNOTYP ERMAP EXONS 4 12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Slp stdy unatnd w/anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95801","description":"Slp stdy unatnd w/anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRF0","description":"ICD-KHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFE0","description":"ICD-GEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKA1","description":"ICD-CFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWE0","description":"ICD-OAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHC1","description":"ICD-EHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Haberman feeder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8265","description":"Haberman feeder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5D","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cgh test developmental delay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3870","description":"Cgh test developmental delay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJF1","description":"ICD-GFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor ix recombinant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7195","description":"Factor ix recombinant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOD1","description":"ICD-KGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90283","description":"Human ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGF1","description":"ICD-KBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGF1","description":"ICD-KGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLD0","description":"ICD-NCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWF1","description":"ICD-LFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup gauntlet plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4013","description":"Cast sup gauntlet plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQD1","description":"ICD-PIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplant palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26485","description":"Transplant palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRA0","description":"ICD-DIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHC0","description":"ICD-NGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11312","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKD0","description":"ICD-CGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFB1","description":"ICD-BIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVA1","description":"ICD-GGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abduction bar-straight","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2310","description":"Abduction bar-straight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28G","description":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-sterile eye pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6411","description":"Non-sterile eye pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52330","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray head for orthodontia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70350","description":"X-ray head for orthodontia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKB1","description":"ICD-GCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTF1","description":"ICD-EGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove rectum w/reservoir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45119","description":"Remove rectum w/reservoir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFC1","description":"ICD-OBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home sleep test/type 4 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0400","description":"Home sleep test/type 4 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETB0","description":"ICD-KETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4431","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","description":"HCPCS-Q4431","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBA1","description":"ICD-JBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFB1","description":"ICD-JGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTC0","description":"ICD-NKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6538","description":"Gc stocking full lngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0012","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0589","description":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99156","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assessment for hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5010","description":"Assessment for hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC26","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTD0","description":"ICD-EGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRD1","description":"ICD-OKRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB110","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic sgd interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2351","description":"Electronic sgd interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB214","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for breast x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19030","description":"Injection for breast x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKA0","description":"ICD-KDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Csit perf on low chd rsk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8965","description":"Csit perf on low chd rsk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLF1","description":"ICD-FDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAF0","description":"ICD-GHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1104","description":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPF1","description":"ICD-KAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Or Replacement Of Implantable Cardioverter-Defibrillator System With Substernal Electrode(S)_ Including All Imaging Guidance And Electrophysiological Evaluation (Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0571T","description":"Insertion Or Replacement Of Implantable Cardioverter-Defibrillator System With Substernal Electrode(S)_ Including All Imaging Guidance And Electrophysiological Evaluation (Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7570","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7570","description":"HCPCS-C7570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15C","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOF1","description":"ICD-DBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Duodenal motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91022","description":"Duodenal motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Omalizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2357","description":"Omalizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEA0","description":"ICD-IAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60270","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYA1","description":"ICD-KIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0602","description":"HCPCS-A0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCB0","description":"ICD-KFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE120","description":"Special Care Low _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0203","description":"HCPCS-A0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mh svc plan dev by non-md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0032","description":"Mh svc plan dev by non-md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPE1","description":"ICD-NDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11A","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv3 vacc no prsv 6-35 mo im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90655","description":"Iiv3 vacc no prsv 6-35 mo im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCME0","description":"ICD-OCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manipulate elbow w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24300","description":"Manipulate elbow w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33901","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVD0","description":"ICD-JGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36470","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct extra finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26587","description":"Reconstruct extra finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0551","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","description":"HCPCS-G0551","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coch imp ext proc/contr rplc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8619","description":"Coch imp ext proc/contr rplc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYE1","description":"ICD-HHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRC1","description":"ICD-CGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUA1","description":"ICD-MAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDD1","description":"ICD-BHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ carmustine (accord)_ not therapeutically equivalent to j9050_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9052","description":"Injection_ carmustine (accord)_ not therapeutically equivalent to j9050_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Dissection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33858","description":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Dissection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Navigational bronchoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31627","description":"Navigational bronchoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQF0","description":"ICD-CDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pelvic abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57010","description":"Drainage of pelvic abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repeat thyroid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60260","description":"Repeat thyroid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABF1","description":"ICD-CABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTF1","description":"ICD-BFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14A","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCD0","description":"ICD-FBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-disposable underpads_ all sizes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4553","description":"Non-disposable underpads_ all sizes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJC0","description":"ICD-FDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15952","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroretinography (ERG)_ with interpretation and report; full field (ie_ ffERG_ flash ERG_ Ganzfeld ERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92273","description":"Electroretinography (ERG)_ with interpretation and report; full field (ie_ ffERG_ flash ERG_ Ganzfeld ERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMC0","description":"ICD-NEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of finger(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73140","description":"X-ray exam of finger(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEE1","description":"ICD-MHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBE1","description":"ICD-MFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27391","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65235","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFB1","description":"ICD-OIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRB1","description":"ICD-OHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of protein any source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84160","description":"Assay of protein any source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKF0","description":"ICD-JHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14D","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc fe+ stores b/4 epo thx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3160F","description":"Doc fe+ stores b/4 epo thx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTF1","description":"ICD-GCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27691","description":"Revise lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99403","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKB0","description":"ICD-JIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDD1","description":"ICD-ODDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECD0","description":"ICD-BECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8C","description":"Very High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFA0","description":"ICD-OBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLF0","description":"ICD-FBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDD1","description":"ICD-KGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEE1","description":"ICD-ODEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGA1","description":"ICD-GDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln cmplt mand chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5731","description":"Denture reln cmplt mand chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0562U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","description":"CPT-0562U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (respiratory infection)_ Myxovirus resistance protein A (MxA) and C-reactive protein (CRP)_ fingerstick whole blood specimen_ each biomarker reported as pre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0442U","description":"Infectious disease (respiratory infection)_ Myxovirus resistance protein A (MxA) and C-reactive protein (CRP)_ fingerstick whole blood specimen_ each biomarker reported as pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 20.1-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12036","description":"Intmd rpr s/a/t/ext 20.1-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33945","description":"Transplantation of heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC44","description":"Very High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVA1","description":"ICD-FCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEB1","description":"ICD-NAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMF1","description":"ICD-FDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKA0","description":"ICD-NEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vestibular device implantation_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0725T","description":"Vestibular device implantation_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of peritoneum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74190","description":"X-ray exam of peritoneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJB0","description":"ICD-OEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPA0","description":"ICD-KFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRA1","description":"ICD-HDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXE1","description":"ICD-GCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIB0","description":"ICD-JIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBD1","description":"ICD-ACBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intervene hlth/behave group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96153","description":"Intervene hlth/behave group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remis 12m not phq-9 score <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9510","description":"Remis 12m not phq-9 score <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB112","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10D","description":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMD1","description":"ICD-IFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHE1","description":"ICD-FIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABA0","description":"ICD-GABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62220","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj ceftazidime per 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0713","description":"Inj ceftazidime per 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEA0","description":"ICD-NAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1058T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1058T","description":"CPT-1058T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBB1","description":"ICD-MLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIB1","description":"ICD-BAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHB0","description":"ICD-AEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERF1","description":"ICD-PERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPE1","description":"ICD-GIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDC0","description":"ICD-OGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEE0","description":"ICD-OLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4D","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98972","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMF0","description":"ICD-BBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIA0","description":"ICD-JCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVA1","description":"ICD-KHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAB0","description":"ICD-IBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stereotactic body radiation therapy_ treatment delivery_ per fraction to 1 or more lesions_ including image guidance and real-time positron emissions-based delivery adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9795","description":"Stereotactic body radiation therapy_ treatment delivery_ per fraction to 1 or more lesions_ including image guidance and real-time positron emissions-based delivery adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Paricalcitol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2501","description":"Paricalcitol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJB0","description":"ICD-JEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco nonsmoker nor 2ndhnd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1033F","description":"Tobacco nonsmoker nor 2ndhnd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTB0","description":"ICD-EDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKA1","description":"ICD-BFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHB0","description":"ICD-FDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vendaje ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4279","description":"Vendaje ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEB1","description":"ICD-KGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPC1","description":"ICD-NFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneum compres w/cal pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0652","description":"Pneum compres w/cal pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLC0","description":"ICD-JHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYE0","description":"ICD-ODYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOD0","description":"ICD-PKOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAC1","description":"ICD-AAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLE1","description":"ICD-AGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19000","description":"Drainage of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWD0","description":"ICD-PDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBB0","description":"ICD-FFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ini phq9 >9 remiss <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9393","description":"Ini phq9 >9 remiss <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBF0","description":"ICD-MEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHC0","description":"ICD-EFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8D","description":"High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11B","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJD1","description":"ICD-BHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Death did not occur after discharge from the hospital within 30 days post procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9817","description":"Death did not occur after discharge from the hospital within 30 days post procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Of Substernal Implantable Defibrillator Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0572T","description":"Insertion Of Substernal Implantable Defibrillator Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Care of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59820","description":"Care of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAA1","description":"ICD-MBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or bila","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7505","description":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or bila","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull for brain wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61571","description":"Incise skull for brain wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQA1","description":"ICD-PCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCF1","description":"ICD-GHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVF0","description":"ICD-JBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40650","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27310","description":"Exploration of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ann breast exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0613","description":"Ann breast exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telethx isodose plan simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77306","description":"Telethx isodose plan simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBF0","description":"ICD-KFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC21","description":"ICD-4HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWF1","description":"ICD-DGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRF0","description":"ICD-CBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement Of Lost Or Broken Retainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8703","description":"Replacement Of Lost Or Broken Retainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9750","description":"Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBF0","description":"ICD-MCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Idecabtagene vicleucel_ up to 460 million autologous anti-BCMA CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9081","description":"Idecabtagene vicleucel_ up to 460 million autologous anti-BCMA CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGF0","description":"ICD-GAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFB0","description":"ICD-FDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHE0","description":"ICD-GBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDE0","description":"ICD-NDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace quadlat socket brim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4020","description":"Replace quadlat socket brim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYC0","description":"ICD-DFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft iliofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35565","description":"Art byp grft iliofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUA0","description":"ICD-BIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJC1","description":"ICD-JHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Note hring tst w/in 6 mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3230F","description":"Note hring tst w/in 6 mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWC1","description":"ICD-DEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iron binding test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83550","description":"Iron binding test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bivalirudin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0583","description":"Bivalirudin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA226","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0102","description":"HCPCS-C0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40810","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSF0","description":"ICD-HFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALC0","description":"ICD-CALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABF1","description":"ICD-EABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx cml acceler phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9124","description":"Onc dx cml acceler phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12A","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUE1","description":"ICD-GGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAA0","description":"ICD-NGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3304","description":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBD1","description":"ICD-JHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2252","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","description":"HCPCS-J2252","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCC0","description":"ICD-NFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I131 iodide sol_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9529","description":"I131 iodide sol_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADC0","description":"ICD-MADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVB0","description":"ICD-NFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEF1","description":"ICD-GCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDC1","description":"ICD-CEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCD1","description":"ICD-BBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tantalum ring application","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8030","description":"Tantalum ring application","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB40","description":"Medium Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21261","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAB1","description":"ICD-MLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heavyduty walker no wheels","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0148","description":"Heavyduty walker no wheels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBE1","description":"ICD-OEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARC1","description":"ICD-LARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8D","description":"Very High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ ep_ 19 or few elect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1730","description":"Cath_ ep_ 19 or few elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSB1","description":"ICD-CGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUE0","description":"ICD-JDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC150","description":"Special Care Low _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Should sling/vest/abrestrain","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4566","description":"Should sling/vest/abrestrain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOB0","description":"ICD-OIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24400","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA17","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPF1","description":"ICD-OEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1404","description":"HCPCS-A1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNF1","description":"ICD-NLNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESF1","description":"ICD-CESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQF1","description":"ICD-HCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25B","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal pelvic lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38562","description":"Removal pelvic lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKD1","description":"ICD-KCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALE1","description":"ICD-JALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDC1","description":"ICD-NKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJA0","description":"ICD-KFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35281","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISD0","description":"ICD-DISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYC0","description":"ICD-OJYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genesis Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4198","description":"Genesis Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCA1","description":"ICD-OFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPE1","description":"ICD-OJPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1282","description":"Patient screened for tobacco use and identified as a tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (urothelial carcinoma)_ DNA_ quantitative methylation-specific PCR of 2 genes (ONECUT2_ VIM)_ algorithmic analysis reported as positive or negative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0465U","description":"Oncology (urothelial carcinoma)_ DNA_ quantitative methylation-specific PCR of 2 genes (ONECUT2_ VIM)_ algorithmic analysis reported as positive or negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPD0","description":"ICD-NIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELA0","description":"ICD-MELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATC0","description":"ICD-KATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for electron microscopy_ diagnostic (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0856T","description":"Digitization of glass microscope slides for electron microscopy_ diagnostic (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis access study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90940","description":"Hemodialysis access study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12A","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27146","description":"Incision of hip bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58974","description":"Transfer of embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1315","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto interm peritoneal dialy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1592","description":"Auto interm peritoneal dialy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE101","description":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJA1","description":"ICD-KEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJE1","description":"ICD-JFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYA1","description":"ICD-LEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKE0","description":"ICD-OEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12007","description":"Rpr s/n/ax/gen/trnk >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tun ip cath w/port","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49419","description":"Insert tun ip cath w/port","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spin/brain pump refil & main","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95990","description":"Spin/brain pump refil & main","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANA0","description":"ICD-KANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20A","description":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ova and parasites smears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87177","description":"Ova and parasites smears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTC0","description":"ICD-FBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ DNA_ next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy_ urine_ algorithms reported as minimal residual disease (MRD) status positive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0467U","description":"Oncology (bladder)_ DNA_ next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy_ urine_ algorithms reported as minimal residual disease (MRD) status positive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTD0","description":"ICD-MGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWF1","description":"ICD-OBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOD1","description":"ICD-HBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWE0","description":"ICD-DAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22850","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGND0","description":"ICD-OGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc cur meds by prov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8427","description":"Doc cur meds by prov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J8541","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","description":"HCPCS-J8541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","description":"CPT-01472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11440","description":"Exc face-mm b9+marg 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIF0","description":"ICD-IGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a baseline pam score and/or a second score within 6 to 12 month of baseline pam score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1344","description":"Patients who did not have a baseline pam score and/or a second score within 6 to 12 month of baseline pam score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGD1","description":"ICD-KEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEB0","description":"ICD-JCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of methemalbumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83857","description":"Assay of methemalbumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Legionella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86713","description":"Legionella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of digit nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64831","description":"Repair of digit nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE212","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist/forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25116","description":"Remove wrist/forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQA1","description":"ICD-HCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACA1","description":"ICD-NACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neck/chest surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21899","description":"Neck/chest surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ metronidazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0030","description":"Injection_ metronidazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bl draw < 3 yrs fem/jugular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36400","description":"Bl draw < 3 yrs fem/jugular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj octafluoropropane mic_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9956","description":"Inj octafluoropropane mic_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22A","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBA1","description":"ICD-MKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"T cell absolute count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86361","description":"T cell absolute count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOE0","description":"ICD-LIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHB0","description":"ICD-OJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYF1","description":"ICD-CAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal myoelectrical activity study_ stomach through colon_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0779T","description":"Gastrointestinal myoelectrical activity study_ stomach through colon_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILB1","description":"ICD-KILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ramucirumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9308","description":"Injection_ ramucirumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKC0","description":"ICD-KFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUE0","description":"ICD-EBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYF0","description":"ICD-HHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXF1","description":"ICD-GAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspergillus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86606","description":"Aspergillus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEC1","description":"ICD-JHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEID0","description":"ICD-NEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKD1","description":"ICD-CBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBF1","description":"ICD-JEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIC1","description":"ICD-OHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRA0","description":"ICD-LIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDB1","description":"ICD-OKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHA0","description":"ICD-GDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML12","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSD0","description":"ICD-LDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open nasoethmoid fx w/o fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21338","description":"Open nasoethmoid fx w/o fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFB1","description":"ICD-JFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTB1","description":"ICD-ICTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDA0","description":"ICD-MFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Activation device for intraurethral drainage device with valve_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1011","description":"Activation device for intraurethral drainage device with valve_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJF1","description":"ICD-NCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iv chelationtherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0300","description":"Iv chelationtherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEC1","description":"ICD-AIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8D","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC134","description":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumb artif diskectomy addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0163T","description":"Lumb artif diskectomy addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNE1","description":"ICD-OBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC21","description":"ICD-4DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEC1","description":"ICD-NHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAC1","description":"ICD-IBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluconazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1450","description":"Fluconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARA0","description":"ICD-KARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXF0","description":"ICD-GAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0849","description":"Pwc gp 3 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neostim dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4267","description":"Neostim dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXC1","description":"ICD-NCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 2)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1714","description":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sirolimus protein-bound particles_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9091","description":"Injection_ sirolimus protein-bound particles_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ntsty modul rad tx dlvr cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77386","description":"Ntsty modul rad tx dlvr cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBD0","description":"ICD-OEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4432","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","description":"HCPCS-Q4432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLB0","description":"ICD-NHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYB1","description":"ICD-PHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Current tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1316","description":"Current tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGD1","description":"ICD-GFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct entire forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21180","description":"Reconstruct entire forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myelogphy 2/> spine regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72270","description":"Myelogphy 2/> spine regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJC1","description":"ICD-GFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21C","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15C","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sps knee device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1811","description":"Sps knee device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthroereisis_ subtalar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2117","description":"Arthroereisis_ subtalar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10B","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDF0","description":"ICD-BIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQF0","description":"ICD-LAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBND0","description":"ICD-JBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psytx crisis initial 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90839","description":"Psytx crisis initial 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC110","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove collar bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23170","description":"Remove collar bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSA0","description":"ICD-KFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAF1","description":"ICD-GFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18X","description":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITE1","description":"ICD-EITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMB0","description":"ICD-IGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAB0","description":"ICD-NIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTC0","description":"ICD-CDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI abdomen w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74182","description":"MRI abdomen w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval on foot documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8410","description":"Eval on foot documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWC0","description":"ICD-CIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postpartum care visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0503F","description":"Postpartum care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meals for clinical trial par","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9996","description":"Meals for clinical trial par","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36901","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINE1","description":"ICD-NINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81289","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22840","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2B","description":"Very High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve teasing preparations","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88362","description":"Nerve teasing preparations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap replace gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43773","description":"Lap replace gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIC0","description":"ICD-GHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDB1","description":"ICD-CHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITC1","description":"ICD-BITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plasma_ frz between 8-24hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9059","description":"Plasma_ frz between 8-24hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Composite byp grft 2 veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35682","description":"Composite byp grft 2 veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDE1","description":"ICD-FHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1 bodytemp >=35.5cw/in 30min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4559F","description":"1 bodytemp >=35.5cw/in 30min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWD1","description":"ICD-GAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNC1","description":"ICD-GDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lesion destruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7465","description":"Lesion destruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBF0","description":"ICD-OBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJC1","description":"ICD-FEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB135","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27446","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ plazomicin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0291","description":"Injection_ plazomicin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBD1","description":"ICD-ADBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1109T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1109T","description":"CPT-1109T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mrcp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8037","description":"Mrcp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDA1","description":"ICD-JFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXB1","description":"ICD-FEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1501","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1501","description":"CDT-D1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1401","description":"HCPCS-A1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27331","description":"Explore/treat knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILB1","description":"ICD-CILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYA0","description":"ICD-HFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPA1","description":"ICD-JCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEF1","description":"ICD-JAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo-vag hyst incl t/o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58552","description":"Laparo-vag hyst incl t/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42971","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKD0","description":"ICD-JIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVD0","description":"ICD-CDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25605","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc sickle cell test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85660","description":"Rbc sickle cell test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGD1","description":"ICD-GBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQA1","description":"ICD-LAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6004","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement breastpump cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4283","description":"Replacement breastpump cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAA1","description":"ICD-MCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQF1","description":"ICD-OJQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJB0","description":"ICD-NJJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB140","description":"Special Care Low _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEE1","description":"ICD-EFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBB1","description":"ICD-MHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5008","description":"Hearing screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEID0","description":"ICD-FEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14A","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy_ with removal of tissue from the sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31259","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy_ with removal of tissue from the sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFND1","description":"ICD-GFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJB1","description":"ICD-JFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRC1","description":"ICD-GDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medrsn no pt category","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9292","description":"Medrsn no pt category","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNA1","description":"ICD-GDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attendant control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2331","description":"Attendant control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHA1","description":"ICD-EFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLD0","description":"ICD-KDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/subs interv 15-30mn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0396","description":"Alcohol/subs interv 15-30mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVD0","description":"ICD-FCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam pelvic limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76857","description":"Us exam pelvic limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debride abdom wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11005","description":"Debride abdom wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analyze neurostim no prog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95970","description":"Analyze neurostim no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75966","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye image valid to dx rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2026F","description":"Eye image valid to dx rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure ureter/bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50930","description":"Closure ureter/bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of umbilicus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49250","description":"Excision of umbilicus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFE0","description":"ICD-CHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATA0","description":"ICD-EATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA31","description":"ICD-4BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFC1","description":"ICD-KFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ptnotrcvngsteroid>/=10mg/day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3750F","description":"Ptnotrcvngsteroid>/=10mg/day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECB0","description":"ICD-OECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKC0","description":"ICD-KHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBB1","description":"ICD-AFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJC1","description":"ICD-BBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIC1","description":"ICD-FDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDED0","description":"ICD-NDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ing hernia init reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49500","description":"Rpr ing hernia init reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBD0","description":"ICD-BFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ urine_ 31 drug panel_ reported as quantitative results_ detected or not detected_ per date of service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ urine_ 31 drug panel_ reported as quantitative results_ detected or not detected_ per date of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEC0","description":"ICD-ABEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC117","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l addl 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13122","description":"Cmplx rpr s/a/l addl 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69631","description":"Repair eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted preventive service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99429","description":"Unlisted preventive service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18H","description":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIID1","description":"ICD-OIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYE0","description":"ICD-HHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKF0","description":"ICD-KBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVB0","description":"ICD-NDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXF0","description":"ICD-GEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEC1","description":"ICD-EGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAD0","description":"ICD-MJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95710","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection Hpc 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9986","description":"Injection Hpc 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0852","description":"Pwc gp 3 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE235","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFF0","description":"ICD-NEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0982T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","description":"CPT-0982T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23600","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0230T","description":"Njx tfrml eprl w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35881","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXB1","description":"ICD-NFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWE0","description":"ICD-GIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Static str toe dev ext/flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1831","description":"Static str toe dev ext/flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEA0","description":"ICD-JEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVA0","description":"ICD-CIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TDD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5272","description":"TDD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Position seat spec orth need","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T5001","description":"Position seat spec orth need","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair spigelian hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49590","description":"Repair spigelian hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX26","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIB1","description":"ICD-AEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDF0","description":"ICD-GDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQC0","description":"ICD-PDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPF0","description":"ICD-NDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSB0","description":"ICD-DDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEA0","description":"ICD-KGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemipelvect canad sing axis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5280","description":"Hemipelvect canad sing axis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWD1","description":"ICD-HIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFB0","description":"ICD-NDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydroxyzine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3410","description":"Hydroxyzine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50553","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vaccina ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90393","description":"Vaccina ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56606","description":"Biopsy of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOF0","description":"ICD-HAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDE0","description":"ICD-CHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","description":"HCPCS-J3391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMB0","description":"ICD-KIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immediate breast prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19340","description":"Immediate breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Netupitant palonosetron oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8655","description":"Netupitant palonosetron oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo ia infuse each addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96423","description":"Chemo ia infuse each addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hip joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27054","description":"Removal of hip joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ onasemnogene abeparvovec-xioi_ per treatment_ up to 5x10^15 vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3399","description":"Injection_ onasemnogene abeparvovec-xioi_ per treatment_ up to 5x10^15 vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHE1","description":"ICD-AHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQD1","description":"ICD-OFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82725","description":"Assay of blood fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Children With A Competing Diagnosis For Upper Respiratory Infection Within Three Days Of Diagnosis Of Pharyngitis (E.G._ Intestinal Infection_ Pertussis_ Bacterial Infection_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2097","description":"Children With A Competing Diagnosis For Upper Respiratory Infection Within Three Days Of Diagnosis Of Pharyngitis (E.G._ Intestinal Infection_ Pertussis_ Bacterial Infection_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC40","description":"Medium Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTD0","description":"ICD-NJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgicl dress hold non-reuse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4461","description":"Surgicl dress hold non-reuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKD0","description":"ICD-GDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHB0","description":"ICD-FBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXF0","description":"ICD-BFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVC0","description":"ICD-GHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37295","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","description":"CPT-37295","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epidurography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72275","description":"Epidurography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Woundplus membrane or e-graft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4277","description":"Woundplus membrane or e-graft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescrl fuse w/ instr l4/l5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0309T","description":"Prescrl fuse w/ instr l4/l5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No abd imag w/o reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9457","description":"No abd imag w/o reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDF0","description":"ICD-FBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21C","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hc pro phone call 11-20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98967","description":"Hc pro phone call 11-20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACC0","description":"ICD-BACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKD1","description":"ICD-BBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC241","description":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCA1","description":"ICD-MDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGB0","description":"ICD-KHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0740T","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRA1","description":"ICD-KCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCF0","description":"ICD-KBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGD0","description":"ICD-FIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lutetium Lu 177 vipivotide tetraxetan_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9607","description":"Lutetium Lu 177 vipivotide tetraxetan_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDE0","description":"ICD-MEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX56","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25C","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraop cyto path consult 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88333","description":"Intraop cyto path consult 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATA1","description":"ICD-EATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea sen ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0429T","description":"Rmvl nstim apnea sen ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00120","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","description":"CPT-00120","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9282","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","description":"HCPCS-J9282","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB211","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0094U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Membrane graft or membrane wrap_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4205","description":"Membrane graft or membrane wrap_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUD0","description":"ICD-MJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEF0","description":"ICD-KFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXA1","description":"ICD-OLXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDC1","description":"ICD-MIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iliac revasc w/stent add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37223","description":"Iliac revasc w/stent add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dschrg med/current med merge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1111F","description":"Dschrg med/current med merge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB146","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDE1","description":"ICD-ODDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRC0","description":"ICD-PHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aicd_ other than sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1882","description":"Aicd_ other than sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1947","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1947","description":"HCPCS-J1947","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDB0","description":"ICD-NDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBC0","description":"ICD-FEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIC1","description":"ICD-GEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKB1","description":"ICD-NAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12B","description":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPB1","description":"ICD-KGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms_ including identification of 20 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0416U","description":"Infectious agent detection by nucleic acid (DNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms_ including identification of 20 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhv-6 dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87533","description":"Hhv-6 dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0404","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0404","description":"CDT-D0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSE1","description":"ICD-OHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39503","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIE0","description":"ICD-OJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPD0","description":"ICD-NFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVE1","description":"ICD-BIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21122","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPD1","description":"ICD-GHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJD0","description":"ICD-CHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB115","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE205","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEE1","description":"ICD-GHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Massage therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97124","description":"Massage therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bumetanide_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1939","description":"Injection_ bumetanide_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Physiologic Monitoring Treatment Management Services_ Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring Interactive C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99458","description":"Remote Physiologic Monitoring Treatment Management Services_ Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring Interactive C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hocm 150-199mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9959","description":"Hocm 150-199mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise max/zygoma b9 tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21030","description":"Excise max/zygoma b9 tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTF0","description":"ICD-EDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIF1","description":"ICD-BGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRA1","description":"ICD-PKRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDND1","description":"ICD-JDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUE0","description":"ICD-NCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pad water circulating heat u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0249","description":"Pad water circulating heat u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQE1","description":"ICD-KAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOE0","description":"ICD-DFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOC0","description":"ICD-CAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMF1","description":"ICD-OEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28F","description":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALC1","description":"ICD-JALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no scrn hcv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9452","description":"Doc med reas no scrn hcv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB130","description":"Reduced Physical Function _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC245","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHME0","description":"ICD-BHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALB1","description":"ICD-FALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBID1","description":"ICD-GBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDB1","description":"ICD-GIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61584","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCE1","description":"ICD-ACCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9024","description":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKC0","description":"ICD-CIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXB0","description":"ICD-GDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHF1","description":"ICD-BIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIF0","description":"ICD-KAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTD0","description":"ICD-ECTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECA0","description":"ICD-GECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28292","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Sequence Analysis_ Exon 10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81339","description":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Sequence Analysis_ Exon 10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHND0","description":"ICD-OHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTF0","description":"ICD-OJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVB1","description":"ICD-NEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5151","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","description":"HCPCS-Q5151","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIME0","description":"ICD-OIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYC0","description":"ICD-CBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00215","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","description":"CPT-00215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHC0","description":"ICD-KHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFE1","description":"ICD-OJFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5155","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","description":"HCPCS-Q5155","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pamidronate disodium /30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2430","description":"Pamidronate disodium /30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOB0","description":"ICD-PCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASE1","description":"ICD-KASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWC1","description":"ICD-KBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ preF_ recombinant subunit_ adjuvanted_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90679","description":"Respiratory syncytial virus vaccine_ preF_ recombinant subunit_ adjuvanted_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBF0","description":"ICD-GBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen supplies regulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1353","description":"Oxygen supplies regulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frame typ socket shoulder di","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6689","description":"Frame typ socket shoulder di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDA0","description":"ICD-MHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFD0","description":"ICD-JIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJD1","description":"ICD-BIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of omentum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49255","description":"Removal of omentum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIE1","description":"ICD-IHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUB0","description":"ICD-GIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRC0","description":"ICD-OIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGC0","description":"ICD-GHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQE1","description":"ICD-CCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinic service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1015","description":"Clinic service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC11","description":"ICD-4FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPF1","description":"ICD-NLPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Porc/ceram inlay >= 3 surfac","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6601","description":"Porc/ceram inlay >= 3 surfac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FMRI brain by tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70554","description":"FMRI brain by tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEB0","description":"ICD-EHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE254","description":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC245","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYE1","description":"ICD-PKYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perp bk ptb thermopls direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5520","description":"Perp bk ptb thermopls direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHF0","description":"ICD-CAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis g dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87527","description":"Hepatitis g dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Construct bladder opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51980","description":"Construct bladder opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0714T","description":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDE1","description":"ICD-OIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Individual_ Follow-Up Session_ At Least 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0592T","description":"Health And Well-Being Coaching Face-To-Face; Individual_ Follow-Up Session_ At Least 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERC1","description":"ICD-HERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTF1","description":"ICD-CBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt recvd 2 rx anti-emet agt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4558F","description":"Pt recvd 2 rx anti-emet agt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18C","description":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALD0","description":"ICD-IALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOE0","description":"ICD-OBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0581U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","description":"CPT-0581U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sebelipase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2840","description":"Injection_ sebelipase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJC0","description":"ICD-OCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYB1","description":"ICD-CHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCA0","description":"ICD-JFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHD1","description":"ICD-MKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTC0","description":"ICD-EGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNE0","description":"ICD-NGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADC0","description":"ICD-FADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/stent plcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45389","description":"Colonoscopy w/stent plcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEED0","description":"ICD-OEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intent pot remv time placemt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9539","description":"Intent pot remv time placemt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gi tract capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0355T","description":"Gi tract capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ZZZZZ","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ZZZZZ","description":"ICD-ZZZZZ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHD0","description":"ICD-KCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin b-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84425","description":"Assay of vitamin b-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9615","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","description":"HCPCS-A9615","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology colon mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81525","description":"Oncology colon mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB121","description":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSA0","description":"ICD-PJSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exchange biliary drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47536","description":"Exchange biliary drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFB0","description":"ICD-NAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBC1","description":"ICD-MJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILA0","description":"ICD-BILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNA1","description":"ICD-NCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest compression gen system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0483","description":"Chest compression gen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC26","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUD0","description":"ICD-EEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33778","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVE1","description":"ICD-BFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18F","description":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove mastoid structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69505","description":"Remove mastoid structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15D","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUE1","description":"ICD-KFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBE0","description":"ICD-JEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ankle ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27696","description":"Repair of ankle ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99151","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEE1","description":"ICD-AAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVE0","description":"ICD-OJVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSD0","description":"ICD-HFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC246","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ bal tis dis_ non-vas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1727","description":"Cath_ bal tis dis_ non-vas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunotherapy one injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95120","description":"Immunotherapy one injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pain assessment documented as positive_ follow-up plan not documented_ documentation the patient is not eligible at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8939","description":"Pain assessment documented as positive_ follow-up plan not documented_ documentation the patient is not eligible at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Beta-blocker therapy rxd/tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4008F","description":"Beta-blocker therapy rxd/tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Truss double w/ standard pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8310","description":"Truss double w/ standard pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHB0","description":"ICD-CCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aortoiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35537","description":"Art byp grft aortoiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA225","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKD0","description":"ICD-KAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLD0","description":"ICD-FDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRF1","description":"ICD-OKRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gum tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41830","description":"Removal of gum tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGE1","description":"ICD-CEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00942","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","description":"CPT-00942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWD0","description":"ICD-HEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCA1","description":"ICD-FDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVF1","description":"ICD-GHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mild-mod dep symp by deptool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3353F","description":"Mild-mod dep symp by deptool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77499","description":"Radiation therapy management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARB0","description":"ICD-KARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB54","description":"High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRC0","description":"ICD-GHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTC0","description":"ICD-ECTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20525","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA21","description":"ICD-3BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGA1","description":"ICD-OKGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRA1","description":"ICD-OHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote physiologic monitoring treatment management services_ 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99457","description":"Remote physiologic monitoring treatment management services_ 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44141","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKND0","description":"ICD-OKND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1903","description":"HCPCS-C1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIA1","description":"ICD-GGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNE0","description":"ICD-KCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27333","description":"Removal of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA36","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXA0","description":"ICD-NIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0496U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","description":"CPT-0496U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription digital visual therapy_ software-only_ FDA cleared_ per course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9292","description":"Prescription digital visual therapy_ software-only_ FDA cleared_ per course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFD1","description":"ICD-OBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33665","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYE0","description":"ICD-PFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary bladder retention","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78730","description":"Urinary bladder retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGC0","description":"ICD-CDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGA0","description":"ICD-GHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUA0","description":"ICD-OLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25515","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXA1","description":"ICD-NDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of salivary gland","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7981","description":"Excision of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ siltuximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2860","description":"Injection_ siltuximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDND0","description":"ICD-CDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVB0","description":"ICD-GGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemi-wheelchair detachable a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1086","description":"Hemi-wheelchair detachable a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rectum surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45999","description":"Rectum surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc elder mal scrn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8536","description":"No doc elder mal scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX60","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSB0","description":"ICD-PGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRD0","description":"ICD-OFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANC1","description":"ICD-OANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos air press prescribe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8852","description":"Pos air press prescribe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI joint lwr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73723","description":"MRI joint lwr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc comp or mort w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9267","description":"Doc comp or mort w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis blood pressure cuff","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4663","description":"Dialysis blood pressure cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAC1","description":"ICD-CGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAD0","description":"ICD-NBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Growth hormone antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86277","description":"Growth hormone antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVF0","description":"ICD-JHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNE0","description":"ICD-JHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC21","description":"ICD-2DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCE0","description":"ICD-BHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Er+ or pr+ breast cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3315F","description":"Er+ or pr+ breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOA1","description":"ICD-PGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQC1","description":"ICD-KCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKA0","description":"ICD-KIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87182","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","description":"CPT-87182","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB31","description":"ICD-3AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWD1","description":"ICD-PAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28113","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNE0","description":"ICD-BFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX12","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIB0","description":"ICD-MKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0644U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0644U","description":"CPT-0644U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Portable liquid oxygen sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0433","description":"Portable liquid oxygen sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD221","description":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFD0","description":"ICD-GBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWC1","description":"ICD-CCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDB0","description":"ICD-GGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENE1","description":"ICD-KENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQB0","description":"ICD-PKQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMB0","description":"ICD-CDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEA1","description":"ICD-FHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26860","description":"Fusion of finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC07","description":"Medium Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97550","description":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKD1","description":"ICD-NAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGB1","description":"ICD-BHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20A","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ace/arb thxpy rxd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8473","description":"Ace/arb thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hdr elctr ntrst/ntrcv brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0395T","description":"Hdr elctr ntrst/ntrcv brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9994","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB120","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDC1","description":"ICD-EGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAA0","description":"ICD-CCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath insertion tray w/bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4354","description":"Cath insertion tray w/bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Symes type medial opening so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5636","description":"Symes type medial opening so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCF0","description":"ICD-CFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANE0","description":"ICD-BANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic exercises","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97110","description":"Therapeutic exercises","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHB1","description":"ICD-MCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYA0","description":"ICD-HBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Restorative foundation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2949","description":"Restorative foundation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE130","description":"Reduced Physical Function _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQA0","description":"ICD-OIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGB1","description":"ICD-NDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFC0","description":"ICD-NAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYD1","description":"ICD-PGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTE0","description":"ICD-JBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAB0","description":"ICD-BEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB31","description":"ICD-1HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQD1","description":"ICD-KFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPF1","description":"ICD-OGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOA0","description":"ICD-KEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE246","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLF1","description":"ICD-JGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove inner ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69970","description":"Remove inner ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJD1","description":"ICD-GHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIB1","description":"ICD-FCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7524","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7524","description":"HCPCS-J7524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33401","description":"Valvuloplasty open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trapeze bar free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0940","description":"Trapeze bar free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJA1","description":"ICD-NAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnt pain noted none prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1126F","description":"Amnt pain noted none prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Isoetharine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7650","description":"Isoetharine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15B","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUA1","description":"ICD-GCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gluco mngmnt plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0540F","description":"Gluco mngmnt plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJB1","description":"ICD-CHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOD1","description":"ICD-HGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ)_ targeted genomic sequence analysis_ formalin-fixed paraffin-embedded (FFPE) tumor tissue_ DNA analysis_ 84 or more genes_ interrogation for sequence va","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0334U","description":"Oncology (solid organ)_ targeted genomic sequence analysis_ formalin-fixed paraffin-embedded (FFPE) tumor tissue_ DNA analysis_ 84 or more genes_ interrogation for sequence va","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKF0","description":"ICD-OCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC21","description":"ICD-1FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEB1","description":"ICD-KFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDE0","description":"ICD-MFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Palliative Care Services Provided To Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9988","description":"Palliative Care Services Provided To Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEB0","description":"ICD-EIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGB1","description":"ICD-JGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJA0","description":"ICD-CIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","description":"HCPCS-L1006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHB0","description":"ICD-CFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAD1","description":"ICD-MAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74475","description":"Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBD0","description":"ICD-CCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sio flex pelvic/sacr pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0621","description":"Sio flex pelvic/sacr pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8X","description":"Very High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBF0","description":"ICD-OLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABA1","description":"ICD-AABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLC1","description":"ICD-MJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJC0","description":"ICD-FIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDE1","description":"ICD-CFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAC0","description":"ICD-FCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFID1","description":"ICD-KFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUA0","description":"ICD-MBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFA0","description":"ICD-JEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tooth reimplantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7270","description":"Tooth reimplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAE1","description":"ICD-NGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHA0","description":"ICD-IDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDME0","description":"ICD-GDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJF1","description":"ICD-BCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGE0","description":"ICD-GHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","description":"CPT-76015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMB1","description":"ICD-NLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYE1","description":"ICD-PCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACD0","description":"ICD-FACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig; scrn clin dep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8433","description":"Pt inelig; scrn clin dep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKE0","description":"ICD-NLKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFA1","description":"ICD-CGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGE0","description":"ICD-CGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMD0","description":"ICD-NKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWD1","description":"ICD-OKWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of pubic bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27282","description":"Fusion of pubic bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0103","description":"HCPCS-C0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0A","description":"Medium Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCD0","description":"ICD-KHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOD0","description":"ICD-KDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWA0","description":"ICD-GBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphere bifocal 7.12-20.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2202","description":"Lens sphere bifocal 7.12-20.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBD1","description":"ICD-JFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSB0","description":"ICD-PDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asthma measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8645","description":"Asthma measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHC0","description":"ICD-OFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD244","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE234","description":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert prost urethral stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53855","description":"Insert prost urethral stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYE1","description":"ICD-CGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of gonadotropin (lh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83002","description":"Assay of gonadotropin (lh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYF0","description":"ICD-KAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; first 30 minutes of technician time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0366T","description":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; first 30 minutes of technician time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients Received Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurrence A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2157","description":"Patients Received Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurrence A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQF0","description":"ICD-LCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin copper sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83026","description":"Hemoglobin copper sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVA1","description":"ICD-OLVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures rebase cmplt mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5711","description":"Dentures rebase cmplt mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine creatinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82570","description":"Assay of urine creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL01","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dyspnea scrnd mod-high dysp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3451F","description":"Dyspnea scrnd mod-high dysp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGB1","description":"ICD-GFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genital surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58999","description":"Genital surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0880","description":"Pwc gp4 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8E","description":"Medium Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICB0","description":"ICD-FICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQE1","description":"ICD-DGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBC1","description":"ICD-CHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQF1","description":"ICD-PCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOB1","description":"ICD-CHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXA1","description":"ICD-NGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUA0","description":"ICD-AHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bowel bulge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57268","description":"Repair of bowel bulge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastroplasty w/o v-band","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43843","description":"Gastroplasty w/o v-band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTE0","description":"ICD-NCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB31","description":"ICD-1GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVA0","description":"ICD-GIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML22","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILD1","description":"ICD-JILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBB1","description":"ICD-EHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3A","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"DuoAmnion_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4327","description":"DuoAmnion_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAA1","description":"ICD-KCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEME0","description":"ICD-NEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4037","description":"Urology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYC1","description":"ICD-GHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRD0","description":"ICD-KFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAD0","description":"ICD-KBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Staggered spondaic word test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92572","description":"Staggered spondaic word test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVB0","description":"ICD-GBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINF1","description":"ICD-FINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9486","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onlay porc/crmc 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6608","description":"Onlay porc/crmc 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILD0","description":"ICD-IILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAA1","description":"ICD-KBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMB0","description":"ICD-AFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFA1","description":"ICD-FEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-52597","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","description":"CPT-52597","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDA1","description":"ICD-CIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHF1","description":"ICD-OHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSA0","description":"ICD-CGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVC0","description":"ICD-CEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMC1","description":"ICD-CAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maternity care procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59899","description":"Maternity care procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDA0","description":"ICD-JDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB113","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUB1","description":"ICD-EFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB225","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing_ Including Repacking_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49014","description":"Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing_ Including Repacking_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat kneecap fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27520","description":"Treat kneecap fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEE1","description":"ICD-AFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Soft tissue allograft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4275","description":"Soft tissue allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Counseling_ group_ by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9003","description":"Counseling_ group_ by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRC1","description":"ICD-CCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJC1","description":"ICD-OLJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQB1","description":"ICD-OKQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAB1","description":"ICD-EDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAC0","description":"ICD-FIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDB0","description":"ICD-IIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMF1","description":"ICD-NBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMB0","description":"ICD-KDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interspinous implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1821","description":"Interspinous implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQA1","description":"ICD-CEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL30","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg >16<=48 w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6238","description":"Hydrocolld drg >16<=48 w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUD1","description":"ICD-AFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23A","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0522U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","description":"CPT-0522U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALC0","description":"ICD-MALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD145","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMD0","description":"ICD-GDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSF0","description":"ICD-GGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKB1","description":"ICD-JBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTC1","description":"ICD-JCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOB1","description":"ICD-OAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOF0","description":"ICD-CEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFME1","description":"ICD-IFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSC1","description":"ICD-PJSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYD0","description":"ICD-PLYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFED0","description":"ICD-CFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUE1","description":"ICD-KEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31511","description":"Remove foreign body larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplant related per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9975","description":"Transplant related per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLE0","description":"ICD-NHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIC1","description":"ICD-NGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Misoprostol_ oral_ 200 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0191","description":"Misoprostol_ oral_ 200 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1B","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69641","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALF0","description":"ICD-BALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFF1","description":"ICD-JEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE230","description":"Special Care High _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1445","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","description":"HCPCS-M1445","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0826T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNB1","description":"ICD-GGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intro/sheath_fixed_peel-away","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1892","description":"Intro/sheath_fixed_peel-away","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0507U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","description":"CPT-0507U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMD0","description":"ICD-BEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCA1","description":"ICD-EDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA11","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYD1","description":"ICD-GDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28F","description":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFB1","description":"ICD-JEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMA1","description":"ICD-NKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQF0","description":"ICD-PJQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Misc/exper non-prescript dru","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9150","description":"Misc/exper non-prescript dru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46748","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXF1","description":"ICD-GDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUA0","description":"ICD-KFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA134","description":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc arm/elbow les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24071","description":"Exc arm/elbow les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBF0","description":"ICD-AEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50395","description":"Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFD0","description":"ICD-GFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIA0","description":"ICD-CIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIF1","description":"ICD-ICIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESE1","description":"ICD-CESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMB0","description":"ICD-ODMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate bone tumor(s) perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20982","description":"Ablate bone tumor(s) perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAD1","description":"ICD-KIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVE0","description":"ICD-BBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51530","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXA1","description":"ICD-NJXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg <=16 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6251","description":"Absorpt drg <=16 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBB0","description":"ICD-AHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision Or Removal Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Programming_ And Imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0588T","description":"Revision Or Removal Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Programming_ And Imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJC0","description":"ICD-OHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCA0","description":"ICD-OJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD244","description":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4C","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAD1","description":"ICD-KBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDA0","description":"ICD-FFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Space maintainer_ fixed_ bilateral_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1517","description":"Space maintainer_ fixed_ bilateral_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25660","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUC1","description":"ICD-OKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISC1","description":"ICD-KISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11A","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37283","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","description":"CPT-37283","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression glove_ custom_ medium weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6579","description":"Gradient compression glove_ custom_ medium weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEA1","description":"ICD-ECEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 25 MCG/0.25 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91314","description":"SARSCOV2 VACCINE BIVALENT 25 MCG/0.25 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTA0","description":"ICD-MFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair ing hernia blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49521","description":"Rerepair ing hernia blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB05","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAA1","description":"ICD-NEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLC1","description":"ICD-OBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEA1","description":"ICD-OEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75741","description":"Artery x-rays lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33735","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC11","description":"ICD-3AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22515","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1047T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1047T","description":"CPT-1047T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAB1","description":"ICD-NCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFD0","description":"ICD-GGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55812","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILB1","description":"ICD-EILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALA1","description":"ICD-NALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDA0","description":"ICD-EFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEND1","description":"ICD-JEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISF1","description":"ICD-DISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asth controlled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9432","description":"Asth controlled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laiv vacc pandemic intranasl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90664","description":"Laiv vacc pandemic intranasl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lyme dis dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87476","description":"Lyme dis dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTB0","description":"ICD-CFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNF1","description":"ICD-NDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18A","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"F18 fdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9552","description":"F18 fdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33777","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAD1","description":"ICD-AHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBB0","description":"ICD-MBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received bone marrow transplant any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1157","description":"Patient received bone marrow transplant any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIA0","description":"ICD-NEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of folic acid serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82746","description":"Assay of folic acid serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGF1","description":"ICD-GHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01941","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","description":"CPT-01941","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADE1","description":"ICD-IADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of volatiles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84600","description":"Assay of volatiles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABE0","description":"ICD-EABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine ost pouch w faucet/tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4428","description":"Urine ost pouch w faucet/tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIC1","description":"ICD-KEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gamma globulin 1 cc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1460","description":"Gamma globulin 1 cc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12B","description":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPB1","description":"ICD-OLPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self-mgmt educ/train 2-4 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98961","description":"Self-mgmt educ/train 2-4 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram_ Calculati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77089","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram_ Calculati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49611","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMC1","description":"ICD-ECMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUF0","description":"ICD-IBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AmnioBand_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4168","description":"AmnioBand_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dev interrog remote 1/2/mlt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93295","description":"Dev interrog remote 1/2/mlt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAD1","description":"ICD-GCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mastectomy sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8010","description":"Mastectomy sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Including Data Preparation And Transmission_ Quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0710T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Including Data Preparation And Transmission_ Quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amitriptyline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6030","description":"Amitriptyline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRD1","description":"ICD-LGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFB1","description":"ICD-NJFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMA1","description":"ICD-GHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCE1","description":"ICD-MHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSE1","description":"ICD-HCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 5_ gene duplication/multiplication) (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0075U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 5_ gene duplication/multiplication) (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSA1","description":"ICD-LDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFF0","description":"ICD-JDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQC0","description":"ICD-HBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients Who Use Palliative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9995","description":"Patients Who Use Palliative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNA1","description":"ICD-CGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA02","description":"High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1060","description":"Thoracic pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALD1","description":"ICD-EALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23D","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQF1","description":"ICD-OFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67915","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALF1","description":"ICD-BALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWF0","description":"ICD-OHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient-Months Where There Are More Than One Medicare Capitated Payment (Mcp) Provider Listed For The Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1025","description":"Patient-Months Where There Are More Than One Medicare Capitated Payment (Mcp) Provider Listed For The Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enteral feed sup kit grav by","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4036","description":"Enteral feed sup kit grav by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADF0","description":"ICD-JADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSD1","description":"ICD-LFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUF0","description":"ICD-CEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Term dev mech hook vol close","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6707","description":"Term dev mech hook vol close","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8931","description":"Mra_ w/dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20200","description":"Muscle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANB1","description":"ICD-KANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin long acting 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5553","description":"Insulin long acting 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMB1","description":"ICD-OIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L8697","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8697","description":"HCPCS-L8697","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYD1","description":"ICD-HDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 60-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0517","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 60-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonpneumatic compression controller without calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1031","description":"Nonpneumatic compression controller without calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKC1","description":"ICD-KBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair vagina/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57210","description":"Repair vagina/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOD1","description":"ICD-OEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0D","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJE0","description":"ICD-CAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESB1","description":"ICD-KESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plastic eye prosth custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2623","description":"Plastic eye prosth custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiography neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70547","description":"Mr angiography neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGE0","description":"ICD-JDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTA0","description":"ICD-FFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAB1","description":"ICD-IGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPB0","description":"ICD-JDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Power bone marrow bx needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1830","description":"Power bone marrow bx needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVC0","description":"ICD-OKVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hgb quant transcutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88738","description":"Hgb quant transcutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMA0","description":"ICD-EDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEF1","description":"ICD-CCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLA0","description":"ICD-OJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tick-borne encephalitis virus vaccine_ inactivated; 0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90626","description":"Tick-borne encephalitis virus vaccine_ inactivated; 0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX30","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELE1","description":"ICD-MELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXF1","description":"ICD-KGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUF1","description":"ICD-GFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15018","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","description":"CPT-15018","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASC0","description":"ICD-OASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVD1","description":"ICD-NIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDD1","description":"ICD-NIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBB0","description":"ICD-EBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPC0","description":"ICD-NGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo variable frict","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5714","description":"Knee-shin exo variable frict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHC0","description":"ICD-JGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0695T","description":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMB0","description":"ICD-JIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHA1","description":"ICD-KHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB110","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUE0","description":"ICD-EDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01230","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","description":"CPT-01230","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKF1","description":"ICD-JCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOE0","description":"ICD-PLOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHE1","description":"ICD-BHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDE0","description":"ICD-FDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","description":"HCPCS-Q4382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTE0","description":"ICD-AGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; vascular procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0133U","description":"Anesthesia for intracranial procedures; vascular procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ arm_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6588","description":"Gradient pressure wrap with adjustable straps_ arm_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD120","description":"Clinically Complex _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJB1","description":"ICD-CEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECA1","description":"ICD-JECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEB1","description":"ICD-JCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCE0","description":"ICD-IDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88377","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHF1","description":"ICD-GEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB05","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiof trsmtr implt scrl neu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8684","description":"Radiof trsmtr implt scrl neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXE0","description":"ICD-FFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of reti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1220","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of reti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD125","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTC0","description":"ICD-MKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYE0","description":"ICD-HBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; duplication/deletion variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81269","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; duplication/deletion variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4D","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensve oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0150","description":"Comprehensve oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBF0","description":"ICD-FHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"XK GNOTYP XK EXONS 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0200U","description":"XK GNOTYP XK EXONS 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPC1","description":"ICD-NJPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunohisto antb addl slide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88341","description":"Immunohisto antb addl slide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMF0","description":"ICD-KBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analysis of saliva sample","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0418","description":"Analysis of saliva sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18A","description":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0588U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","description":"CPT-0588U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Histotripsy (ie_ non-thermal ablation via acoustic energy delivery) of malignant renal tissue_ including imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0888T","description":"Histotripsy (ie_ non-thermal ablation via acoustic energy delivery) of malignant renal tissue_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Truss addition to std pad wa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8320","description":"Truss addition to std pad wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35141","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45380","description":"Colonoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xray endovasc thor ao repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75957","description":"Xray endovasc thor ao repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTB1","description":"ICD-NKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCC0","description":"ICD-KDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE160","description":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Been Ordered Or Performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2119","description":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Been Ordered Or Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL54","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental occlusal guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9940","description":"Dental occlusal guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trac stand free stand pelvic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0900","description":"Trac stand free stand pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFD1","description":"ICD-OCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEA0","description":"ICD-GAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUD0","description":"ICD-MFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNC0","description":"ICD-GHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUE1","description":"ICD-MFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMF1","description":"ICD-EHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin seal protect moisturizr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6250","description":"Skin seal protect moisturizr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPC1","description":"ICD-FDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWC0","description":"ICD-CEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGC0","description":"ICD-FBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKC1","description":"ICD-KFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHC0","description":"ICD-MCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYA1","description":"ICD-KGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair accessory_ lateral thigh or knee support_ any type including fixed mounting hardware_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0953","description":"Wheelchair accessory_ lateral thigh or knee support_ any type including fixed mounting hardware_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00916","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","description":"CPT-00916","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGC1","description":"ICD-KAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00210","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","description":"CPT-00210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Single Trajectory For 1 Si","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61736","description":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Single Trajectory For 1 Si","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Counseling for the control and prevention of adverse oral_ behavioral_ and systemic health effects associated with high-risk substance use","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1321","description":"Counseling for the control and prevention of adverse oral_ behavioral_ and systemic health effects associated with high-risk substance use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tumor imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78803","description":"Tumor imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0515U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","description":"CPT-0515U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53515","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAC0","description":"ICD-JIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMA0","description":"ICD-NDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9736","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIF0","description":"ICD-ACIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transthor diaphrag hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43334","description":"Transthor diaphrag hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBE0","description":"ICD-CCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lev 2 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0381","description":"Lev 2 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKA0","description":"ICD-GCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQE0","description":"ICD-KIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTF0","description":"ICD-MKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHF0","description":"ICD-KAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Head control interface mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2327","description":"Head control interface mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIB0","description":"ICD-BEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHE1","description":"ICD-BEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13D","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44403","description":"Colonoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair rectum-vagina fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57300","description":"Repair rectum-vagina fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSE0","description":"ICD-OJSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch clsd w barrier/filtr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4416","description":"Ost pch clsd w barrier/filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx/pro/dx inj same drug adon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96376","description":"Tx/pro/dx inj same drug adon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15D","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-86581","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","description":"CPT-86581","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1121","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCB0","description":"ICD-GCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repositioning of teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7290","description":"Repositioning of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTE0","description":"ICD-KCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWD0","description":"ICD-PGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAC0","description":"ICD-KHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAD1","description":"ICD-MGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collect blood from picc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36592","description":"Collect blood from picc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL07","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26545","description":"Reconstruct finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB31","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast 1st strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19283","description":"Perq dev breast 1st strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXE1","description":"ICD-FAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21182","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDF0","description":"ICD-NLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96168","description":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAE1","description":"ICD-CHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHB0","description":"ICD-EIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAB0","description":"ICD-KHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIC0","description":"ICD-JBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAA0","description":"ICD-JIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXA1","description":"ICD-KGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE231","description":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEME0","description":"ICD-EEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBD0","description":"ICD-EBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9301","description":"HCPCS-C9301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOD1","description":"ICD-CEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/chemicl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86970","description":"Rbc pretx incubatj w/chemicl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHC0","description":"ICD-OAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy irrig cone/cath w brs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4399","description":"Ostomy irrig cone/cath w brs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDC1","description":"ICD-GGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEME0","description":"ICD-GEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ each separat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0836T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ each separat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analgesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9230","description":"Analgesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBE1","description":"ICD-MLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28750","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUF1","description":"ICD-IFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBE0","description":"ICD-AEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJB0","description":"ICD-JAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1803","description":"HCPCS-B1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKA1","description":"ICD-JDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNC0","description":"ICD-NKNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sitz bath chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0162","description":"Sitz bath chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGA0","description":"ICD-JFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0B","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQA1","description":"ICD-LEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group I_ for microorganisms (eg_ acid fast_ methenamine silver) (List separatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0756T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group I_ for microorganisms (eg_ acid fast_ methenamine silver) (List separatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13A","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Advancing rheumatology patient care mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0053","description":"Advancing rheumatology patient care mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGC1","description":"ICD-GFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDED0","description":"ICD-BDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNA0","description":"ICD-OFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart image spect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78494","description":"Heart image spect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace molded calf lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4050","description":"Replace molded calf lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove femur lesion/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27357","description":"Remove femur lesion/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKA1","description":"ICD-CBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11644","description":"Exc f/e/e/n/l mal+mrg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNC1","description":"ICD-CCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQC0","description":"ICD-CDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37264","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","description":"CPT-37264","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA121","description":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDC1","description":"ICD-MEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHF0","description":"ICD-KGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQF1","description":"ICD-DHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blinded administration of convulsive therapy procedure_ either electroconvulsive therapy (ect_ current covered gold standard) or magnetic seizure therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2000","description":"Blinded administration of convulsive therapy procedure_ either electroconvulsive therapy (ect_ current covered gold standard) or magnetic seizure therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX35","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteoarthritis assessed (OA) Includes assessment of all the following compo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0109U","description":"Osteoarthritis assessed (OA) Includes assessment of all the following compo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1801","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1801","description":"CDT-D1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXF1","description":"ICD-CGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSF1","description":"ICD-CHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc membranes fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111T","description":"Rbc membranes fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct angiograph pelv w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72191","description":"Ct angiograph pelv w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES146","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOC0","description":"ICD-CDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBE0","description":"ICD-KGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVE1","description":"ICD-BBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy cleaning brush","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4626","description":"Tracheostomy cleaning brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dynamic cavernosometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54231","description":"Dynamic cavernosometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBC1","description":"ICD-GGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFF0","description":"ICD-FIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients on immune checkpoint inhibitor therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1180","description":"Patients on immune checkpoint inhibitor therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of sternum separation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21750","description":"Repair of sternum separation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec seat depth/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1298","description":"Wheelchair spec seat depth/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWE1","description":"ICD-KBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9154","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","description":"HCPCS-A9154","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEF0","description":"ICD-MIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21421","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADE0","description":"ICD-OADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABE1","description":"ICD-KABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEA0","description":"ICD-MHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYB1","description":"ICD-OBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYE0","description":"ICD-OLYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Duplicate/copy patient_s records","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9961","description":"Duplicate/copy patient_s records","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDA0","description":"ICD-JBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLA0","description":"ICD-NKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressant tricyclic 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80335","description":"Antidepressant tricyclic 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXA0","description":"ICD-NLXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFB0","description":"ICD-FCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mold socket ank hgt w/ toe f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5010","description":"Mold socket ank hgt w/ toe f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOF0","description":"ICD-PAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA40","description":"Medium Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVC1","description":"ICD-FBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB11","description":"ICD-4AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep ak ischial open end","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5585","description":"Prep ak ischial open end","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWB0","description":"ICD-GEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPC0","description":"ICD-OGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rotary wing air transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0431","description":"Rotary wing air transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23B","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWE0","description":"ICD-LHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXC0","description":"ICD-KDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKA1","description":"ICD-FGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSB0","description":"ICD-CFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0514U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","description":"CPT-0514U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDB1","description":"ICD-JFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ganciclovir sodium (exela) not therapeutically equivalent to j1570_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1574","description":"Injection_ ganciclovir sodium (exela) not therapeutically equivalent to j1570_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVE0","description":"ICD-GGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Itraconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80189","description":"Itraconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPA0","description":"ICD-FCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPB1","description":"ICD-NAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evasc prlng admn rx agnt add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61651","description":"Evasc prlng admn rx agnt add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNC0","description":"ICD-JFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lifestyle mod 4th stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0342","description":"Lifestyle mod 4th stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGD1","description":"ICD-OIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-99445","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","description":"CPT-99445","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonneedle injection device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4210","description":"Nonneedle injection device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBB0","description":"ICD-OEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise finger/toe nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64702","description":"Revise finger/toe nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv saliv glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64611","description":"Chemodenerv saliv glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trifoc prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0508","description":"Trifoc prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit prenatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99500","description":"Home visit prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLC1","description":"ICD-MDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEF1","description":"ICD-ICEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLA1","description":"ICD-FCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth sperm duct surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92251","description":"Anesth sperm duct surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHF1","description":"ICD-GAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUB1","description":"ICD-CGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDE0","description":"ICD-BCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMB1","description":"ICD-MDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOE0","description":"ICD-PHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ talquetamab-tgvs_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3055","description":"Injection_ talquetamab-tgvs_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWB0","description":"ICD-GFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ low complexity_ requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An exami","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97169","description":"Athletic training evaluation_ low complexity_ requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An exami","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No pharm ther osteo rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8635","description":"No pharm ther osteo rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NeoPatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4176","description":"NeoPatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXB1","description":"ICD-FIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBB1","description":"ICD-EDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee detach ar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1172","description":"Wheelchair amputee detach ar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove armpit lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38745","description":"Remove armpit lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCA1","description":"ICD-JFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anal sp inf pmp w/reprg&fill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62369","description":"Anal sp inf pmp w/reprg&fill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10C","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIF1","description":"ICD-CIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMF1","description":"ICD-FGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAA1","description":"ICD-IEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd guide wire insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43248","description":"Egd guide wire insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISA1","description":"ICD-PISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aortic circulation assist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33971","description":"Aortic circulation assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX55","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNB0","description":"ICD-GGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJF1","description":"ICD-CBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGD0","description":"ICD-GHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0549","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","description":"HCPCS-G0549","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phenotype dna hiv w/culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87903","description":"Phenotype dna hiv w/culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKD0","description":"ICD-FHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot insert remov molded spe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3001","description":"Foot insert remov molded spe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUE0","description":"ICD-OLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB22","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDF1","description":"ICD-AHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thawing cryopresrved oocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89356","description":"Thawing cryopresrved oocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker rigid adjust/fixed ht","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0130","description":"Walker rigid adjust/fixed ht","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ggt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82977","description":"Assay of ggt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKA0","description":"ICD-GBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit declotting kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5517","description":"Hit declotting kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Minor blunt trauma w/head ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9529","description":"Minor blunt trauma w/head ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNA0","description":"ICD-GBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC136","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHD0","description":"ICD-MJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECE1","description":"ICD-NECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYC1","description":"ICD-GCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCD1","description":"ICD-FDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ toripalimab-tpzi_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3263","description":"Injection_ toripalimab-tpzi_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYF1","description":"ICD-CGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBB0","description":"ICD-FHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reusable rectal thermometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4932","description":"Reusable rectal thermometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ edaravone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9493","description":"Injection_ edaravone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric wheelchair nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1229","description":"Pediatric wheelchair nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grp psych partial hosp 45-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0410","description":"Grp psych partial hosp 45-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIE1","description":"ICD-NHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80435","description":"Insulin tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81520","description":"Oncology (breast)_ mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPF1","description":"ICD-OCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFB1","description":"ICD-OBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEA1","description":"ICD-MFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient  compression arm sleeve_ custom_ medium weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6576","description":"Gradient  compression arm sleeve_ custom_ medium weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICA0","description":"ICD-MICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo sprng wir drsflx calf bd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1900","description":"Afo sprng wir drsflx calf bd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mass spectrometry qual/quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83789","description":"Mass spectrometry qual/quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHD0","description":"ICD-AAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth fat layer removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80251","description":"Anesth fat layer removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7d/.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2207","description":"Lens sphcy bifocal 4.25-7d/.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0654U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0654U","description":"CPT-0654U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHF0","description":"ICD-MAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWD1","description":"ICD-CEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVC1","description":"ICD-CEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDE1","description":"ICD-OHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBB1","description":"ICD-OIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWD0","description":"ICD-LFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL15","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ clevidipine butyrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9248","description":"Inj_ clevidipine butyrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEC1","description":"ICD-BBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVB0","description":"ICD-OIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01712","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","description":"CPT-01712","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACA1","description":"ICD-OACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colostomy with biopsies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44322","description":"Colostomy with biopsies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00640","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","description":"CPT-00640","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33954","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spinal lamina add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63048","description":"Remove spinal lamina add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHF0","description":"ICD-ACHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEB0","description":"ICD-JDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAA1","description":"ICD-BDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal fb skin/areolar tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7530","description":"Removal fb skin/areolar tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iodine I-131 iobenguane_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9408","description":"Iodine I-131 iobenguane_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temple bone implant revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69717","description":"Temple bone implant revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIME0","description":"ICD-MIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHA1","description":"ICD-CFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE104","description":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40844","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDD0","description":"ICD-GBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNA1","description":"ICD-JHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB113","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETE1","description":"ICD-EETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med admin_ not oral/inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1503","description":"Med admin_ not oral/inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRD1","description":"ICD-PIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWE0","description":"ICD-DEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFD1","description":"ICD-JIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUB1","description":"ICD-EBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIF1","description":"ICD-CFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCE0","description":"ICD-BFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD121","description":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQF1","description":"ICD-PDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRF0","description":"ICD-KGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC101","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDC0","description":"ICD-MFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQB0","description":"ICD-PDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAE0","description":"ICD-GCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADD0","description":"ICD-JADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ includes titer(s)_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0224U","description":"Antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ includes titer(s)_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc order given stop antibio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4049F","description":"Doc order given stop antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALB0","description":"ICD-FALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg >16<=48 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6243","description":"Hydrogel drg >16<=48 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB141","description":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB12","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11303","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC14","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1247","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB215","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVE1","description":"ICD-GIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJF0","description":"ICD-FGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhs/hospice of rn ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0299","description":"Hhs/hospice of rn ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emergency Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4003","description":"Emergency Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUB0","description":"ICD-MBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue Transglutaminase_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86364","description":"Tissue Transglutaminase_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAA0","description":"ICD-GEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of hip cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29305","description":"Application of hip cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUA0","description":"ICD-BAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital bed institutional t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0270","description":"Hospital bed institutional t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEF1","description":"ICD-GGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with injection(s) for augmentation (eg_ percutaneous_ transoral)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31574","description":"Laryngoscopy_ flexible; with injection(s) for augmentation (eg_ percutaneous_ transoral)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXB1","description":"ICD-NBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQF1","description":"ICD-GEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXB0","description":"ICD-GEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83655","description":"Assay of lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42215","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLD0","description":"ICD-MLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBD0","description":"ICD-GGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQA0","description":"ICD-DIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"64 lead ecg w/tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0179T","description":"64 lead ecg w/tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Warfrn or othr antcog no rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8971","description":"Warfrn or othr antcog no rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKE1","description":"ICD-GGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA124","description":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43192","description":"Esophagoscp rig trnso inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUB0","description":"ICD-AGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCC0","description":"ICD-BBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEC1","description":"ICD-BAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA44","description":"Medium Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69300","description":"Revise external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel sach cushion type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3450","description":"Shoe heel sach cushion type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUA0","description":"ICD-GGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRE1","description":"ICD-CDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAE1","description":"ICD-BHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove part of neck vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22110","description":"Remove part of neck vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16076","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscop ultrasound exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43231","description":"Esophagoscop ultrasound exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2002","description":"HCPCS-A2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA256","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCC1","description":"ICD-ICCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0965T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","description":"CPT-0965T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMC1","description":"ICD-CHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAB0","description":"ICD-IFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pap oral interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7044","description":"Pap oral interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB144","description":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLF1","description":"ICD-KHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIA0","description":"ICD-EFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUB1","description":"ICD-FAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVB0","description":"ICD-OFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13C","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder prosthesis removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23334","description":"Shoulder prosthesis removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQC1","description":"ICD-HGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9748","description":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Per pm reeval est pat infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99391","description":"Per pm reeval est pat infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0A","description":"Very High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFC0","description":"ICD-CBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEE1","description":"ICD-OEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBA0","description":"ICD-IEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rural health clinic or federally qualified health center (RHC or FQHC) only_ general care management_ 20 minutes or more of clinical staff time for chronic care management ser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0511","description":"Rural health clinic or federally qualified health center (RHC or FQHC) only_ general care management_ 20 minutes or more of clinical staff time for chronic care management ser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder fb deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23333","description":"Remove shoulder fb deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPD0","description":"ICD-FHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ using oral fluid_ reported as a comparison to an estimated steady-state range_ per date of service inclu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ using oral fluid_ reported as a comparison to an estimated steady-state range_ per date of service inclu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTA1","description":"ICD-JCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITA0","description":"ICD-FITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLA1","description":"ICD-MCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand tendon reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26500","description":"Hand tendon reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic wrist rotator any","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7259","description":"Electronic wrist rotator any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBE1","description":"ICD-KIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQC1","description":"ICD-GHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sip and puff interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2325","description":"Sip and puff interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSF1","description":"ICD-DCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB11","description":"ICD-4BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBB1","description":"ICD-FFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVB1","description":"ICD-NDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anterior colporrhaphy_ repair of cystocele with or without repair of urethrocele_ including cystourethroscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57240","description":"Anterior colporrhaphy_ repair of cystocele with or without repair of urethrocele_ including cystourethroscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOC1","description":"ICD-KDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22B","description":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neoxflo or clarixflo 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4155","description":"Neoxflo or clarixflo 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00546","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","description":"CPT-00546","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHF0","description":"ICD-FIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99238","description":"Hospital discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB21","description":"ICD-4IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB14","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M.avium-intra dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87561","description":"M.avium-intra dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGA0","description":"ICD-KEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult electric hook","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7009","description":"Adult electric hook","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSB0","description":"ICD-OHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWB0","description":"ICD-PCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTF0","description":"ICD-ODTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD126","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABB1","description":"ICD-NABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX51","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOE0","description":"ICD-GHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nicotine patch legend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4990","description":"Nicotine patch legend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq sacral augmt bilat inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0201T","description":"Perq sacral augmt bilat inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAID1","description":"ICD-IAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mst rcnt hbb < 10g/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8973","description":"Mst rcnt hbb < 10g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3C","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB244","description":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg arterial four or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33536","description":"Cabg arterial four or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEE0","description":"ICD-GCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB116","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMC0","description":"ICD-NJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWD0","description":"ICD-DGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gardner vag dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87512","description":"Gardner vag dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9983","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRD0","description":"ICD-GBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25907","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBE0","description":"ICD-JDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Centrifuge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1500","description":"Centrifuge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAE1","description":"ICD-AHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8F","description":"Low Rehab_ ADL Index 0-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vent mgmt nf per day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94004","description":"Vent mgmt nf per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27511","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family psytx w/patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90847","description":"Family psytx w/patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64575","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQD0","description":"ICD-CEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENB0","description":"ICD-FENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKA0","description":"ICD-GDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trapeze bar attached to bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0910","description":"Trapeze bar attached to bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOA1","description":"ICD-LFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCB0","description":"ICD-KHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pharm thx for op rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4005F","description":"Pharm thx for op rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary rubber pouch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4383","description":"Urinary rubber pouch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phys blood bank serv authrj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86079","description":"Phys blood bank serv authrj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6036","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","description":"HCPCS-L6036","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJD1","description":"ICD-JEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYF1","description":"ICD-KFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair rotator cuff acute","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23410","description":"Repair rotator cuff acute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst w/enterocele compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58294","description":"Vag hyst w/enterocele compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (MAIA)_ not therapeutically equivalent to J9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9051","description":"Injection_ bortezomib (MAIA)_ not therapeutically equivalent to J9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct chest spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72128","description":"Ct chest spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEE1","description":"ICD-ACEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infant safety class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9447","description":"Infant safety class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilated fundus eval done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2020F","description":"Dilated fundus eval done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation tx delivery imrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6015","description":"Radiation tx delivery imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEC0","description":"ICD-MHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ldl-c <100 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3048F","description":"Ldl-c <100 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSE0","description":"ICD-DCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transition service coordination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7337","description":"Transition service coordination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINB0","description":"ICD-FINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE124","description":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFD1","description":"ICD-JGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHA0","description":"ICD-GHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIC1","description":"ICD-NIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adj skin pro wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2623","description":"Adj skin pro wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQB0","description":"ICD-PIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SkinTE_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4200","description":"SkinTE_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCD0","description":"ICD-CGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBA0","description":"ICD-EDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33261","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgraft ft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4268","description":"Surgraft ft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVB1","description":"ICD-CBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow imaging mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78103","description":"Bone marrow imaging mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIC0","description":"ICD-NCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEF1","description":"ICD-OIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pet not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0235","description":"Pet not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFE1","description":"ICD-JBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXB1","description":"ICD-CIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albuterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7609","description":"Albuterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAID0","description":"ICD-BAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAF0","description":"ICD-KBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ avacincaptad pegol_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9162","description":"Injection_ avacincaptad pegol_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Escharotomy addl incision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16036","description":"Escharotomy addl incision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1056T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1056T","description":"CPT-1056T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35302","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Administration Of Chemotherapy Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0618","description":"Hospital Special Treatment Room Support Component (Hstrsc) Administration Of Chemotherapy Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWB1","description":"ICD-LDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARA0","description":"ICD-HARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEA1","description":"ICD-OBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32940","description":"Revision of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAME1","description":"ICD-CAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABD0","description":"ICD-CABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00322","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","description":"CPT-00322","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOE1","description":"ICD-OFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAB0","description":"ICD-MCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheal suction tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4624","description":"Tracheal suction tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKB0","description":"ICD-BCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12B","description":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYF1","description":"ICD-HEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behav chng smoking 3-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99406","description":"Behav chng smoking 3-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDF1","description":"ICD-AGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family homecare training 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5110","description":"Family homecare training 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous vertebral augmentations_ first lumbar and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7508","description":"Percutaneous vertebral augmentations_ first lumbar and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient reason for not screening for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety (e.g._ patient declined or othe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1237","description":"Patient reason for not screening for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety (e.g._ patient declined or othe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJB0","description":"ICD-CFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOD0","description":"ICD-CCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast add lesion us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19084","description":"Bx breast add lesion us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+ cell percentage <15%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3497F","description":"Cd4+ cell percentage <15%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOF0","description":"ICD-DDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Breast Ductal Carcinoma In Situ)_ Protein Expression Profiling By Immunohistochemistry Of 7 Proteins (Cox2_ Foxa1_ Her2_ Ki-67_ P16_ Pr_ Siah2)_ With 4 Clinicopathol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0295U","description":"Oncology (Breast Ductal Carcinoma In Situ)_ Protein Expression Profiling By Immunohistochemistry Of 7 Proteins (Cox2_ Foxa1_ Her2_ Ki-67_ P16_ Pr_ Siah2)_ With 4 Clinicopathol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKB1","description":"ICD-FDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGE1","description":"ICD-FDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc osmotic fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85557","description":"Rbc osmotic fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMB0","description":"ICD-NDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCE0","description":"ICD-NLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61314","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous injection of calcium-based biodegradable osteoconductive material_ proximal femur_ including imaging guidance_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0814T","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material_ proximal femur_ including imaging guidance_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVA0","description":"ICD-OKVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB213","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGA1","description":"ICD-JDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMD0","description":"ICD-JBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHF1","description":"ICD-CEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23125","description":"Removal of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15B","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68325","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vasopressin_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2598","description":"Injection_ vasopressin_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary stress testing (eg_ 6-minute walk test)_ including measurement of heart rate_ oximetry_ and oxygen titration_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94618","description":"Pulmonary stress testing (eg_ 6-minute walk test)_ including measurement of heart rate_ oximetry_ and oxygen titration_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKA0","description":"ICD-NHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKA1","description":"ICD-KFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac guide differs nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9062","description":"Onc prac guide differs nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUD1","description":"ICD-BGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNC1","description":"ICD-FHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLE1","description":"ICD-JGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRF1","description":"ICD-GCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1092T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1092T","description":"CPT-1092T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrocochleography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92584","description":"Electrocochleography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHF1","description":"ICD-IDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPF0","description":"ICD-BIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBF1","description":"ICD-IHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure of valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33602","description":"Closure of valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHD1","description":"ICD-CFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYD0","description":"ICD-OHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESC0","description":"ICD-DESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB155","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathogen reduced plasma sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9071","description":"Pathogen reduced plasma sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epsd bk pain for 6 wks/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1134F","description":"Epsd bk pain for 6 wks/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHF0","description":"ICD-ADHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOD0","description":"ICD-PEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGB0","description":"ICD-OGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25426","description":"Repair/graft radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group health education","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99078","description":"Group health education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBC1","description":"ICD-BGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bone for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20902","description":"Removal of bone for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB220","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAE0","description":"ICD-IGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEF1","description":"ICD-JCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJC0","description":"ICD-JCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo multilig ank sup pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1906","description":"Afo multilig ank sup pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJA1","description":"ICD-JEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTB0","description":"ICD-CDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18E","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLE1","description":"ICD-OJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIB1","description":"ICD-ADIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Standard size footplate each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0042","description":"Standard size footplate each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQD0","description":"ICD-CAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIA1","description":"ICD-BAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLA1","description":"ICD-GFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNE1","description":"ICD-FCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pituitary evaluation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80418","description":"Pituitary evaluation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJF0","description":"ICD-JAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental tomographic survey","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0322","description":"Dental tomographic survey","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHD0","description":"ICD-BEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDD0","description":"ICD-MHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72170","description":"X-ray exam of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0530U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","description":"CPT-0530U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB211","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8A","description":"Very High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYA1","description":"ICD-GIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCC1","description":"ICD-BFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Audiometry air & bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92553","description":"Audiometry air & bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC106","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLF0","description":"ICD-OCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBB1","description":"ICD-JEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Derm autograft face/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15135","description":"Derm autograft face/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5949","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5949","description":"CDT-D5949","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone sodium phos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1100","description":"Dexamethasone sodium phos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34051","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0640U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0640U","description":"CPT-0640U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDB1","description":"ICD-CIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUD1","description":"ICD-OLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHB0","description":"ICD-BHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXF1","description":"ICD-CCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATB0","description":"ICD-JATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92517","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Restrata_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2007","description":"Restrata_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSE1","description":"ICD-GCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Slings","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4565","description":"Slings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJB1","description":"ICD-KFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ftl cgen abnor 3 proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81509","description":"Ftl cgen abnor 3 proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Habil res waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2016","description":"Habil res waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB42","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24600","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAA1","description":"ICD-MLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcath mtral vlve repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0345T","description":"Transcath mtral vlve repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIA0","description":"ICD-CFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKD0","description":"ICD-NCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC13","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAD0","description":"ICD-ABAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDA1","description":"ICD-ODDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occlusal guard adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9943","description":"Occlusal guard adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26428","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct orbit/forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21175","description":"Reconstruct orbit/forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj arthroscopy synovectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7875","description":"Tmj arthroscopy synovectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunofluorescence_ per specimen; each additional single antibody stain procedure (List separately in addition to code for primary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0846T","description":"Digitization of glass microscope slides for immunofluorescence_ per specimen; each additional single antibody stain procedure (List separately in addition to code for primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTD0","description":"ICD-MHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Touch quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0106T","description":"Touch quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHF1","description":"ICD-BCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVB0","description":"ICD-JBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA110","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRE1","description":"ICD-CFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTC1","description":"ICD-MLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXB1","description":"ICD-JEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTD0","description":"ICD-NBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML06","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst exten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11771","description":"Remove pilonidal cyst exten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA31","description":"ICD-3JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD111","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHID1","description":"ICD-AHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXA0","description":"ICD-FBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAF1","description":"ICD-CEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFF1","description":"ICD-OIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYA0","description":"ICD-HIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2B","description":"Ultra High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92313","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAD1","description":"ICD-BBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove in/ex hem grps w/fist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46262","description":"Remove in/ex hem grps w/fist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWD1","description":"ICD-HAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot single axis ankle/foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5974","description":"Foot single axis ankle/foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERC0","description":"ICD-LERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIF1","description":"ICD-BFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILA1","description":"ICD-IILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKA0","description":"ICD-OCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelet survival kinetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78190","description":"Platelet survival kinetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"G compression stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6549","description":"G compression stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20B","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1250","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLA1","description":"ICD-MBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1557","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1557","description":"HCPCS-L1557","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUE0","description":"ICD-CCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurectomy hamstring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27325","description":"Neurectomy hamstring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEA1","description":"ICD-NLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIB0","description":"ICD-NEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICE1","description":"ICD-IICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXE0","description":"ICD-OHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMF1","description":"ICD-BCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIB1","description":"ICD-IAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGE1","description":"ICD-CHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRE0","description":"ICD-PHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISA0","description":"ICD-GISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of breast capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19371","description":"Removal of breast capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ pelvis and hips_ infant or child_ minimum of two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73540","description":"Radiologic examination_ pelvis and hips_ infant or child_ minimum of two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJF0","description":"ICD-GHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFE1","description":"ICD-JFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISA0","description":"ICD-PISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adhesive remover per ounce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4455","description":"Adhesive remover per ounce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prefab stnlss steel crown pe","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2931","description":"Prefab stnlss steel crown pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJND0","description":"ICD-NJND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFB1","description":"ICD-FHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng ace/arb blker <3mos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4481F","description":"Pt rcvng ace/arb blker <3mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC21","description":"ICD-3AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB21","description":"ICD-2DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIE0","description":"ICD-NEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIF0","description":"ICD-EGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBD1","description":"ICD-JGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61556","description":"Incise skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPA0","description":"ICD-CIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Halo cervical into jckt vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0810","description":"Halo cervical into jckt vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 65 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0145U","description":"Drug assay_ definitive_ 65 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRF1","description":"ICD-HGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCB0","description":"ICD-KBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4543","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","description":"HCPCS-A4543","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin alfa_ 100 units esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4081","description":"Epoetin alfa_ 100 units esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Variable asphericity lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2499","description":"Variable asphericity lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUD1","description":"ICD-IFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRA1","description":"ICD-LGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCF1","description":"ICD-NKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for prescribing systemic antimicrobials","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9960","description":"Documentation of medical reason(s) for prescribing systemic antimicrobials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ monaural_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5243","description":"Hearing aid_ monaural_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not die within 30 days of the procedure or during the index hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9813","description":"Patient did not die within 30 days of the procedure or during the index hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72132","description":"Ct lumbar spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVD1","description":"ICD-NBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of fecal fat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82715","description":"Assay of fecal fat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monoclonal antibodies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7505","description":"Monoclonal antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWD0","description":"ICD-OHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQE0","description":"ICD-PEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUE1","description":"ICD-CBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3406","description":"HCPCS-J3406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31295","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onco (ovar) two proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81500","description":"Onco (ovar) two proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDC1","description":"ICD-JIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARA1","description":"ICD-KARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dstrj neurofibromata xtnsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0420T","description":"Dstrj neurofibromata xtnsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":">85y scope othr rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9661","description":">85y scope othr rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOE1","description":"ICD-PKOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digoxin immune fab (ovine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1162","description":"Digoxin immune fab (ovine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Npo (nothing-mouth) ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6020F","description":"Npo (nothing-mouth) ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDF0","description":"ICD-EBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDF0","description":"ICD-OBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic deluxe shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5508","description":"Diabetic deluxe shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy prostatic imp 1-3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9739","description":"Cystoscopy prostatic imp 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUD0","description":"ICD-NBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion 32 or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2267","description":"Induced abortion 32 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXC1","description":"ICD-JEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJA0","description":"ICD-NHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlorhexidine antisept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4248","description":"Chlorhexidine antisept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt disch to home by day#7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8818","description":"Pt disch to home by day#7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient is not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in whee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9719","description":"Patient is not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in whee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHE1","description":"ICD-IAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENB0","description":"ICD-NENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frame depth less than 22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2203","description":"Frame depth less than 22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBF1","description":"ICD-GFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVF0","description":"ICD-GCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-99470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","description":"CPT-99470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCB1","description":"ICD-OGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB234","description":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCE0","description":"ICD-KDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKF0","description":"ICD-BIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWF1","description":"ICD-CHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMF1","description":"ICD-FEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWF0","description":"ICD-CGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVE0","description":"ICD-CEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYC0","description":"ICD-OBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repositioning Of Previously Implanted Substernal Implantable Defibrillator-Pacing Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0574T","description":"Repositioning Of Previously Implanted Substernal Implantable Defibrillator-Pacing Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anticoagulant mgmt subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99364","description":"Anticoagulant mgmt subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIC0","description":"ICD-JHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ inotuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9229","description":"Injection_ inotuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFA0","description":"ICD-OFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUC0","description":"ICD-FFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPC0","description":"ICD-NBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1B","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCE0","description":"ICD-OCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01670","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","description":"CPT-01670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCD1","description":"ICD-NKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIME1","description":"ICD-AIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mediastinoscpy w/lmph nod bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39402","description":"Mediastinoscpy w/lmph nod bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/2.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2308","description":"Lens sphc trifocal 4.25-7/2.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ntrk1 (Neurotrophic Receptor Tyrosine Kinase 1) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81191","description":"Ntrk1 (Neurotrophic Receptor Tyrosine Kinase 1) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBA0","description":"ICD-BIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lockingelbow forearm cntrbal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6693","description":"Lockingelbow forearm cntrbal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEA1","description":"ICD-JAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPB1","description":"ICD-JIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt neurostim elctr each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8680","description":"Implt neurostim elctr each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37285","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","description":"CPT-37285","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj lumbar plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64449","description":"N block inj lumbar plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93227","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (CT) ima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0808T","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (CT) ima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap ablat uterine fibroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0336T","description":"Lap ablat uterine fibroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFF1","description":"ICD-JGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYE0","description":"ICD-GHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETD0","description":"ICD-JETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBED0","description":"ICD-JBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist/elbow bowden cbl dir f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6582","description":"Wrist/elbow bowden cbl dir f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQC1","description":"ICD-PLQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJD0","description":"ICD-KCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELE1","description":"ICD-AELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWD1","description":"ICD-OAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ with specimen verification including DNA authentication in comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0020U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ with specimen verification including DNA authentication in comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUA0","description":"ICD-EFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEF1","description":"ICD-GDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64836","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES125","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLB0","description":"ICD-OHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYD1","description":"ICD-GHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGE1","description":"ICD-CDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCE1","description":"ICD-JGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUA0","description":"ICD-OIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","description":"HCPCS-Q4404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBC0","description":"ICD-OGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMC1","description":"ICD-OEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQC0","description":"ICD-LIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFME1","description":"ICD-CFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay resin 3 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2663","description":"Dental onlay resin 3 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE201","description":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASD1","description":"ICD-DASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDE1","description":"ICD-NLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L8721","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8721","description":"HCPCS-L8721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8B","description":"High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPB1","description":"ICD-BDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMD1","description":"ICD-BFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITD0","description":"ICD-MITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHE1","description":"ICD-MLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPD1","description":"ICD-GFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPF0","description":"ICD-OAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEE0","description":"ICD-CHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine specimen collect mult","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9615","description":"Urine specimen collect mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVF0","description":"ICD-GDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASE0","description":"ICD-PASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIF0","description":"ICD-BCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD246","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAE0","description":"ICD-OEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD124","description":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEE1","description":"ICD-MBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adenovirus ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87260","description":"Adenovirus ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOA1","description":"ICD-PIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; seco","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22868","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; seco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair calf rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0995","description":"Wheelchair calf rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGB0","description":"ICD-JFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0661T","description":"Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTC1","description":"ICD-NJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult size pull-on lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4527","description":"Adult size pull-on lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Htlv-i antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86687","description":"Htlv-i antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HTR2A (5-hydroxytryptamine receptor 2A)_ HTR2C (5-hydroxytryptamine receptor 2C) (eg_ citalopram metabolism) gene analysis_ common variants (ie_ HTR2A rs7997012 [c.614-2211T>C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0033U","description":"HTR2A (5-hydroxytryptamine receptor 2A)_ HTR2C (5-hydroxytryptamine receptor 2C) (eg_ citalopram metabolism) gene analysis_ common variants (ie_ HTR2A rs7997012 [c.614-2211T>C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lactic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83605","description":"Assay of lactic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLE0","description":"ICD-JHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJE0","description":"ICD-FFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQC0","description":"ICD-HEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVA1","description":"ICD-GEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33130","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDF0","description":"ICD-GIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27638","description":"Remove/graft leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBB1","description":"ICD-BHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDD1","description":"ICD-JEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stress tte only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93350","description":"Stress tte only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAB1","description":"ICD-CIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUC0","description":"ICD-JGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0916T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","description":"CPT-0916T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Advncd care plan addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99498","description":"Advncd care plan addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9351","description":"Doc >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart vessel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33501","description":"Repair heart vessel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPE1","description":"ICD-BBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess bengn docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3342F","description":"Mammo assess bengn docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWA1","description":"ICD-OJWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALE0","description":"ICD-AALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asp not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9436","description":"Asp not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUF0","description":"ICD-FGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITA1","description":"ICD-AITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0942T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","description":"CPT-0942T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFA0","description":"ICD-KFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 4/5vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72050","description":"X-ray exam neck spine 4/5vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport lodgng recip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0180","description":"Noner transport lodgng recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA33","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuromatrix nerve cuff_ cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9355","description":"Neuromatrix nerve cuff_ cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi_ antibody detection of 5 recombinant protein groups_ by immunoblot_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0041U","description":"Borrelia burgdorferi_ antibody detection of 5 recombinant protein groups_ by immunoblot_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGE0","description":"ICD-NLGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXE0","description":"ICD-OCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28B","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And Mai","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95716","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And Mai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXD0","description":"ICD-CIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSC0","description":"ICD-PFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo cholecystoenterostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47570","description":"Laparo cholecystoenterostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of feces porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84126","description":"Assay of feces porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sugars multiple qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84377","description":"Sugars multiple qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal_ Osseointegrated Implant_ Skull; With Percutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69726","description":"Removal_ Osseointegrated Implant_ Skull; With Percutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59350","description":"Repair of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRC0","description":"ICD-HHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUE0","description":"ICD-MJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPE1","description":"ICD-CDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDF1","description":"ICD-KIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76018","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","description":"CPT-76018","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp subclav-axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35616","description":"Art byp subclav-axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Via matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4309","description":"Via matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0675T","description":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct urethra/penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54352","description":"Reconstruct urethra/penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of arm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24320","description":"Repair of arm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheterize for urine spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9612","description":"Catheterize for urine spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levamisole 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0177","description":"Levamisole 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTA0","description":"ICD-CFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supplies and accessories (e.g._ transducer) for low frequency ultrasonic diathermy treatment device_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1036","description":"Supplies and accessories (e.g._ transducer) for low frequency ultrasonic diathermy treatment device_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4366","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","description":"HCPCS-Q4366","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transdermal gfr measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0602T","description":"Transdermal gfr measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBC1","description":"ICD-MHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temple bne implnt w/stimulat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69715","description":"Temple bne implnt w/stimulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWC1","description":"ICD-CBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay rbc protoporphyrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84202","description":"Assay rbc protoporphyrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orbital prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5915","description":"Orbital prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc expectant management pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9053","description":"Onc expectant management pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35216","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDD1","description":"ICD-JIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATD1","description":"ICD-GATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68328","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEB1","description":"ICD-ADEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Symes ankle w/o (sach) foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5703","description":"Symes ankle w/o (sach) foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cygnus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4170","description":"Cygnus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXA1","description":"ICD-OAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQB0","description":"ICD-HHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJD0","description":"ICD-CIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2130","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBC1","description":"ICD-JCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko adj jnt pos r sup pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1832","description":"Ko adj jnt pos r sup pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTD0","description":"ICD-BBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPA0","description":"ICD-NCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Robt lin-radsurg fractx 2-5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0340","description":"Robt lin-radsurg fractx 2-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Specimen not intraop image","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8873","description":"Specimen not intraop image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAA1","description":"ICD-AFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8913","description":"Mra w/o cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHF1","description":"ICD-KIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMA0","description":"ICD-OJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAA1","description":"ICD-MIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exercise test for bronchospasm_ including pre- and post-spirometry_ electrocardiographic recording(s)_ and pulse oximetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94617","description":"Exercise test for bronchospasm_ including pre- and post-spirometry_ electrocardiographic recording(s)_ and pulse oximetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24B","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVF0","description":"ICD-GBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJE1","description":"ICD-NBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments_ plasma_ prognostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0357U","description":"Oncology (melanoma)_ artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments_ plasma_ prognostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYD1","description":"ICD-GFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAD1","description":"ICD-OLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALE0","description":"ICD-GALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No prol intub req","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8570","description":"No prol intub req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBA0","description":"ICD-IHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALB0","description":"ICD-KALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLE0","description":"ICD-JCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVE1","description":"ICD-BAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ initial single antibody stain procedure (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0760T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ initial single antibody stain procedure (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSB1","description":"ICD-OFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nelarabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9261","description":"Nelarabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAA0","description":"ICD-NFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA124","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22D","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evaluate pt use of inhaler","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94664","description":"Evaluate pt use of inhaler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alveolus clsd reduc stblz te","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7771","description":"Alveolus clsd reduc stblz te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAD1","description":"ICD-GEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBE0","description":"ICD-MHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNE0","description":"ICD-CGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBF1","description":"ICD-CBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCA1","description":"ICD-MJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLE0","description":"ICD-BGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDB0","description":"ICD-NBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKC1","description":"ICD-KAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALC0","description":"ICD-KALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOB1","description":"ICD-GEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCC1","description":"ICD-JBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKA0","description":"ICD-NKKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCA0","description":"ICD-GBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p day 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90970","description":"Esrd home pt serv p day 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occupational multifocal lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2786","description":"Occupational multifocal lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDC1","description":"ICD-MKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKF1","description":"ICD-CGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCC1","description":"ICD-GGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQA0","description":"ICD-GGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-47384","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","description":"CPT-47384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHC0","description":"ICD-CCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fem focal defic constant fri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5230","description":"Fem focal defic constant fri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAA0","description":"ICD-OIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin pneum swg frct exo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5722","description":"Knee-shin pneum swg frct exo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUF1","description":"ICD-AFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50974","description":"Ureter endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD111","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aerosol mask used w nebulize","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7015","description":"Aerosol mask used w nebulize","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMA1","description":"ICD-AGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJF0","description":"ICD-JGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including inte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2010","description":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including inte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluoride applicator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5986","description":"Fluoride applicator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50782","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHA1","description":"ICD-MFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFB0","description":"ICD-KGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28F","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTF0","description":"ICD-NCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEF0","description":"ICD-GDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWC1","description":"ICD-LDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCA0","description":"ICD-NCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYF0","description":"ICD-DIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Developmental testing_ (includes assessment of motor_ language_ social_ adaptive_ and/or cognitive functioning by standardized developmental instruments) with interpretation a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96111","description":"Developmental testing_ (includes assessment of motor_ language_ social_ adaptive_ and/or cognitive functioning by standardized developmental instruments) with interpretation a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAF0","description":"ICD-MJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAD0","description":"ICD-IFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1028","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDF1","description":"ICD-JHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl semi/precision attach","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6091","description":"Repl semi/precision attach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAB0","description":"ICD-FBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVA0","description":"ICD-NHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHA0","description":"ICD-NHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUB1","description":"ICD-BDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCB0","description":"ICD-GHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEE0","description":"ICD-IEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPF0","description":"ICD-FGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBD0","description":"ICD-ICBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1601","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1601","description":"CDT-D1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMB1","description":"ICD-CCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOA1","description":"ICD-GBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methylnaltrexone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2212","description":"Methylnaltrexone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASC1","description":"ICD-HASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 100 mcg/0.5mL dosage_ for in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91301","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 100 mcg/0.5mL dosage_ for in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srs linear based","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77372","description":"Srs linear based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE211","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp axill-fem-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35654","description":"Art byp axill-fem-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prkns diag rviewed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1400F","description":"Prkns diag rviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Toilet seat raised","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0244","description":"Toilet seat raised","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt instr nrml activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4245F","description":"Pt instr nrml activities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB33","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incis w/discectomy lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22224","description":"Incis w/discectomy lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries_ including right heart catheterization_ pulmonary artery angiography_ and all imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0793T","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries_ including right heart catheterization_ pulmonary artery angiography_ and all imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB125","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISB0","description":"ICD-GISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDC0","description":"ICD-AFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPB0","description":"ICD-CHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5B","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVD0","description":"ICD-OCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6783","description":"Crown 3/4 porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX01","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAF1","description":"ICD-NKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replantation digit complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20816","description":"Replantation digit complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_ fine needle aspirate of thyroid nodule_ algorithmic analysis reported as a categorical result (Posi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0026U","description":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_ fine needle aspirate of thyroid nodule_ algorithmic analysis reported as a categorical result (Posi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDB1","description":"ICD-NKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTC0","description":"ICD-JBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGE1","description":"ICD-BHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD251","description":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1002","description":"HCPCS-A1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec size w foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1223","description":"Wheelchair spec size w foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIE1","description":"ICD-OBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACE1","description":"ICD-OACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQA1","description":"ICD-PHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thera par drugs 2 or > admin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9612","description":"Thera par drugs 2 or > admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHF0","description":"ICD-BHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEC0","description":"ICD-EDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJD0","description":"ICD-CBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLC0","description":"ICD-OCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18F","description":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69602","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elevat legrst up hangr brack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0047","description":"Elevat legrst up hangr brack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifo 7.25-12/.25-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2211","description":"Lens sphcy bifo 7.25-12/.25-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCD1","description":"ICD-OBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44620","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYA0","description":"ICD-KHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54530","description":"Removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC21","description":"ICD-4IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAB1","description":"ICD-BAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXA1","description":"ICD-NCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal Aneuploidy Short Tandem-Repeat Comparative Analysis_ Fetal Dna From Products Of Conception_ Reported As Normal (Euploidy)_ Monosomy_ Trisomy_ Or Partial Deletion/Duplica","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0252U","description":"Fetal Aneuploidy Short Tandem-Repeat Comparative Analysis_ Fetal Dna From Products Of Conception_ Reported As Normal (Euploidy)_ Monosomy_ Trisomy_ Or Partial Deletion/Duplica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHME1","description":"ICD-JHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14D","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of idh enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83570","description":"Assay of idh enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUA1","description":"ICD-JGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anidulafungin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0348","description":"Anidulafungin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEE1","description":"ICD-FDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB17","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWB1","description":"ICD-CBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVD1","description":"ICD-ODVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77261","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change g-tube to g-j perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49446","description":"Change g-tube to g-j perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTF1","description":"ICD-ECTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJC0","description":"ICD-OLJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFID1","description":"ICD-OFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRA1","description":"ICD-KFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (Mood Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 144 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0291U","description":"Psychiatry (Mood Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 144 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic compression controller with sequential calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0680","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radial keratotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65771","description":"Radial keratotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAF1","description":"ICD-CHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adrenal cortex & medulla img","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78075","description":"Adrenal cortex & medulla img","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYC1","description":"ICD-OKYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHC0","description":"ICD-OKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNB1","description":"ICD-OBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFF1","description":"ICD-KAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAC0","description":"ICD-JAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ toe caps_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6572","description":"Gradient compression garment_ toe caps_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAB1","description":"ICD-ODAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCB1","description":"ICD-IHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIC1","description":"ICD-NFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCE0","description":"ICD-MFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66999","description":"Eye surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25240","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTE1","description":"ICD-OBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium (hikma) not therapeutically equivalent to j0650_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0652","description":"Injection_ levothyroxine sodium (hikma) not therapeutically equivalent to j0650_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLC1","description":"ICD-GBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHA1","description":"ICD-MCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWD0","description":"ICD-HAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUB0","description":"ICD-GGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAND1","description":"ICD-BAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBA1","description":"ICD-MHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERE0","description":"ICD-LERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKA0","description":"ICD-OJKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41000","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8C","description":"Very High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEB1","description":"ICD-IHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL44","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDME0","description":"ICD-NDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJB1","description":"ICD-GBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMF0","description":"ICD-EBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pyridoxine hcl 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3415","description":"Pyridoxine hcl 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagus motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91010","description":"Esophagus motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull/brain surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61720","description":"Incise skull/brain surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLD1","description":"ICD-BDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35879","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLA0","description":"ICD-OLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAF0","description":"ICD-OAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ondansetron oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0162","description":"Ondansetron oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXD1","description":"ICD-OBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHC0","description":"ICD-KFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDD1","description":"ICD-ICDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQD0","description":"ICD-CBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/o stablj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21315","description":"Closed tx nose fx w/o stablj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOE0","description":"ICD-HIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFED0","description":"ICD-GFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAF1","description":"ICD-GDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (wg critical care)_ per 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0611","description":"Injection_ calcium gluconate (wg critical care)_ per 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNC0","description":"ICD-KDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX46","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth ear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12451","description":"Anesth ear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYC1","description":"ICD-KIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental bitewings two films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0272","description":"Dental bitewings two films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace lithium battery 1.5v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4602","description":"Replace lithium battery 1.5v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aortic anrysm 6/> cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9004F","description":"Aortic anrysm 6/> cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 22 Or Functional Status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2144","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 22 Or Functional Status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous rf 1st vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36475","description":"Endovenous rf 1st vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cst bse mtl inlay >= 3 surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6605","description":"Cst bse mtl inlay >= 3 surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of neck wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15825","description":"Removal of neck wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIE0","description":"ICD-MGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom grad sleeve heavy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8423","description":"Custom grad sleeve heavy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ureter lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51535","description":"Repair of ureter lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt queried pain fxn w/ instr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1502F","description":"Pt queried pain fxn w/ instr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavior counsel obesity 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0447","description":"Behavior counsel obesity 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit est age 18-39","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99395","description":"Prev visit est age 18-39","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMD1","description":"ICD-OLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPE1","description":"ICD-GHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFC0","description":"ICD-JFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITB1","description":"ICD-MITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52301","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGF0","description":"ICD-GFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAB0","description":"ICD-EEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair non-electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0171","description":"Commode chair non-electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGB0","description":"ICD-CGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transverse Aortic Arch Graft_ With Cardiopulmonary Bypass_ With Profound Hypothermia_ Total Circulatory Arrest And Isolated Cerebral Perfusion With Reimplantation Of Arch Vess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33871","description":"Transverse Aortic Arch Graft_ With Cardiopulmonary Bypass_ With Profound Hypothermia_ Total Circulatory Arrest And Isolated Cerebral Perfusion With Reimplantation Of Arch Vess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGD0","description":"ICD-JIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVA0","description":"ICD-OAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bilirubin direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82248","description":"Bilirubin direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFC0","description":"ICD-NBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIB0","description":"ICD-AFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise ileoanal reservior","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45136","description":"Excise ileoanal reservior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXA0","description":"ICD-CGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFD0","description":"ICD-CIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXF0","description":"ICD-KDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMC1","description":"ICD-KEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shrt leg plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4037","description":"Cast sup shrt leg plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBD0","description":"ICD-OGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJE0","description":"ICD-CDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tongue to lip surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41510","description":"Tongue to lip surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mitomycin pyelocalyceal instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9064","description":"Mitomycin pyelocalyceal instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0A","description":"Medium Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGA0","description":"ICD-OJGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81171","description":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGF0","description":"ICD-FBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWB1","description":"ICD-DHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYA1","description":"ICD-DCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tcd emboli detect w/inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93893","description":"Tcd emboli detect w/inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHF1","description":"ICD-KGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEE0","description":"ICD-GDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRC0","description":"ICD-LCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion/graft of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25805","description":"Fusion/graft of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPD1","description":"ICD-FEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aortic aneurysm 5-5.4cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9002F","description":"Aortic aneurysm 5-5.4cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroscopic procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76496","description":"Fluoroscopic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stress tte complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93351","description":"Stress tte complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qty act mcc mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9670","description":"Qty act mcc mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cftr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81220","description":"Cftr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic sock multi ply bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8420","description":"Prosthetic sock multi ply bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVD1","description":"ICD-KHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDA0","description":"ICD-KCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOE0","description":"ICD-CGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46080","description":"Incision of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC21","description":"ICD-3KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSA1","description":"ICD-KDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx multi myeloma unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9130","description":"Onc dx multi myeloma unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINE0","description":"ICD-BINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0559U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","description":"CPT-0559U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27236","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental Case Management - Patients With Special Health Care Needs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9997","description":"Dental Case Management - Patients With Special Health Care Needs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYE1","description":"ICD-LCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTB1","description":"ICD-AGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8901","description":"Mra w/o cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEC0","description":"ICD-JFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFME1","description":"ICD-FFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA224","description":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYC0","description":"ICD-DGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq & icut allg test venoms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95017","description":"Perq & icut allg test venoms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat midfoot fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28456","description":"Treat midfoot fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNE1","description":"ICD-GCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68525","description":"Biopsy of tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXB0","description":"ICD-JGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caffeine citrate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0706","description":"Caffeine citrate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARD1","description":"ICD-DARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply intrcav radiat compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77763","description":"Apply intrcav radiat compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIC0","description":"ICD-BCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC05","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGC1","description":"ICD-GHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJD1","description":"ICD-NAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJC0","description":"ICD-BBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHC1","description":"ICD-EBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whelchr fxd full length arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1050","description":"Whelchr fxd full length arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antidepres rxthxpy not rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4063F","description":"Antidepres rxthxpy not rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary ovarian cancer (eg_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing a combination of NGS_ Sanger_ MLPA_ and arr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0103U","description":"Hereditary ovarian cancer (eg_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing a combination of NGS_ Sanger_ MLPA_ and arr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMD1","description":"ICD-CEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKC1","description":"ICD-CGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of rbc galactokinase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82759","description":"Assay of rbc galactokinase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Velaglucerase alfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3385","description":"Velaglucerase alfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4044","description":"Cast sup lng leg splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of chest wall lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19260","description":"Removal of chest wall lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMC0","description":"ICD-MKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor_ including s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0309","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor_ including s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Back school visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9117","description":"Back school visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Placement Of Intra-Socket Biological Dressing To Aid In Hemostasis Or Clot Stabiliization_ Per Site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7922","description":"Placement Of Intra-Socket Biological Dressing To Aid In Hemostasis Or Clot Stabiliization_ Per Site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWA0","description":"ICD-PAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQD0","description":"ICD-HIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUF1","description":"ICD-FBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9068","description":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88304","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDA1","description":"ICD-GFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evacuation Of Meibomian Glands_ Using Heat Delivered Through Wearable_ Open-Eye Eyelid Treatment Devices And Manual Gland Expression_ Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0563T","description":"Evacuation Of Meibomian Glands_ Using Heat Delivered Through Wearable_ Open-Eye Eyelid Treatment Devices And Manual Gland Expression_ Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXC0","description":"ICD-GFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metyrapone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80436","description":"Metyrapone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0901T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","description":"CPT-0901T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOB1","description":"ICD-DIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cell enumeration & id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86152","description":"Cell enumeration & id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWC0","description":"ICD-PJWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMD1","description":"ICD-JEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with guided transhepatic cholangiography with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47561","description":"Laparoscopy_ surgical; with guided transhepatic cholangiography with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate inf turbinate superf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30801","description":"Ablate inf turbinate superf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina tissue part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57107","description":"Remove vagina tissue part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAC1","description":"ICD-EIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNE1","description":"ICD-KGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove nail plate add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11732","description":"Remove nail plate add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAE0","description":"ICD-MGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQC1","description":"ICD-KBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTA1","description":"ICD-GCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCME1","description":"ICD-OCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFF0","description":"ICD-JCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spec site no cutaneous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9430","description":"Spec site no cutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA21","description":"ICD-1BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE104","description":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61559","description":"Excision of skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWC1","description":"ICD-GCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEE0","description":"ICD-OBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endometrial sampling or hysteroscopy with biopsy and results not documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9824","description":"Endometrial sampling or hysteroscopy with biopsy and results not documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHD1","description":"ICD-GFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDE1","description":"ICD-JCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glasses bone conduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5080","description":"Glasses bone conduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGA0","description":"ICD-BEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy w/exc of tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31540","description":"Laryngoscopy w/exc of tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia with hypothermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99116","description":"Anesthesia with hypothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAD0","description":"ICD-NAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Specimen handling pt-lab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99001","description":"Specimen handling pt-lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTD1","description":"ICD-EDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBC0","description":"ICD-BDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEA1","description":"ICD-AGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFD1","description":"ICD-JEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVB1","description":"ICD-OJVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWA1","description":"ICD-HCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKB0","description":"ICD-NKKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHE1","description":"ICD-JDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEF1","description":"ICD-EGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2C","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAB1","description":"ICD-OGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1601","description":"HCPCS-C1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0498U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","description":"CPT-0498U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPD1","description":"ICD-KDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBA1","description":"ICD-KHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99223","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENE1","description":"ICD-GENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transtemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61595","description":"Transtemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth iridectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14751","description":"Anesth iridectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXD0","description":"ICD-JHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl bifo 7.25-12/2.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2212","description":"Lens sphcyl bifo 7.25-12/2.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALF1","description":"ICD-GALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21B","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFA0","description":"ICD-KEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc no burn prior to d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8909","description":"Pt doc no burn prior to d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metal frame recipro hip & ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2628","description":"Metal frame recipro hip & ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOF1","description":"ICD-OGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAC0","description":"ICD-NIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No off assis eol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9382","description":"No off assis eol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete ivf nos case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4015","description":"Complete ivf nos case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CT/MRI brain done w/in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3111F","description":"CT/MRI brain done w/in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPE1","description":"ICD-FFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder abduction joint pai","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6640","description":"Shoulder abduction joint pai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Womans shoe oxford brace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3224","description":"Womans shoe oxford brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of larynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31578","description":"Removal of larynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amb infusion pump mechanical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0779","description":"Amb infusion pump mechanical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28E","description":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALB1","description":"ICD-NALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20D","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35236","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLC0","description":"ICD-IDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELD1","description":"ICD-CELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMD1","description":"ICD-KDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coma stimulation per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9056","description":"Coma stimulation per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ thrombectomy/embolect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1757","description":"Cath_ thrombectomy/embolect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic control band & belt b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2640","description":"Pelvic control band & belt b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL35","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEB0","description":"ICD-NAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDD0","description":"ICD-MBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1313","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITD0","description":"ICD-NITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50972","description":"Ureter endoscopy & catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWA0","description":"ICD-KCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEF1","description":"ICD-AGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whirlpool portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1300","description":"Whirlpool portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for hip x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27093","description":"Injection for hip x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNB0","description":"ICD-GFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHB0","description":"ICD-OAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0788","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0788","description":"HCPCS-E0788","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTA0","description":"ICD-CHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noc retail items andsupplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1999","description":"Noc retail items andsupplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00454","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","description":"CPT-00454","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43124","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSC1","description":"ICD-ODSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTA0","description":"ICD-JFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) Wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2147","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) Wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28F","description":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBB1","description":"ICD-MIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24006","description":"Release elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair rectum/remove sigmoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45550","description":"Repair rectum/remove sigmoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57455","description":"Biopsy of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visit to determ ldct elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0296","description":"Visit to determ ldct elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ peripheral nerve_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64598","description":"Revision or removal of neurostimulator electrode array_ peripheral nerve_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurofilament light chain_ digital immunoassay_ plasma_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0361U","description":"Neurofilament light chain_ digital immunoassay_ plasma_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daratumumab 10 mg and hyaluronidase-fihj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9062","description":"Injection_ daratumumab 10 mg and hyaluronidase-fihj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUF0","description":"ICD-GGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0166","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","description":"HCPCS-J0166","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain/ceramic subs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2740","description":"Crown porcelain/ceramic subs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cstm dme other than wheelchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0900","description":"Cstm dme other than wheelchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX43","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUF0","description":"ICD-GDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Press pad alternating w/ pum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0181","description":"Press pad alternating w/ pum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64864","description":"Repair of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIB1","description":"ICD-FHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert xdrl body thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63302","description":"Remove vert xdrl body thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB34","description":"Medium Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor vii proconvertin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85230","description":"Clot factor vii proconvertin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIF1","description":"ICD-NJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Not Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2122","description":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Not Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28476","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEC0","description":"ICD-FBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Diffuse Large B-Cell Lymphoma [Dlbcl])_ Mrna_ Gene Expression Profiling By Fluorescent Probe Hybridization Of 20 Genes_ Formalin-Fixed Paraffin-Embedded Tissue_ Algo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0017M","description":"Oncology (Diffuse Large B-Cell Lymphoma [Dlbcl])_ Mrna_ Gene Expression Profiling By Fluorescent Probe Hybridization Of 20 Genes_ Formalin-Fixed Paraffin-Embedded Tissue_ Algo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFD0","description":"ICD-CDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFF0","description":"ICD-NKFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLA0","description":"ICD-GGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68360","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36571","description":"Insert picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLME1","description":"ICD-MLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2B","description":"Medium Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq cardiac angioplast 1 art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92920","description":"Prq cardiac angioplast 1 art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWB1","description":"ICD-GAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25A","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt no ref otolo no spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8568","description":"Pt no ref otolo no spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEB0","description":"ICD-BDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQB1","description":"ICD-ODQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reclining back add ped w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1014","description":"Reclining back add ped w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress disc rf lumbar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2348","description":"Decompress disc rf lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEB0","description":"ICD-NIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcv hedia outpt dyls fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8956","description":"Pt rcv hedia outpt dyls fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy_ by abdominal or retroperitoneal incision_ unilateral (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34820","description":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy_ by abdominal or retroperitoneal incision_ unilateral (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIB0","description":"ICD-JAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJF0","description":"ICD-NGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRF1","description":"ICD-LFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBA1","description":"ICD-CEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","description":"HCPCS-J3402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIF1","description":"ICD-BDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACME0","description":"ICD-ACME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESF0","description":"ICD-KESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBD1","description":"ICD-JEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27664","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mecp2 gene dup/delet variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81304","description":"Mecp2 gene dup/delet variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILE1","description":"ICD-MILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRB0","description":"ICD-KBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQE1","description":"ICD-DIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKD0","description":"ICD-CHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXF1","description":"ICD-FFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lodging per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9976","description":"Lodging per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6553","description":"Gradient compression stocking_ below knee_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNE0","description":"ICD-OHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQB1","description":"ICD-PBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAF0","description":"ICD-BEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHC1","description":"ICD-IAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSD0","description":"ICD-HDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPF0","description":"ICD-OEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alpha-1-antitrypsin pheno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82104","description":"Alpha-1-antitrypsin pheno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUB1","description":"ICD-BHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0626U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","description":"CPT-0626U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXB1","description":"ICD-KDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNA1","description":"ICD-JCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJE0","description":"ICD-NFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTE0","description":"ICD-KDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient immunocompromised","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1062","description":"Patient immunocompromised","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin b-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84207","description":"Assay of vitamin b-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70559","description":"MRI brain w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PROTON THERAPY","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77524","description":"PROTON THERAPY","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1252","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDF0","description":"ICD-IEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEF1","description":"ICD-NDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (Stress Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 72 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0292U","description":"Psychiatry (Stress Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 72 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWB1","description":"ICD-LEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNB1","description":"ICD-CDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYC1","description":"ICD-PGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNC1","description":"ICD-OJNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHF1","description":"ICD-KEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE225","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX41","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPD0","description":"ICD-FGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96936","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB250","description":"Clinically Complex _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA51","description":"Default_ /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBC0","description":"ICD-JHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKE0","description":"ICD-OHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81538","description":"Oncology lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISA1","description":"ICD-LISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay tumor qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86294","description":"Immunoassay tumor qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCD0","description":"ICD-JBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6074","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD154","description":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Candida species panel (C. albicans_ C. glabrata_ C. parapsilosis_ C. kruseii_ C tropicalis_ and C. auris)_ amplified probe technique with qualitative report of the presence or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0068U","description":"Candida species panel (C. albicans_ C. glabrata_ C. parapsilosis_ C. kruseii_ C tropicalis_ and C. auris)_ amplified probe technique with qualitative report of the presence or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBE0","description":"ICD-OGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIA0","description":"ICD-AGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXE1","description":"ICD-NGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJE1","description":"ICD-NDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulpal therapy anterior prim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3230","description":"Pulpal therapy anterior prim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIE0","description":"ICD-FBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE260","description":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTF0","description":"ICD-GFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOF0","description":"ICD-GFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt cat/pn cat/hist grd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3260F","description":"Pt cat/pn cat/hist grd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC210","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA56","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA31","description":"ICD-1EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 21 valent (PCV21)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90684","description":"Pneumococcal conjugate vaccine_ 21 valent (PCV21)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Disease_ Bacterial Vaginosis_ Quantitative Real-Time Amplification Of Rna Markers For Atopobium Vaginae_ Gardnerella Vaginalis_ And Lactobacillus Species_ Utilizing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81513","description":"Infectious Disease_ Bacterial Vaginosis_ Quantitative Real-Time Amplification Of Rna Markers For Atopobium Vaginae_ Gardnerella Vaginalis_ And Lactobacillus Species_ Utilizing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB10","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ethinyl estradiol and etonogestrel 0.015 mg_ 0.12 mg per 24hours; monthly vaginal ring_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7295","description":"Ethinyl estradiol and etonogestrel 0.015 mg_ 0.12 mg per 24hours; monthly vaginal ring_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANC0","description":"ICD-NANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCB1","description":"ICD-MCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Francisella tularensis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86668","description":"Francisella tularensis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78609","description":"Brain imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRE0","description":"ICD-CHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLC0","description":"ICD-AHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENC1","description":"ICD-FENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEF1","description":"ICD-FCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPC0","description":"ICD-BCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB201","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCB1","description":"ICD-CFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDA0","description":"ICD-NIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye surgery follow-up add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67331","description":"Eye surgery follow-up add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42660","description":"Dilation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0702","description":"HCPCS-A0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interro eval npgs sleep apne","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0434T","description":"Interro eval npgs sleep apne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amobarbital 125 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0300","description":"Amobarbital 125 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Atropine sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0461","description":"Atropine sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic control pelvic sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2580","description":"Pelvic control pelvic sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUC0","description":"ICD-FIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Budesonide non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7626","description":"Budesonide non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJE1","description":"ICD-JHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pow mobil dev no dmepdac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0899","description":"Pow mobil dev no dmepdac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMA1","description":"ICD-NIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor viii vw ristoctn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85245","description":"Clot factor viii vw ristoctn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Static str shldr dev rom adj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1841","description":"Static str shldr dev rom adj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Paranasal sinus ultrasound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9024","description":"Paranasal sinus ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESD0","description":"ICD-HESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54860","description":"Removal of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87513","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","description":"CPT-87513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce radius and ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25492","description":"Reinforce radius and ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infiltration of sustained release therapeutic drug - single or multiple sites","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9613","description":"Infiltration of sustained release therapeutic drug - single or multiple sites","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ high complexity_ requiring these components: A medical history and physical activity profile_ with 3 or more comorbidities that affect physical a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97171","description":"Athletic training evaluation_ high complexity_ requiring these components: A medical history and physical activity profile_ with 3 or more comorbidities that affect physical a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54055","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQF1","description":"ICD-PLQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC31","description":"ICD-4EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAD1","description":"ICD-MIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRE1","description":"ICD-GHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66720","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDA0","description":"ICD-FIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mult mech switches","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2322","description":"Mult mech switches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAE0","description":"ICD-CBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHF1","description":"ICD-ECHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ alemtuzumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0202","description":"Injection_ alemtuzumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBC1","description":"ICD-GHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft brchl-ulnr-rdl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35523","description":"Art byp grft brchl-ulnr-rdl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA130","description":"Clinically Complex _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAD1","description":"ICD-GBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRE0","description":"ICD-PBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATD0","description":"ICD-GATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asth not controlled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9434","description":"Asth not controlled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCD0","description":"ICD-OLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWD1","description":"ICD-GIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular disease_ plasma_ analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019M","description":"Cardiovascular disease_ plasma_ analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNB0","description":"ICD-GDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eyelid lining surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68399","description":"Eyelid lining surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAF0","description":"ICD-ADAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC131","description":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryosurgery anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46916","description":"Cryosurgery anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shingrix vaccine was not administered for reasons documented by clinician (e.g._ patient administered vaccine other than Shingr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1065","description":"Shingrix vaccine was not administered for reasons documented by clinician (e.g._ patient administered vaccine other than Shingr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRB0","description":"ICD-GFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHB1","description":"ICD-MGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUA1","description":"ICD-KIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57260","description":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of mastoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70120","description":"X-ray exam of mastoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICC0","description":"ICD-GICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFF1","description":"ICD-KIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUB0","description":"ICD-OHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABF1","description":"ICD-GABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shock absorber for power w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1016","description":"Shock absorber for power w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBD1","description":"ICD-KCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10004","description":"Fine needle aspiration biopsy_ without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound cleanser any type/size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6260","description":"Wound cleanser any type/size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFA0","description":"ICD-JBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB154","description":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPD1","description":"ICD-JGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sterile water/saline_ 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4216","description":"Sterile water/saline_ 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFE1","description":"ICD-ODFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Facial replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5929","description":"Facial replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diskectomy_ anterior_ with d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2351","description":"Diskectomy_ anterior_ with d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin pneum/swg pha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5830","description":"Endo knee-shin pneum/swg pha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUB0","description":"ICD-IBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gold sodium thiomaleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1600","description":"Gold sodium thiomaleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantable pump replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0786","description":"Implantable pump replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dtap-ipv vaccine 4-6 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90696","description":"Dtap-ipv vaccine 4-6 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDA0","description":"ICD-OGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC13","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX07","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKA1","description":"ICD-NAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAF1","description":"ICD-BIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio upr extrm w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73206","description":"Ct angio upr extrm w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGB1","description":"ICD-GCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXF1","description":"ICD-KAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation shield","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5984","description":"Radiation shield","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFC0","description":"ICD-OAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj test 7-8 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95910","description":"Nrv cndj test 7-8 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAED0","description":"ICD-CAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUF1","description":"ICD-IDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOC1","description":"ICD-CBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13101","description":"Cmplx rpr trunk 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEC0","description":"ICD-NEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of arm nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64861","description":"Repair of arm nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMC0","description":"ICD-FEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPA0","description":"ICD-OGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTA0","description":"ICD-KHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4C","description":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEC1","description":"ICD-CGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLC0","description":"ICD-KHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evaluate speech production","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92522","description":"Evaluate speech production","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nikaidoh proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33782","description":"Nikaidoh proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBD1","description":"ICD-BCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18G","description":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYE0","description":"ICD-KCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB21","description":"ICD-1DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQA1","description":"ICD-KEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flortaucipir F 18 injection_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9601","description":"Flortaucipir F 18 injection_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUE0","description":"ICD-GFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFA1","description":"ICD-GFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYA0","description":"ICD-HGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35011","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25C","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB21","description":"ICD-3KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQC0","description":"ICD-CGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOB0","description":"ICD-DGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHD1","description":"ICD-OLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUE0","description":"ICD-MFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIA0","description":"ICD-BIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMC1","description":"ICD-BFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RAS (KRAS or NRAS) gene mutation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9843","description":"RAS (KRAS or NRAS) gene mutation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOD1","description":"ICD-OFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYC0","description":"ICD-PGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11422","description":"Exc h-f-nk-sp b9+marg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14B","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epidural lysis on single day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62264","description":"Epidural lysis on single day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUC0","description":"ICD-MFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srs cranial lesion simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61796","description":"Srs cranial lesion simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indium in-111 auto wbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9570","description":"Indium in-111 auto wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant/replace hearing aid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69710","description":"Implant/replace hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWB0","description":"ICD-GDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIE0","description":"ICD-OLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22600","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amphotericin b lipid complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0287","description":"Amphotericin b lipid complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYC0","description":"ICD-KAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49606","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWF1","description":"ICD-GDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture interm cmplt maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5810","description":"Denture interm cmplt maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1334","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARF1","description":"ICD-GARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther/diag concurrent inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96368","description":"Ther/diag concurrent inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES317","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXE1","description":"ICD-OIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFC1","description":"ICD-JBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay other fluid chlorides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82438","description":"Assay other fluid chlorides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental other tmj films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0321","description":"Dental other tmj films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYE1","description":"ICD-HBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8B","description":"Medium Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr umbil hern block < 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49582","description":"Rpr umbil hern block < 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJB1","description":"ICD-NAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA105","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27442","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3d photographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0351","description":"3d photographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous femoral-popliteal arterial revascularization_ with transcatheter placement of intravascular stent graft(s) and closure by any method_ including percutaneous or open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0505T","description":"Endovenous femoral-popliteal arterial revascularization_ with transcatheter placement of intravascular stent graft(s) and closure by any method_ including percutaneous or open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28H","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88161","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sutures diff surgeon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15851","description":"Remove sutures diff surgeon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEC0","description":"ICD-NKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ashkenazi jewish assoc dis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81412","description":"Ashkenazi jewish assoc dis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1026","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17106","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXB1","description":"ICD-GDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB44","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTF0","description":"ICD-OFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAA1","description":"ICD-CBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICF0","description":"ICD-NICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd remove lesion snare","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43251","description":"Egd remove lesion snare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKE0","description":"ICD-OJKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIB1","description":"ICD-EHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAF0","description":"ICD-MAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFB0","description":"ICD-BGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHA0","description":"ICD-EEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUF1","description":"ICD-ADUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PalinGen or PalinGen XPlus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4173","description":"PalinGen or PalinGen XPlus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNF1","description":"ICD-FGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Saquinavir_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0140","description":"Saquinavir_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUA0","description":"ICD-NAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"22nf nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2360","description":"22nf nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQF0","description":"ICD-GIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inc for vagus n elect impl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64568","description":"Inc for vagus n elect impl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFF0","description":"ICD-KAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69645","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC31","description":"ICD-3EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Migration inhibitory factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86378","description":"Migration inhibitory factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSC0","description":"ICD-PCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Online e/m by phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99444","description":"Online e/m by phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTA1","description":"ICD-CHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKE0","description":"ICD-GFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUE1","description":"ICD-IGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O2/water vapor enrich w/heat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1405","description":"O2/water vapor enrich w/heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIC0","description":"ICD-MDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOE1","description":"ICD-DBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEC0","description":"ICD-BGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lipoprotein bld hr fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83701","description":"Lipoprotein bld hr fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23B","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYD1","description":"ICD-HEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Uveal Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 15 Genes (12 Content And 3 Housekeeping)_ Utilizing Fine Needle Aspirate Or Formalin-Fixed Pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81552","description":"Oncology (Uveal Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 15 Genes (12 Content And 3 Housekeeping)_ Utilizing Fine Needle Aspirate Or Formalin-Fixed Pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQD1","description":"ICD-DGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant spinal canal cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62350","description":"Implant spinal canal cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBE0","description":"ICD-GEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open aortic tube prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34830","description":"Open aortic tube prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXE0","description":"ICD-NCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCA0","description":"ICD-ODCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYA1","description":"ICD-HHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95938","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test presump optical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0477","description":"Drug test presump optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0601","description":"HCPCS-A0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBC0","description":"ICD-NBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ rimabotulinumtoxinb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0587","description":"Inj_ rimabotulinumtoxinb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMF1","description":"ICD-JEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Room and Board Rate - A flat per diem rate before area wage adjustment for patients whose home is a nursing home.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0606","description":"Room and Board Rate - A flat per diem rate before area wage adjustment for patients whose home is a nursing home.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29884","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18I","description":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUC0","description":"ICD-ECUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHE0","description":"ICD-IDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDF0","description":"ICD-KHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25A","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0447T","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKE1","description":"ICD-NGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj levocarnitine per 1 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1955","description":"Inj levocarnitine per 1 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA21","description":"ICD-1AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0546U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","description":"CPT-0546U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of etiocholanolone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82696","description":"Assay of etiocholanolone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep bk ptb thermopls molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5530","description":"Prep bk ptb thermopls molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUA0","description":"ICD-EAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTC0","description":"ICD-OFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRB1","description":"ICD-HHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWD0","description":"ICD-LHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ difelikefalin_ 0.1 microgram_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0879","description":"Injection_ difelikefalin_ 0.1 microgram_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBC0","description":"ICD-OBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMA0","description":"ICD-AEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC244","description":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGE0","description":"ICD-NIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exposure behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by physician or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0363T","description":"Exposure behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by physician or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair deformity of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28313","description":"Repair deformity of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adenovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86603","description":"Adenovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47620","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of paste boot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29580","description":"Application of paste boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93244","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTE1","description":"ICD-IGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGD1","description":"ICD-FIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rep part denture cast frame","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5620","description":"Rep part denture cast frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLA0","description":"ICD-JHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of cheek nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64734","description":"Incision of cheek nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay 17- ketosteroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83586","description":"Assay 17- ketosteroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMD1","description":"ICD-NAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWB0","description":"ICD-PGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70332","description":"X-ray exam of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAE1","description":"ICD-KCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47760","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise thumb tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26490","description":"Revise thumb tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEB1","description":"ICD-JHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOE1","description":"ICD-KAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Verteporfin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3396","description":"Verteporfin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla typing a b or c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86812","description":"Hla typing a b or c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incis spine 3 column adl seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22208","description":"Incis spine 3 column adl seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUE1","description":"ICD-KCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins mark thor for rt perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32553","description":"Ins mark thor for rt perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Child fostercare th per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5145","description":"Child fostercare th per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJA0","description":"ICD-FFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBD1","description":"ICD-KEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRD1","description":"ICD-LFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYE0","description":"ICD-HAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIA0","description":"ICD-GBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99412","description":"Preventive counseling group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Initial Prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0569T","description":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Initial Prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUF1","description":"ICD-BDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anti-phospholipid antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86148","description":"Anti-phospholipid antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHA1","description":"ICD-FGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUC0","description":"ICD-EAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mobility current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8978","description":"Mobility current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMA0","description":"ICD-FFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDA1","description":"ICD-AHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune diseases (eg_ systemic lupus erythematosus [SLE])_ analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorben","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0312U","description":"Autoimmune diseases (eg_ systemic lupus erythematosus [SLE])_ analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorben","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-rays bone survey limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77074","description":"X-rays bone survey limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA21","description":"Default_ /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHA1","description":"ICD-FBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ configuration of wave form_ battery status_ elect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95973","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ configuration of wave form_ battery status_ elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of skull seams","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61550","description":"Release of skull seams","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEF1","description":"ICD-BHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBB1","description":"ICD-NHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXF0","description":"ICD-NDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Molecular diagnostic test reader_ nonprescription self-administered and self-collected use_ fda approved_ authorized or cleared","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1035","description":"Molecular diagnostic test reader_ nonprescription self-administered and self-collected use_ fda approved_ authorized or cleared","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Podiatry Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4028","description":"Podiatry Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65175","description":"Removal of ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (Alzheimer Disease)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 24 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0289U","description":"Neurology (Alzheimer Disease)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 24 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1160","description":"Wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert card electrodes dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33211","description":"Insert card electrodes dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAC0","description":"ICD-JGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electric wound treatment dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0769","description":"Electric wound treatment dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGC1","description":"ICD-JAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of femur 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73551","description":"X-ray exam of femur 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0667T","description":"Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD212","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMF1","description":"ICD-GBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPA0","description":"ICD-FBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy control bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43227","description":"Esophagoscopy control bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis B Vaccine (Hepb)_ 3-Antigen (S_ Pre-S1_ Pre-S2)_ 10 Mcg Dosage_ 3 Dose Schedule_ For Intramuscular Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90759","description":"Hepatitis B Vaccine (Hepb)_ 3-Antigen (S_ Pre-S1_ Pre-S2)_ 10 Mcg Dosage_ 3 Dose Schedule_ For Intramuscular Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49615","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDA1","description":"ICD-KCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Csi any other than pci 2 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8964","description":"Csi any other than pci 2 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4223","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4223","description":"HCPCS-Q4223","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADME1","description":"ICD-ADME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFF1","description":"ICD-BGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision/fixation of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27165","description":"Incision/fixation of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Select picture audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92583","description":"Select picture audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vasopressin (american regent) not therapeutically equivalent to j2598_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2599","description":"Injection_ vasopressin (american regent) not therapeutically equivalent to j2598_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270_ up to 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2272","description":"Injection_ morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270_ up to 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOA0","description":"ICD-KBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEC1","description":"ICD-FGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recd scrn hcv infec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9383","description":"Recd scrn hcv infec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKA0","description":"ICD-FFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSC0","description":"ICD-LFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAA1","description":"ICD-BGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ vincristine sul lip 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9371","description":"Inj_ vincristine sul lip 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18C","description":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of large breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19318","description":"Reduction of large breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHF1","description":"ICD-ADHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seat/back cus no dmepdac ver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0669","description":"Seat/back cus no dmepdac ver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive hand surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26250","description":"Extensive hand surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXE1","description":"ICD-JGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","description":"HCPCS-J0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAF1","description":"ICD-CDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 3 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3378F","description":"Ajcc brstcncr stage 3 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lith-ion batt elec/pneum vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0506","description":"Lith-ion batt elec/pneum vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0018","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ coated/cov w/del sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1874","description":"Stent_ coated/cov w/del sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCF0","description":"ICD-EGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mass spectrometry and tandem mass spectrometry (ms_ ms/ms)_ analyte notelsewhere specified; qualitative_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83788","description":"Mass spectrometry and tandem mass spectrometry (ms_ ms/ms)_ analyte notelsewhere specified; qualitative_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deoxyribonucleic acid (DNA) antibody_ double stranded_ high avidity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0039U","description":"Deoxyribonucleic acid (DNA) antibody_ double stranded_ high avidity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBB0","description":"ICD-KHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWC0","description":"ICD-OBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychia interven rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4526F","description":"Neuropsychia interven rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPF0","description":"ICD-GIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIA0","description":"ICD-JEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYD0","description":"ICD-PDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAC1","description":"ICD-ECAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69550","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOA1","description":"ICD-OLOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKC1","description":"ICD-BEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect hip tum w/innom bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27077","description":"Resect hip tum w/innom bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8497","description":"Cabg meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj beta interferon im 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3027","description":"Inj beta interferon im 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKE0","description":"ICD-GBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGC1","description":"ICD-OAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report_ unilateral or b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92242","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report_ unilateral or b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC46","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLC1","description":"ICD-EGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJD1","description":"ICD-GBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECA0","description":"ICD-IECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLE1","description":"ICD-OCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC21","description":"ICD-2AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUB1","description":"ICD-NHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXF1","description":"ICD-OBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMC0","description":"ICD-GCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA01","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUB0","description":"ICD-BIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0485U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","description":"CPT-0485U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of arm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23931","description":"Drainage of arm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replantation digit complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20822","description":"Replantation digit complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0671U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671U","description":"CPT-0671U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bed pan fracture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0276","description":"Bed pan fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEA0","description":"ICD-ACEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot_ adductus positioning device_ adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1015","description":"Foot_ adductus positioning device_ adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJA0","description":"ICD-JGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0C","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Interpretation And Report On Fracture-Risk Only By Other Qualified Health Care Professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77092","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Interpretation And Report On Fracture-Risk Only By Other Qualified Health Care Professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIE0","description":"ICD-ICIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part hand myo exclu term dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6026","description":"Part hand myo exclu term dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ etelcalcetide_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0606","description":"Injection_ etelcalcetide_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ naloxone hydrochloride (zimhi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2311","description":"Injection_ naloxone hydrochloride (zimhi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYE1","description":"ICD-DAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLF1","description":"ICD-GDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSA0","description":"ICD-GBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; preparation_ screening and interpretation (List separately in addition to code for primary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0833T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; preparation_ screening and interpretation (List separately in addition to code for primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGA1","description":"ICD-JAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32998","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adalimumab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80145","description":"Adalimumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20C","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rolapitant_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9464","description":"Injection_ rolapitant_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQA0","description":"ICD-CFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQB1","description":"ICD-PLQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Team evaluation & management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1024","description":"Team evaluation & management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Camisole post-mast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8460","description":"Camisole post-mast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal)_ microRNA_ RT-PCR expression profiling of miR-31-3p_ formalin-fixed paraffin-embedded tissue_ algorithm reported as an expression score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0069U","description":"Oncology (colorectal)_ microRNA_ RT-PCR expression profiling of miR-31-3p_ formalin-fixed paraffin-embedded tissue_ algorithm reported as an expression score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No knee/ankle joints w/ ft b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5210","description":"No knee/ankle joints w/ ft b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUD1","description":"ICD-FHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGD0","description":"ICD-NIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC31","description":"ICD-3KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0983T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","description":"CPT-0983T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQF1","description":"ICD-LGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary compliance study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94750","description":"Pulmonary compliance study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHF1","description":"ICD-OEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEC0","description":"ICD-BFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33788","description":"Revision of pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physical Therapy/Occupational Therapy Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4026","description":"Physical Therapy/Occupational Therapy Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPC0","description":"ICD-OAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYC1","description":"ICD-ODYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supplemental electrical test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92547","description":"Supplemental electrical test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLB0","description":"ICD-ODLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFF0","description":"ICD-CIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGE1","description":"ICD-NJGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATF1","description":"ICD-NATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opioids & opiate analogs 3/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80363","description":"Opioids & opiate analogs 3/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cysto impl 4 or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9740","description":"Cysto impl 4 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADC1","description":"ICD-NADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foll-up eval q3mo opiod tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9562","description":"Foll-up eval q3mo opiod tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFC1","description":"ICD-JDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gonadotropin chorionic (hCG) immunoassay with direct optical observation blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0167U","description":"Gonadotropin chorionic (hCG) immunoassay with direct optical observation blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of big toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28310","description":"Revision of big toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIE0","description":"ICD-IHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ehrlichia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86666","description":"Ehrlichia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILF1","description":"ICD-NILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFE0","description":"ICD-GFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1214","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALC0","description":"ICD-EALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQD1","description":"ICD-PFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Systemic antimicrobials not prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9959","description":"Systemic antimicrobials not prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPD1","description":"ICD-FCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clean rem part denture max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9934","description":"Clean rem part denture max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGF1","description":"ICD-JCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIE0","description":"ICD-ACIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYB1","description":"ICD-HEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKA0","description":"ICD-NAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUF0","description":"ICD-NAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardioassist external","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92971","description":"Cardioassist external","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWF0","description":"ICD-KHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOA0","description":"ICD-OHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBD0","description":"ICD-NHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOF0","description":"ICD-DEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSB0","description":"ICD-KCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC110","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25929","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso flex w/rigid stays cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0629","description":"Lso flex w/rigid stays cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEC0","description":"ICD-OGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBA1","description":"ICD-BIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEB1","description":"ICD-CFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHE1","description":"ICD-KIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC11","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOF0","description":"ICD-OEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq stent/chest vert art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0075T","description":"Perq stent/chest vert art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collect & appl blood product","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7921","description":"Collect & appl blood product","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; incarcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49622","description":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; incarcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKB1","description":"ICD-FFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKE1","description":"ICD-BHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB31","description":"ICD-3HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteochondral knee autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27416","description":"Osteochondral knee autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61567","description":"Incision of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initiated Episode Of Rehabilitation Therapy_ Medical_ Or Chiropractic Care For Neck Impairment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1143","description":"Initiated Episode Of Rehabilitation Therapy_ Medical_ Or Chiropractic Care For Neck Impairment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl cardiac modulj pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0412T","description":"Rmvl cardiac modulj pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIE0","description":"ICD-GAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gen_ neuro_ non-hf rechg bat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1820","description":"Gen_ neuro_ non-hf rechg bat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair spinal fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63707","description":"Repair spinal fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Paraffin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4265","description":"Paraffin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINE1","description":"ICD-FINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11311","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDB1","description":"ICD-CGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHE0","description":"ICD-GIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9748","description":"Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYA1","description":"ICD-OJYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glasses bicros hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5230","description":"Glasses bicros hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50120","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI upper extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73219","description":"MRI upper extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAD1","description":"ICD-MFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCB1","description":"ICD-MDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELC0","description":"ICD-IELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 60 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90638","description":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 60 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01860","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","description":"CPT-01860","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNF1","description":"ICD-CBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHB1","description":"ICD-JEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj progesterone per 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2675","description":"Inj progesterone per 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMA1","description":"ICD-FFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22103","description":"Remove extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82105","description":"Alpha-fetoprotein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retrograde ejaculation anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89331","description":"Retrograde ejaculation anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEND0","description":"ICD-NEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj dihydroergotamine mesylt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1110","description":"Inj dihydroergotamine mesylt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAB0","description":"ICD-EDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24C","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE256","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No smok b/4 anes day of surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9644","description":"No smok b/4 anes day of surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNB1","description":"ICD-JCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMA1","description":"ICD-EDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGE1","description":"ICD-GAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYC1","description":"ICD-PBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWF1","description":"ICD-PBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCA1","description":"ICD-GBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIC1","description":"ICD-OKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBF0","description":"ICD-IHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADA1","description":"ICD-NADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAND0","description":"ICD-OAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maintenance 5% WL from baseline weight in months 7-12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9888","description":"Maintenance 5% WL from baseline weight in months 7-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHD0","description":"ICD-GHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection torsemide 10 mg/ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3265","description":"Injection torsemide 10 mg/ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (multiple myeloma)_ liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ monoclonal paraprotein sequencing analysis_ serum_ results reported as baseline pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0450U","description":"Oncology (multiple myeloma)_ liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ monoclonal paraprotein sequencing analysis_ serum_ results reported as baseline pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIB0","description":"ICD-NFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILE0","description":"ICD-MILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54308","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYB1","description":"ICD-PEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABD0","description":"ICD-KABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Professional services for the administration of antiinfective_ pain management_ chelation_ pulmonary hypertension_ and/or inotr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0068","description":"Professional services for the administration of antiinfective_ pain management_ chelation_ pulmonary hypertension_ and/or inotr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth hernia repair preemie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83651","description":"Anesth hernia repair preemie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of metatarsals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28322","description":"Repair of metatarsals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95832","description":"Hand muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDA0","description":"ICD-EHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDED1","description":"ICD-KDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of foot infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28002","description":"Treatment of foot infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIF0","description":"ICD-GFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Molecular Fluorescent Imaging Of Suspicious Nevus; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0701T","description":"Molecular Fluorescent Imaging Of Suspicious Nevus; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmi is documented within normal parameters and no follow-up plan is required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1296","description":"Bmi is documented within normal parameters and no follow-up plan is required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1239","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB32","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL20","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSA1","description":"ICD-KFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNB0","description":"ICD-CHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGE1","description":"ICD-NGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray skull epidural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75872","description":"Vein x-ray skull epidural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlh w/t/o 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58571","description":"Tlh w/t/o 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBID1","description":"ICD-CBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHB0","description":"ICD-FGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHC1","description":"ICD-OJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVA0","description":"ICD-OJVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA25","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cellesta_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4184","description":"Cellesta_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ allopurinol sodium_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0206","description":"Injection_ allopurinol sodium_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESF1","description":"ICD-DESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tongue and mouth surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41599","description":"Tongue and mouth surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80406","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0979T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","description":"CPT-0979T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gammaplex injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1557","description":"Gammaplex injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Establish access to artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36120","description":"Establish access to artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upr/l xtremity art 2 levels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93922","description":"Upr/l xtremity art 2 levels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKC1","description":"ICD-FAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73620","description":"X-ray exam of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB136","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy vulva lesion/s compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56515","description":"Destroy vulva lesion/s compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"One way chest drain valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7040","description":"One way chest drain valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJD0","description":"ICD-JDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOE0","description":"ICD-LHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUB1","description":"ICD-MJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc of tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9276","description":"Doc of tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC33","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25C","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUA0","description":"ICD-BEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDA0","description":"ICD-FHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26650","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hypoxia response curve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94450","description":"Hypoxia response curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFID1","description":"ICD-FFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orbital prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8042","description":"Orbital prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26121","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAC0","description":"ICD-FBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28I","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLA1","description":"ICD-JGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18H","description":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care pl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9038","description":"Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care pl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYB0","description":"ICD-OIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ for screening for peripheral arterial disease_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0860T","description":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ for screening for peripheral arterial disease_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQA0","description":"ICD-DFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPB1","description":"ICD-FFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAD1","description":"ICD-NLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33985","description":"Ecmo/ecls rmvl ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERA1","description":"ICD-HERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69604","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIC1","description":"ICD-MEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA254","description":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct interp both jaw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0367","description":"Cone beam ct interp both jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cold agglutinin titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86157","description":"Cold agglutinin titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUD0","description":"ICD-EAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26562","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGF0","description":"ICD-KCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDB0","description":"ICD-JHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise oral mucosa for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40818","description":"Excise oral mucosa for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGB1","description":"ICD-CFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACB1","description":"ICD-AACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx nodule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32608","description":"Thoracoscopy w/bx nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ polyvalent_ for children under 5 years_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90669","description":"Pneumococcal conjugate vaccine_ polyvalent_ for children under 5 years_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp pop-tibl-prl-other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35571","description":"Art byp pop-tibl-prl-other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl met band kafo-afo calf/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4090","description":"Repl met band kafo-afo calf/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPE1","description":"ICD-BAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRF0","description":"ICD-CHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0555T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","description":"HCPCS-E1032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain to peritoneal cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49062","description":"Drain to peritoneal cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95717","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYA0","description":"ICD-DEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMC1","description":"ICD-KCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHC0","description":"ICD-GDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg pain was not measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1052","description":"Leg pain was not measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O shoe add instep extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3570","description":"O shoe add instep extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablation Pros Tr Hifu Incl I Guid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9747","description":"Ablation Pros Tr Hifu Incl I Guid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOC1","description":"ICD-KEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPC0","description":"ICD-NJPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCF1","description":"ICD-NLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBD0","description":"ICD-JDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression gauntlet_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6565","description":"Gradient compression gauntlet_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQB1","description":"ICD-DHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMC0","description":"ICD-GDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Convert nephrostomy catheter to nephroureteral catheter_ percutaneous via pre-existing nephrostomy tract_ with ureteral stricture balloon dialation_ including diagnostic nephr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7547","description":"Convert nephrostomy catheter to nephroureteral catheter_ percutaneous via pre-existing nephrostomy tract_ with ureteral stricture balloon dialation_ including diagnostic nephr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1360","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dispensing fee binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5160","description":"Dispensing fee binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYC1","description":"ICD-OGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMB1","description":"ICD-CHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLA0","description":"ICD-KHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70390","description":"X-ray exam of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALD1","description":"ICD-KALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCID0","description":"ICD-GCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21510","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lanreotide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1930","description":"Lanreotide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG_ PCA3_ and SPDEF)_ urine_ algorithm reported as risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0005U","description":"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG_ PCA3_ and SPDEF)_ urine_ algorithm reported as risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Halo repl liner/interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0861","description":"Halo repl liner/interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKC1","description":"ICD-NDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01500","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","description":"CPT-01500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rt heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93530","description":"Rt heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWB0","description":"ICD-OIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove limb nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64782","description":"Remove limb nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVD0","description":"ICD-KCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVA1","description":"ICD-KGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIME1","description":"ICD-IIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLA1","description":"ICD-GBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFD1","description":"ICD-BHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGC1","description":"ICD-OKGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEF1","description":"ICD-NGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSE0","description":"ICD-HHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1014","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILA0","description":"ICD-MILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cefotaxime sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0698","description":"Cefotaxime sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc hep gene risk classifier","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0006M","description":"Onc hep gene risk classifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPC1","description":"ICD-GHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services utilized by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9694","description":"Hospice services utilized by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFC1","description":"ICD-GFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sterile gauze > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6404","description":"Sterile gauze > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLE1","description":"ICD-CHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKA1","description":"ICD-FAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYA1","description":"ICD-HBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVC0","description":"ICD-BEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gene test hippel-lindau","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3842","description":"Gene test hippel-lindau","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUA1","description":"ICD-NCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLF1","description":"ICD-MHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nhl relapse/refractor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9137","description":"Onc dx nhl relapse/refractor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHC1","description":"ICD-NBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGF1","description":"ICD-OFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFF0","description":"ICD-KDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL12","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo sng solid stirrup w/o j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2010","description":"Kafo sng solid stirrup w/o j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHE0","description":"ICD-MBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPF1","description":"ICD-JIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special stains group 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88312","description":"Special stains group 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGE0","description":"ICD-BGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLF1","description":"ICD-FFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral; with deployment of intragastric bariatric balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43290","description":"Esophagogastroduodenoscopy_ flexible_ transoral; with deployment of intragastric bariatric balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDF0","description":"ICD-EIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBC0","description":"ICD-GCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNC1","description":"ICD-FBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAE1","description":"ICD-CAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWE1","description":"ICD-OLWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUD0","description":"ICD-IIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGF0","description":"ICD-JCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00520","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","description":"CPT-00520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCC0","description":"ICD-GCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30200","description":"Injection treatment of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJB1","description":"ICD-FBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCND1","description":"ICD-NCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNF0","description":"ICD-GFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIB0","description":"ICD-GBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYA1","description":"ICD-GHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJC0","description":"ICD-JHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84446","description":"Assay of vitamin e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLA0","description":"ICD-MFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX01","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE117","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Motor-cognitive_ semi-immersive virtual reality-facilitated gait training_ each 15 minutes (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0791T","description":"Motor-cognitive_ semi-immersive virtual reality-facilitated gait training_ each 15 minutes (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILD0","description":"ICD-CILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFC1","description":"ICD-FGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKA0","description":"ICD-OBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bile duct endoscopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47550","description":"Bile duct endoscopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHB1","description":"ICD-EBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILE0","description":"ICD-GILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53250","description":"Removal of urethra gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gallium ga-68 psma-11_ diagnostic_ (ucsf)_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9593","description":"Gallium ga-68 psma-11_ diagnostic_ (ucsf)_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBD1","description":"ICD-FBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUD0","description":"ICD-CFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQE0","description":"ICD-CCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJA0","description":"ICD-JDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTA1","description":"ICD-FGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA230","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc rsn no scr uter malig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9619","description":"Doc rsn no scr uter malig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77334","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLE1","description":"ICD-BHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQF1","description":"ICD-GHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54332","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIA0","description":"ICD-NIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision/drain abscess intra","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7511","description":"Incision/drain abscess intra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFE1","description":"ICD-OAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent_ chest_ including preparation andadministration of agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9791","description":"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent_ chest_ including preparation andadministration of agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVB1","description":"ICD-GIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tap block uni by infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64487","description":"Tap block uni by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 15-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88262","description":"Chromosome analysis 15-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region infection at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1039","description":"Patients with a diagnosis of lumbar spine region infection at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FMRI brain by phys/psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70555","description":"FMRI brain by phys/psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOE1","description":"ICD-OIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dextran 75 infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7110","description":"Dextran 75 infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNC1","description":"ICD-CBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNB0","description":"ICD-GHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer ultrasonic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0575","description":"Nebulizer ultrasonic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKA0","description":"ICD-FHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66840","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDB1","description":"ICD-MKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGE1","description":"ICD-FIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxymorphone hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2410","description":"Oxymorphone hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43116","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx bronchoscope/wash","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31622","description":"Dx bronchoscope/wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKA1","description":"ICD-OFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27445","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBD1","description":"ICD-FCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDD1","description":"ICD-OLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCE0","description":"ICD-AGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCB0","description":"ICD-OKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEB0","description":"ICD-GHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","description":"HCPCS-J0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGA1","description":"ICD-NJGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB25","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGID0","description":"ICD-EGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon extent unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9089","description":"Onc dx colon extent unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAB1","description":"ICD-BDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No elig tpa init w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8601","description":"No elig tpa init w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"System reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9192","description":"System reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37276","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","description":"CPT-37276","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33755","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRB0","description":"ICD-KHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOB0","description":"ICD-LAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJC1","description":"ICD-FGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of calcium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82310","description":"Assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYD0","description":"ICD-LIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-fixed paraffin embedded tissue or fresh frozen tissue_ predictive algorithm reported as potential ta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019U","description":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-fixed paraffin embedded tissue or fresh frozen tissue_ predictive algorithm reported as potential ta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMC0","description":"ICD-IIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGF1","description":"ICD-JFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVD1","description":"ICD-OHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL53","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMD0","description":"ICD-EGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRA0","description":"ICD-GDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-84393","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","description":"CPT-84393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLD0","description":"ICD-JDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57120","description":"Closure of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJA1","description":"ICD-GHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL24","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAA0","description":"ICD-IFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Habil prevoc waiver_ per d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2014","description":"Habil prevoc waiver_ per d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIND1","description":"ICD-OIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening methadone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80358","description":"Drug screening methadone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVD0","description":"ICD-FBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33720","description":"Repair of heart defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dexmedetomidine_ oral_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1105","description":"Dexmedetomidine_ oral_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography with right heart catheterization with endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7521","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography with right heart catheterization with endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device_ percutaneous approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0545T","description":"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device_ percutaneous approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair nerve/shorten bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64876","description":"Repair nerve/shorten bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYF0","description":"ICD-HEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release finger contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26525","description":"Release finger contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed; with enterocele repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57265","description":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed; with enterocele repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOF0","description":"ICD-PHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supported employ_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2023","description":"Supported employ_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5D","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSB1","description":"ICD-PBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQA0","description":"ICD-LEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCD0","description":"ICD-GHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERF0","description":"ICD-OERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disp wound suct_ drsg/access","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9272","description":"Disp wound suct_ drsg/access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay for phencyclidine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83992","description":"Assay for phencyclidine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOF1","description":"ICD-PAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of toes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29550","description":"Strapping of toes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDE0","description":"ICD-MKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLA1","description":"ICD-IFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCE1","description":"ICD-FDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBD1","description":"ICD-JDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1253","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc cath >90d for maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9265","description":"Doc cath >90d for maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise finger tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26055","description":"Incise finger tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental unspec restorative pr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2999","description":"Dental unspec restorative pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADC0","description":"ICD-CADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4228","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4228","description":"HCPCS-A4228","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Res_ nos waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2033","description":"Res_ nos waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of forehead wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15824","description":"Removal of forehead wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc rect tum transanal part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45171","description":"Exc rect tum transanal part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFE0","description":"ICD-KBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCB0","description":"ICD-OFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRE1","description":"ICD-OFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rollabout chair with casters","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1031","description":"Rollabout chair with casters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18B","description":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abd imag w/us_ ct or MRI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9455","description":"Abd imag w/us_ ct or MRI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis Of Schizophrenia_ Schizoaffective Disorder_ Or Bipolar Disorder On Or Between January 1 Of The","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0032","description":"Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis Of Schizophrenia_ Schizoaffective Disorder_ Or Bipolar Disorder On Or Between January 1 Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLC1","description":"ICD-KGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of donor heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33930","description":"Removal of donor heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin/1000u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0725","description":"Chorionic gonadotropin/1000u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDA0","description":"ICD-OHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise pharynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42808","description":"Excise pharynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0481U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","description":"CPT-0481U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC160","description":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1B","description":"Default_ /PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ includes closed feedback loop leads and all implantable components_ with rechargeable battery and charging system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1826","description":"Generator_ neurostimulator (implantable)_ includes closed feedback loop leads and all implantable components_ with rechargeable battery and charging system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"History of preoperative posterior capsule rupture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9759","description":"History of preoperative posterior capsule rupture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPE0","description":"ICD-OKPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCE0","description":"ICD-CDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWC1","description":"ICD-HCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2020","description":"Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBD0","description":"ICD-EHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transport chair_ ped size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1037","description":"Transport chair_ ped size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA125","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXE0","description":"ICD-CEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIF0","description":"ICD-NGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEB0","description":"ICD-MAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPA0","description":"ICD-FFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL42","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOB1","description":"ICD-ODOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKF0","description":"ICD-JGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng arm splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4019","description":"Cast sup lng arm splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIC0","description":"ICD-IAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIB1","description":"ICD-ABIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove anal fist 2 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46285","description":"Remove anal fist 2 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDB0","description":"ICD-GHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trb@ gene rearrange amplify","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81340","description":"Trb@ gene rearrange amplify","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICF1","description":"ICD-NICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB16","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJF1","description":"ICD-BAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo_ walk boot type_ cus fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4631","description":"Afo_ walk boot type_ cus fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICD0","description":"ICD-AICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHE0","description":"ICD-JGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLB1","description":"ICD-KGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQF0","description":"ICD-PIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB30","description":"Very High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTD0","description":"ICD-OKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8005","description":"HCPCS-C8005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45505","description":"Repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetes prev standard curr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0403T","description":"Diabetes prev standard curr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVE0","description":"ICD-GHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4B","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLE0","description":"ICD-EHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reusable nipple prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8032","description":"Reusable nipple prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMC0","description":"ICD-GHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0586T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L2221","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","description":"HCPCS-L2221","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDB0","description":"ICD-JDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye socket implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67560","description":"Revise eye socket implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXA0","description":"ICD-GDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQB1","description":"ICD-DDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pegloticase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2507","description":"Pegloticase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXC0","description":"ICD-OEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEF1","description":"ICD-BDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRC0","description":"ICD-DIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIE1","description":"ICD-MCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8E","description":"High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQE1","description":"ICD-GIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBF0","description":"ICD-ICBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC213","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCC0","description":"ICD-FDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Over-bed table","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0274","description":"Over-bed table","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTA0","description":"ICD-JCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Water softening system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1625","description":"Water softening system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denervation of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27035","description":"Denervation of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERA1","description":"ICD-OERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ls pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8661","description":"Fun stat score ls pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29807","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit immunotherapy diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9338","description":"Hit immunotherapy diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHA0","description":"ICD-FHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ oritavancin (Kimyrsa)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2406","description":"Injection_ oritavancin (Kimyrsa)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYF0","description":"ICD-GHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWB0","description":"ICD-PDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSA1","description":"ICD-PFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE225","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRF0","description":"ICD-LIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99251","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Morcellator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1782","description":"Morcellator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No beta-lactam abx ther_ rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9560","description":"No beta-lactam abx ther_ rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92987","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXF0","description":"ICD-KGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERE1","description":"ICD-CERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microbe suscept mycobacteri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87190","description":"Microbe suscept mycobacteri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic ftwear ladies oxf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3215","description":"Orthopedic ftwear ladies oxf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQF0","description":"ICD-PHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPF0","description":"ICD-NFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB117","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX31","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1403","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1403","description":"CDT-D1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQF0","description":"ICD-OBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB236","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33750","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDC1","description":"ICD-KDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1251","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8F","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAE1","description":"ICD-BDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVE0","description":"ICD-KGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flex thermoplastic collar mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0130","description":"Flex thermoplastic collar mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9878","description":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99375","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIC1","description":"ICD-KDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB21","description":"ICD-2LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXE0","description":"ICD-GAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCME1","description":"ICD-CCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTA1","description":"ICD-JFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral supply kit premix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4220","description":"Parenteral supply kit premix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; each additional 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96137","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; each additional 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXE1","description":"ICD-OLXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYC1","description":"ICD-HCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Instillation_ taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0911","description":"Instillation_ taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace cvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36580","description":"Replace cvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC226","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic pulpotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3220","description":"Therapeutic pulpotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHC1","description":"ICD-AIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney imaging with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78701","description":"Kidney imaging with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSD1","description":"ICD-LHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vol reduction of blood/prod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86960","description":"Vol reduction of blood/prod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDF1","description":"ICD-OGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg thorac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22212","description":"Incis 1 vertebral seg thorac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin sys hydraul stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5848","description":"Knee-shin sys hydraul stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCA0","description":"ICD-BHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace molded thigh lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4040","description":"Replace molded thigh lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11301","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmoscopy_ Extended; With Drawing Of Optic Nerve Or Macula (Eg_ For Glaucoma_ Macular Pathology_ Tumor) With Interpretation And Report_ Unilateral Or Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92202","description":"Ophthalmoscopy_ Extended; With Drawing Of Optic Nerve Or Macula (Eg_ For Glaucoma_ Macular Pathology_ Tumor) With Interpretation And Report_ Unilateral Or Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCF1","description":"ICD-OGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6059","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med pt reas no hcc scrn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9456","description":"Doc med pt reas no hcc scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOF0","description":"ICD-GCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOA0","description":"ICD-HCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intentional replantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3470","description":"Intentional replantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERA1","description":"ICD-DERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXC1","description":"ICD-CAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18D","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHC0","description":"ICD-OGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFB0","description":"ICD-OGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ valoctocogene roxaparvovec-rvox_ per ml_ containing nominal 2 x 10^13 vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1412","description":"Injection_ valoctocogene roxaparvovec-rvox_ per ml_ containing nominal 2 x 10^13 vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDID1","description":"ICD-CDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5947","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5947","description":"CDT-D5947","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVC1","description":"ICD-OAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYA0","description":"ICD-OIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJC1","description":"ICD-FBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFB1","description":"ICD-OLFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mh partial hosp tx under 24h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0035","description":"Mh partial hosp tx under 24h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTE0","description":"ICD-NGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCED0","description":"ICD-FCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMD1","description":"ICD-BEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNF1","description":"ICD-CCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft axill-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35521","description":"Art byp grft axill-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGE0","description":"ICD-NCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01990","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","description":"CPT-01990","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECB1","description":"ICD-GECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of bladder abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51080","description":"Drainage of bladder abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACB0","description":"ICD-IACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFD1","description":"ICD-FAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deb bone add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11047","description":"Deb bone add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVF1","description":"ICD-GAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00870","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","description":"CPT-00870","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transhepatic biliary drainage with contrast monitoring_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75980","description":"Percutaneous transhepatic biliary drainage with contrast monitoring_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFA0","description":"ICD-NCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB55","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryoprecipitated fibrinogen complex_ pathogen reduced_ eachunit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9026","description":"Cryoprecipitated fibrinogen complex_ pathogen reduced_ eachunit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADD1","description":"ICD-KADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLC1","description":"ICD-AFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXC0","description":"ICD-NGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRC1","description":"ICD-GGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXF0","description":"ICD-OGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1002T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","description":"CPT-1002T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAB1","description":"ICD-NIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAE0","description":"ICD-FHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNB0","description":"ICD-FDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ emapalumab-lzsg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9210","description":"Injection_ emapalumab-lzsg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18E","description":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQF0","description":"ICD-PBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special eye evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92060","description":"Special eye evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74270","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEF0","description":"ICD-CEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No screening performed_ partial screening performed or positive screen without recommendations and reason is not given or otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9921","description":"No screening performed_ partial screening performed or positive screen without recommendations and reason is not given or otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC120","description":"Clinically Complex _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25D","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDC1","description":"ICD-EHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFB0","description":"ICD-BFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWE0","description":"ICD-PDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKB1","description":"ICD-JAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraop cyst eval not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9608","description":"Intraop cyst eval not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33460","description":"Revision of tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c vent tray fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1029","description":"W/c vent tray fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28A","description":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFE0","description":"ICD-BFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJF1","description":"ICD-BIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg 41-60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95812","description":"Eeg 41-60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRB0","description":"ICD-DBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSB0","description":"ICD-CBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALF0","description":"ICD-KALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECB1","description":"ICD-JECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXA0","description":"ICD-BGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIE1","description":"ICD-MKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt scrn dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3759F","description":"Pt scrn dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair upper jaw fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30580","description":"Repair upper jaw fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUF1","description":"ICD-NBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cisplatin 10 mg injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9060","description":"Cisplatin 10 mg injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHF0","description":"ICD-MIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQE0","description":"ICD-HEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25C","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove bilat space maintain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1525","description":"Remove bilat space maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB11","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYD1","description":"ICD-LIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alveoplasty w/ extraction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7310","description":"Alveoplasty w/ extraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCD1","description":"ICD-AGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart vessel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33500","description":"Repair heart vessel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11642","description":"Exc f/e/e/n/l mal+mrg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gamma globulin > 10 cc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1560","description":"Gamma globulin > 10 cc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEE1","description":"ICD-GAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCD0","description":"ICD-BBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOA0","description":"ICD-LGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXF1","description":"ICD-NEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye socket wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65290","description":"Repair of eye socket wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intro/sheath_ laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2629","description":"Intro/sheath_ laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAE0","description":"ICD-AIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDED1","description":"ICD-EDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ anesthetic agent; carotid sinus (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64508","description":"Injection_ anesthetic agent; carotid sinus (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFF0","description":"ICD-NJFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interim implant crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6085","description":"Interim implant crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSA0","description":"ICD-DBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mtms by pharm np 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99605","description":"Mtms by pharm np 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVC1","description":"ICD-OHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTD0","description":"ICD-GDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA21","description":"ICD-1CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hypothermia ill neonate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99184","description":"Hypothermia ill neonate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo plastic pediatric size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2035","description":"Kafo plastic pediatric size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23660","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBB0","description":"ICD-FDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKC0","description":"ICD-FIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEC1","description":"ICD-AAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATB1","description":"ICD-OATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEB1","description":"ICD-OHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tint_ any color/solid/grad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2745","description":"Tint_ any color/solid/grad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Posterior Chamber Of Eye_ Medication","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0699T","description":"Injection_ Posterior Chamber Of Eye_ Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB230","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9884","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHC1","description":"ICD-OCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRD1","description":"ICD-OFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assistive technology assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97755","description":"Assistive technology assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of burn scab initi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16035","description":"Incision of burn scab initi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBD0","description":"ICD-ACBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8H","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOA0","description":"ICD-LEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMA0","description":"ICD-OFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIB0","description":"ICD-ODIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXA0","description":"ICD-FAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXB1","description":"ICD-JIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTF0","description":"ICD-FBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLB1","description":"ICD-IHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCB1","description":"ICD-GDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVE1","description":"ICD-KDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDF0","description":"ICD-KBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOF1","description":"ICD-LAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHF1","description":"ICD-OKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21194","description":"Reconst lwr jaw w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment planning for magnetic field induction ablation of malignant prostate tissue_ using data from previously performed magnetic resonance imaging (MRI) examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0738T","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue_ using data from previously performed magnetic resonance imaging (MRI) examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had an intravitreal or periocular corticosteroid injection (e.g._ triamcinolone_ preservative-free triamcinolone_ dexamethasone_ dexamethasone intravitreal implan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1324","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g._ triamcinolone_ preservative-free triamcinolone_ dexamethasone_ dexamethasone intravitreal implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDA0","description":"ICD-OFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKD1","description":"ICD-FBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray stress view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77071","description":"X-ray stress view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14A","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tl201 thallium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9505","description":"Tl201 thallium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCB1","description":"ICD-OFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGA1","description":"ICD-OAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIE1","description":"ICD-MHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEA1","description":"ICD-KGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB50","description":"Very High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko adj jnt pos r sup pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1833","description":"Ko adj jnt pos r sup pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive review of data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88325","description":"Comprehensive review of data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDC0","description":"ICD-ABDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01680","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","description":"CPT-01680","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgigraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4183","description":"Surgigraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL20","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28D","description":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Canakinumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0638","description":"Canakinumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NEURO INH ATAXIA DNA 12 COM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0216U","description":"NEURO INH ATAXIA DNA 12 COM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHA0","description":"ICD-ABHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xm archive tissue molec anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88363","description":"Xm archive tissue molec anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUE0","description":"ICD-FAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUF0","description":"ICD-IIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEA1","description":"ICD-EGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYD0","description":"ICD-CDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collect & prep genetic samp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0422","description":"Collect & prep genetic samp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"InnovaMatrix PD_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2023","description":"InnovaMatrix PD_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA01","description":"Medium Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO knee intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9727","description":"Patient unable to complete the FOTO knee intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANF0","description":"ICD-FANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24B","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDA0","description":"ICD-BHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQB0","description":"ICD-DFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTB1","description":"ICD-OKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELB0","description":"ICD-CELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33722","description":"Repair of heart defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTA1","description":"ICD-MDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy snare les remv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43217","description":"Esophagoscopy snare les remv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hook/hand_ hvy dty_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6722","description":"Hook/hand_ hvy dty_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj protirelin per 250 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2725","description":"Inj protirelin per 250 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOE0","description":"ICD-KEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth testis exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92451","description":"Anesth testis exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILC1","description":"ICD-KILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab-nuna_ biosimilar_ (Byooviz)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5124","description":"Injection_ ranibizumab-nuna_ biosimilar_ (Byooviz)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lngleg cylndr ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4035","description":"Cast sup lngleg cylndr ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETB1","description":"ICD-JETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXC0","description":"ICD-GIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXC1","description":"ICD-GBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGF1","description":"ICD-BDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIC0","description":"ICD-MEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68505","description":"Partial removal tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8H","description":"Medium Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITB0","description":"ICD-BITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKA1","description":"ICD-NJKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary reflex study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51792","description":"Urinary reflex study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFA0","description":"ICD-GDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOD1","description":"ICD-GIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/o preop order iv ab pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8918","description":"Pt w/o preop order iv ab pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPE1","description":"ICD-OCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCF0","description":"ICD-ECCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCA0","description":"ICD-NGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPE1","description":"ICD-NKPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECE1","description":"ICD-KECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc prosth taa add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33884","description":"Endovasc prosth taa add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rotation wrst w/ cable lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6625","description":"Rotation wrst w/ cable lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1504","description":"HCPCS-B1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVE0","description":"ICD-GEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87880","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opiate(s)_ drug and metabolites_ each procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6056","description":"Opiate(s)_ drug and metabolites_ each procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36570","description":"Insert picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Portable gas oxygen system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0738","description":"Portable gas oxygen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients receiving rrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1199","description":"Patients receiving rrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4D","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSE1","description":"ICD-GGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lithium ion battery charger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7368","description":"Lithium ion battery charger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJF0","description":"ICD-GDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIF1","description":"ICD-EEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2001","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2001","description":"CDT-D2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSD0","description":"ICD-HBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDF0","description":"ICD-GCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg coma or sleep only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95822","description":"Eeg coma or sleep only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63076","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC21","description":"ICD-4GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung ventilation imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78579","description":"Lung ventilation imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myomectomy abdom method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58140","description":"Myomectomy abdom method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGD1","description":"ICD-OHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1901","description":"HCPCS-C1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCA0","description":"ICD-CHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWA1","description":"ICD-KGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTA0","description":"ICD-OBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGE0","description":"ICD-CEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient not screened for unhealthy alcohol use using a systematic screening method_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2199","description":"Patient not screened for unhealthy alcohol use using a systematic screening method_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCD1","description":"ICD-CHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUE0","description":"ICD-GEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53020","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair spinal fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63709","description":"Repair spinal fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSA1","description":"ICD-HFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Azithromycin dihydrate_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0144","description":"Azithromycin dihydrate_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48152","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTE0","description":"ICD-FCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Precision attachment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6950","description":"Precision attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methadone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1230","description":"Methadone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUE1","description":"ICD-NLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKE0","description":"ICD-KCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Csf leakage imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78650","description":"Csf leakage imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Measles virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90705","description":"Measles virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0321","description":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYC0","description":"ICD-HFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD220","description":"Reduced Physical Function _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor_ ear level_ replacement_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8624","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor_ ear level_ replacement_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILB0","description":"ICD-BILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBC0","description":"ICD-OIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGE1","description":"ICD-JIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of nickel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83885","description":"Assay of nickel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKF0","description":"ICD-GBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFB1","description":"ICD-KFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36500","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOA0","description":"ICD-CCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic_ pectus carinatum orthosis_ sternal compression_ rigid circumferential frame with anterior and posterior rigid pads_ custom fabricated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1320","description":"Thoracic_ pectus carinatum orthosis_ sternal compression_ rigid circumferential frame with anterior and posterior rigid pads_ custom fabricated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Type location activityassess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1052F","description":"Type location activityassess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXC1","description":"ICD-JHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rho(d) immune globulin h_ sd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2792","description":"Rho(d) immune globulin h_ sd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSB0","description":"ICD-LHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hocm 350-399mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9963","description":"Hocm 350-399mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBE1","description":"ICD-JHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opioid &opiate analog 5/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80364","description":"Opioid &opiate analog 5/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTA1","description":"ICD-NGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACB1","description":"ICD-JACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Polycentric hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6600","description":"Polycentric hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray female genital tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74740","description":"X-ray female genital tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGF1","description":"ICD-OHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGME1","description":"ICD-BGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB31","description":"ICD-3CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA54","description":"Medium Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ipilimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9228","description":"Ipilimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apc gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81202","description":"Apc gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNC0","description":"ICD-CFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLC0","description":"ICD-GFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14C","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVA0","description":"ICD-OEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adm Tocilizu COVID-19 1st dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0249","description":"Adm Tocilizu COVID-19 1st dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 21 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP21","description":"Auto test panel pricing code_ 21 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICE0","description":"ICD-KICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEE0","description":"ICD-CCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBB1","description":"ICD-CDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21700","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch drain w bar & filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4424","description":"Ost pch drain w bar & filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; 50 Cc Or Less Injectate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15771","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; 50 Cc Or Less Injectate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSB0","description":"ICD-DHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18X","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wedge resect of lung add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32506","description":"Wedge resect of lung add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dalbavancin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0875","description":"Injection_ dalbavancin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAB1","description":"ICD-BIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microfluid analy tears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83861","description":"Microfluid analy tears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BTK (Bruton_s tyrosine kinase) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ C481S_ C481R_ C481F)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81233","description":"BTK (Bruton_s tyrosine kinase) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ C481S_ C481R_ C481F)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXB0","description":"ICD-CHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teplizumab-mzwv_ 5 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9149","description":"Injection_ teplizumab-mzwv_ 5 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gingival flap proc w/ planin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4240","description":"Gingival flap proc w/ planin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E2403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2403","description":"HCPCS-E2403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00144","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","description":"CPT-00144","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQA0","description":"ICD-OJQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whchr litwt det arm leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1240","description":"Whchr litwt det arm leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPF1","description":"ICD-FHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63746","description":"Removal of spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHME0","description":"ICD-FHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01392","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","description":"CPT-01392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYE1","description":"ICD-OHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJED0","description":"ICD-OJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm ped fbrglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4012","description":"Cast sup sht arm ped fbrglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOB1","description":"ICD-LCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETD0","description":"ICD-NETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Angina absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1012F","description":"Angina absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrst mld sck flx hng tri pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6050","description":"Wrst mld sck flx hng tri pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHB0","description":"ICD-AAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADA0","description":"ICD-IADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANC1","description":"ICD-CANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA31","description":"ICD-2IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB110","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUF0","description":"ICD-ICUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cross-over vein graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34520","description":"Cross-over vein graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSA1","description":"ICD-OKSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmv ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90291","description":"Cmv ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMA0","description":"ICD-AIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28D","description":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31287","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abduct control hip semi-flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1630","description":"Abduct control hip semi-flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHED0","description":"ICD-IHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55840","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add metal substructure to acrylic full denture (per arch)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5876","description":"Add metal substructure to acrylic full denture (per arch)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0653U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0653U","description":"CPT-0653U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74019","description":"Radiologic examination_ abdomen; 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTF0","description":"ICD-IHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGD0","description":"ICD-JCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67040","description":"Laser treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63282","description":"Bx/exc idrl spine lesn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYD1","description":"ICD-PJYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTC0","description":"ICD-BDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRF0","description":"ICD-DGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-visit patient screening","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9912","description":"Pre-visit patient screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antiepileptics nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80339","description":"Antiepileptics nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABB1","description":"ICD-EABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISC0","description":"ICD-DISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; transmitter component only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0863T","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; transmitter component only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHD0","description":"ICD-NFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNA1","description":"ICD-NGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45135","description":"Excision of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHD1","description":"ICD-NGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKA1","description":"ICD-FDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27457","description":"Realignment of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGD0","description":"ICD-KFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBB0","description":"ICD-KBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAD0","description":"ICD-CHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELA1","description":"ICD-GELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQD1","description":"ICD-LIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAC1","description":"ICD-NDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77431","description":"Radiation therapy management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3A","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92137","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","description":"CPT-92137","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLE0","description":"ICD-CBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reimplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50380","description":"Reimplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of thyroid activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84442","description":"Assay of thyroid activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth ear surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12051","description":"Anesth ear surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJD0","description":"ICD-GEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antistreptolysin o titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86060","description":"Antistreptolysin o titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUC0","description":"ICD-NHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJF1","description":"ICD-OFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACE0","description":"ICD-OACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAD0","description":"ICD-NHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64784","description":"Remove nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLC1","description":"ICD-EDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group psychotherapy service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7903","description":"Group psychotherapy service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYF1","description":"ICD-LGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRE0","description":"ICD-PFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor viii ahg 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85240","description":"Clot factor viii ahg 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTB1","description":"ICD-BBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightweight det a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1090","description":"Wheelchair lightweight det a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluzone vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2038","description":"Fluzone vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDC0","description":"ICD-BFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILC0","description":"ICD-FILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31291","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPA0","description":"ICD-NJPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYB0","description":"ICD-DEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proton treatment complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77525","description":"Proton treatment complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA11","description":"ICD-1FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSB1","description":"ICD-OBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUD0","description":"ICD-ADUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBF0","description":"ICD-OCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEE0","description":"ICD-CBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/drain eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67440","description":"Explore/drain eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXE1","description":"ICD-CCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calculus assay quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82360","description":"Calculus assay quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAF1","description":"ICD-EAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWA0","description":"ICD-GCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0972T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","description":"CPT-0972T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILC1","description":"ICD-CILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8D","description":"Medium Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Each Additional Prosthesis During Same Session (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0570T","description":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Each Additional Prosthesis During Same Session (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMC1","description":"ICD-FCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ dual focus_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2525","description":"Contact lens_ hydrophilic_ dual focus_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKB0","description":"ICD-BFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDE0","description":"ICD-KEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAE0","description":"ICD-NHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exam/biopsy of vulva w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56821","description":"Exam/biopsy of vulva w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lengthen radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25393","description":"Lengthen radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHD0","description":"ICD-KHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped caloric dense>/=0.7kc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4160","description":"Ef ped caloric dense>/=0.7kc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostoma hmes filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7504","description":"Tracheostoma hmes filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSE1","description":"ICD-PJSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA30","description":"Low Rehab_ ADL Index 0-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUB0","description":"ICD-CEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36218","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cromolyn sodium noncomp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7631","description":"Cromolyn sodium noncomp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNF1","description":"ICD-CDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHF1","description":"ICD-JFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENB1","description":"ICD-KENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKB1","description":"ICD-BIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPB1","description":"ICD-KFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPF0","description":"ICD-NLPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health risk assessment test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99420","description":"Health risk assessment test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWD1","description":"ICD-PDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open treatment of rib fracture without fixation_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21805","description":"Open treatment of rib fracture without fixation_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sebelipase alfa_ 1mg (Kanuma)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9478","description":"Injection_ sebelipase alfa_ 1mg (Kanuma)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMD0","description":"ICD-JDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEED1","description":"ICD-KEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Habil res waiver 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2017","description":"Habil res waiver 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETB0","description":"ICD-IETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Admission to mccm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9480","description":"Admission to mccm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76705","description":"Echo exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSA1","description":"ICD-HGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJB0","description":"ICD-NFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPC1","description":"ICD-KEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB12","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMD0","description":"ICD-AGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53600","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAB1","description":"ICD-OHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast 1st mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19287","description":"Perq dev breast 1st mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGF1","description":"ICD-KEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUD0","description":"ICD-CHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk pain & fxn assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1130F","description":"Bk pain & fxn assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) PEGylated_ 1 I.U.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9137","description":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) PEGylated_ 1 I.U.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVE0","description":"ICD-BCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUE1","description":"ICD-BDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18X","description":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66170","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNA1","description":"ICD-FGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA115","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADD1","description":"ICD-JADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYC0","description":"ICD-GFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-77437","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","description":"CPT-77437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMB0","description":"ICD-MEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repositioning of phrenic nerve stimulator transvenous lead(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33281","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMB0","description":"ICD-BEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67800","description":"Remove eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA160","description":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","description":"HCPCS-L6032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 4 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0869","description":"Pwc gp 4 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psysoc rehab svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2018","description":"Psysoc rehab svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (baxter)_ not therapeutically equivalent to j0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0689","description":"Injection_ cefazolin sodium (baxter)_ not therapeutically equivalent to j0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4349","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","description":"HCPCS-Q4349","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHB1","description":"ICD-AAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leveen/shunt patency exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78291","description":"Leveen/shunt patency exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTE1","description":"ICD-ICTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUA1","description":"ICD-EAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBD1","description":"ICD-JBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD113","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQA1","description":"ICD-OAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERE0","description":"ICD-PERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc face les sc <2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21011","description":"Exc face les sc <2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAE0","description":"ICD-EEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonpowered pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0373","description":"Nonpowered pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36261","description":"Revision of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLC1","description":"ICD-IFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18E","description":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Expiratory positive airway pressure intranasal resistance valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7049","description":"Expiratory positive airway pressure intranasal resistance valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter w/o bag 2-way latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4311","description":"Catheter w/o bag 2-way latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tte w or w/o contr_ cont ecg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8930","description":"Tte w or w/o contr_ cont ecg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAF0","description":"ICD-BIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUC0","description":"ICD-AFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKF0","description":"ICD-JFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0921T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","description":"CPT-0921T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIB1","description":"ICD-AFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periodic orthodontc tx visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8670","description":"Periodic orthodontc tx visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJF0","description":"ICD-GGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limb muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95831","description":"Limb muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36640","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDD0","description":"ICD-KCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8564","description":"Pt ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAE1","description":"ICD-GEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEE0","description":"ICD-AHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQA1","description":"ICD-DBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXF1","description":"ICD-GEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBA1","description":"ICD-NJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 3 or more views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74021","description":"Radiologic examination_ abdomen; 3 or more views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFB1","description":"ICD-CFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMB0","description":"ICD-OEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBF0","description":"ICD-BEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJD0","description":"ICD-FGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDD1","description":"ICD-NFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0505","description":"HCPCS-C0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYE1","description":"ICD-CCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLA0","description":"ICD-FCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIA1","description":"ICD-GFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise spin&cord 2 stgs thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63199","description":"Incise spin&cord 2 stgs thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext h rate sz 14 day ri only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0382T","description":"Ext h rate sz 14 day ri only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair retinal detach cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67113","description":"Repair retinal detach cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXE1","description":"ICD-FHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAD1","description":"ICD-NAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of neck muscle/rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21705","description":"Revision of neck muscle/rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFC1","description":"ICD-OFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLME0","description":"ICD-NLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair nasal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30545","description":"Repair nasal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures rebase part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5721","description":"Dentures rebase part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy vag lesions simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57061","description":"Destroy vag lesions simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Odontics endosteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6010","description":"Odontics endosteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYD1","description":"ICD-GEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOD1","description":"ICD-PFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0402","description":"HCPCS-C0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAC0","description":"ICD-OCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rabies ig heat treated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90376","description":"Rabies ig heat treated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOB1","description":"ICD-HIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cutting ramus open w/graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7943","description":"Cutting ramus open w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls daily mgmt-venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33948","description":"Ecmo/ecls daily mgmt-venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt srv p day 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90968","description":"Esrd home pt srv p day 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBC0","description":"ICD-GFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEA0","description":"ICD-OJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHF0","description":"ICD-BGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILB1","description":"ICD-JILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAC1","description":"ICD-OGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc leg/ankle les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27632","description":"Exc leg/ankle les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYF0","description":"ICD-CBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA51","description":"High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJB0","description":"ICD-KBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSE1","description":"ICD-KDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA31","description":"ICD-3KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ugt1a1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81350","description":"Ugt1a1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLF1","description":"ICD-CBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33030","description":"Partial removal of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCA0","description":"ICD-MGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVE1","description":"ICD-OFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYE1","description":"ICD-PAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPC0","description":"ICD-JIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDB0","description":"ICD-AHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLB0","description":"ICD-NBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIA0","description":"ICD-JAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALC0","description":"ICD-BALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant spine infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62361","description":"Implant spine infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOA1","description":"ICD-OIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7529","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7529","description":"HCPCS-J7529","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBC0","description":"ICD-BCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX01","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25628","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"E & M Of Beneficiary_S Ac Change Cond Nsg Fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9685","description":"E & M Of Beneficiary_S Ac Change Cond Nsg Fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chorion biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59015","description":"Chorion biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUC0","description":"ICD-JDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATF0","description":"ICD-GATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc hand tum deep 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26113","description":"Exc hand tum deep 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0703","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0703","description":"CDT-D0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJC1","description":"ICD-FFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKB1","description":"ICD-OAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0672U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672U","description":"CPT-0672U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCB1","description":"ICD-ICCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJB0","description":"ICD-KIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTD0","description":"ICD-IDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroscopy (separate procedure)_ up to 1 hour physician or other qualified health care professional time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76000","description":"Fluoroscopy (separate procedure)_ up to 1 hour physician or other qualified health care professional time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAA0","description":"ICD-MKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTB1","description":"ICD-IDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal scalp blood sample","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59030","description":"Fetal scalp blood sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUD0","description":"ICD-IBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVE1","description":"ICD-KGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Battery charger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4613","description":"Battery charger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01922","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","description":"CPT-01922","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colon ca scrn not hi rsk ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0121","description":"Colon ca scrn not hi rsk ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13D","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0183","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","description":"HCPCS-G0183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0767T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virus inoculate eggs/animal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87250","description":"Virus inoculate eggs/animal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAC1","description":"ICD-IIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIA1","description":"ICD-MEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFE0","description":"ICD-OIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24360","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of intracatheter or catheter into renal pelvis for drainag and/or injection_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50392","description":"Introduction of intracatheter or catheter into renal pelvis for drainag and/or injection_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD231","description":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC104","description":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXD1","description":"ICD-JIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB106","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/repl vagus n eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64569","description":"Revise/repl vagus n eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMF1","description":"ICD-BDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ meloxicam_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9059","description":"Injection_ meloxicam_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLF0","description":"ICD-CHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-49186","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","description":"CPT-49186","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB246","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUD0","description":"ICD-FIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ DNA (523 genes) and RNA (55 genes) by next-generation sequencing_ interrogation for sequence variants_ gene cop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0379U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ DNA (523 genes) and RNA (55 genes) by next-generation sequencing_ interrogation for sequence variants_ gene cop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0543","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","description":"HCPCS-G0543","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMA1","description":"ICD-NEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Als 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0433","description":"Als 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22D","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early ind/delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9356","description":"Early ind/delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A8005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","description":"HCPCS-A8005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB154","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLB0","description":"ICD-FDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermabrasion other than face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15782","description":"Dermabrasion other than face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9815","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9815","description":"HCPCS-C9815","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJC1","description":"ICD-KDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate w/rise psa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9080","description":"Onc dx prostate w/rise psa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDE0","description":"ICD-GDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMC1","description":"ICD-IAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behav chng smoking > 10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99407","description":"Behav chng smoking > 10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSE0","description":"ICD-HCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical revision procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4268","description":"Surgical revision procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVA1","description":"ICD-GFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCB1","description":"ICD-NGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRF0","description":"ICD-DDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCB0","description":"ICD-BGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATE1","description":"ICD-IATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental case management - patient education to improve oral health literacy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9994","description":"Dental case management - patient education to improve oral health literacy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLE0","description":"ICD-FHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPB0","description":"ICD-OLPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIE0","description":"ICD-IEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient  compression arm sleeve_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6578","description":"Gradient  compression arm sleeve_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL22","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEF1","description":"ICD-MDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAC1","description":"ICD-JHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic Ultrafiltration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0692T","description":"Therapeutic Ultrafiltration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTD1","description":"ICD-MLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No hist type doc on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9284","description":"No hist type doc on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ age 12 years or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31554","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ age 12 years or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-sterile gauze>16<=48 sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6217","description":"Non-sterile gauze>16<=48 sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22C","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0669T","description":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUB1","description":"ICD-MLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJE1","description":"ICD-GFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ringers lactate infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7120","description":"Ringers lactate infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCF1","description":"ICD-CBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","description":"HCPCS-J3373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0703","description":"HCPCS-B0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAA0","description":"ICD-OFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCE0","description":"ICD-NBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct midface no graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7948","description":"Reconstruct midface no graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body pos goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8982","description":"Body pos goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERE1","description":"ICD-DERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement air bubble detec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1530","description":"Replacement air bubble detec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33368","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levalbuterol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7612","description":"Levalbuterol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKF1","description":"ICD-BAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLB0","description":"ICD-JFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43020","description":"Incision of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31087","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spec site no lung","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9420","description":"Spec site no lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIA1","description":"ICD-KIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVA0","description":"ICD-JEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMD0","description":"ICD-GIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQA0","description":"ICD-PGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75807","description":"Lymph vessel x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-123 sod iodide mic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9516","description":"Iodine i-123 sod iodide mic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11307","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); percutaneous femoral vein approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0805T","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); percutaneous femoral vein approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUD0","description":"ICD-MAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biomechanical mapping_ transvaginal_ with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0487T","description":"Biomechanical mapping_ transvaginal_ with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Avalglucosidase Alfa-Ngpt_ 4 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9085","description":"Injection_ Avalglucosidase Alfa-Ngpt_ 4 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA56","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHA0","description":"ICD-OIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIF0","description":"ICD-OCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD225","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec sz spec ht b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1228","description":"Wheelchair spec sz spec ht b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Power wheelchair noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0898","description":"Power wheelchair noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPA1","description":"ICD-NIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEC1","description":"ICD-BDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15B","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUE1","description":"ICD-OAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTA1","description":"ICD-MCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBB0","description":"ICD-NFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enema tube_ any type_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1013","description":"Enema tube_ any type_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection estrone per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1435","description":"Injection estrone per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANA1","description":"ICD-FANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87502","description":"Influenza dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDB1","description":"ICD-AHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAA0","description":"ICD-NLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reaching/grabbing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9281","description":"Reaching/grabbing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHE0","description":"ICD-ADHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPF1","description":"ICD-CEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1834","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","description":"HCPCS-J1834","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXF0","description":"ICD-BDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ DNA_ PIK3CA (phosphatidylinositol-4_5-bisphosphate 3-kinase_ catalytic subunit alpha) (eg_ breast cancer) gene analysis (ie_ p.C420R_ p.E542K_ p.E545","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0155U","description":"Oncology (breast cancer)_ DNA_ PIK3CA (phosphatidylinositol-4_5-bisphosphate 3-kinase_ catalytic subunit alpha) (eg_ breast cancer) gene analysis (ie_ p.C420R_ p.E542K_ p.E545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMA1","description":"ICD-MEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv no prsv increased ag im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90662","description":"Iiv no prsv increased ag im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYF1","description":"ICD-DGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUB0","description":"ICD-EEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implnt/abut fixed dent mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6115","description":"Implnt/abut fixed dent mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8G","description":"Medium Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64467","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","description":"CPT-64467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUE1","description":"ICD-NIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Male external catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4326","description":"Male external catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Keramatrix_ per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4165","description":"Keramatrix_ per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFE1","description":"ICD-GCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia)_ gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ short tandem repeat (STR) expa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0233U","description":"FXN (frataxin) (eg_ Friedreich ataxia)_ gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ short tandem repeat (STR) expa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHB0","description":"ICD-KHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUC0","description":"ICD-NCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDB1","description":"ICD-IGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0804","description":"HCPCS-B0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73090","description":"X-ray exam of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplt allo lymphocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38242","description":"Transplt allo lymphocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Granisetron 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0091","description":"Granisetron 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens aniseikonic trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2318","description":"Lens aniseikonic trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp axillary-pop-tibial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35623","description":"Art byp axillary-pop-tibial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"late eposode 0-13 therapies_clinical severity level 1_ functional sererity level","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKS","description":"late eposode 0-13 therapies_clinical severity level 1_ functional sererity level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBC1","description":"ICD-ACBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic Radiology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4001","description":"Diagnostic Radiology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHE1","description":"ICD-OBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXC1","description":"ICD-BEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluvirin vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2037","description":"Fluvirin vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSF1","description":"ICD-PGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreserve stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38207","description":"Cryopreserve stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCV2 3MCG TRS-SUCR 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0082A","description":"ADM SARSCV2 3MCG TRS-SUCR 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWA0","description":"ICD-LHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMC1","description":"ICD-OCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMD0","description":"ICD-BAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95715","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSE0","description":"ICD-GCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAB1","description":"ICD-CHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBE1","description":"ICD-OGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydroxyprogesterone caproate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1725","description":"Hydroxyprogesterone caproate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBE1","description":"ICD-GEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWB1","description":"ICD-HBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc shoulder les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23071","description":"Exc shoulder les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0648T","description":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQD1","description":"ICD-CAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23D","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOB0","description":"ICD-HDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96131","description":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYC0","description":"ICD-PCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENA0","description":"ICD-KENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01440","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","description":"CPT-01440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNE1","description":"ICD-NFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt no elg phar ther osteo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8634","description":"Pt no elg phar ther osteo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenting class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9444","description":"Parenting class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Day habil waiver per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2021","description":"Day habil waiver per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSC0","description":"ICD-GCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITF0","description":"ICD-GITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIC1","description":"ICD-BDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67975","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr fe/e/en/l/m 20.1-30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12017","description":"Rpr fe/e/en/l/m 20.1-30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA44","description":"Default_ /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4D","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBD0","description":"ICD-KCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQC1","description":"ICD-KAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m pyrophosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9538","description":"Tc99m pyrophosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq tx malar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21355","description":"Perq tx malar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXF1","description":"ICD-GHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4024","description":"Cast sup sht arm splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERD0","description":"ICD-HERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOD0","description":"ICD-KAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial limited study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93888","description":"Intracranial limited study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGA1","description":"ICD-NKGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ca screen;pelvic/breast exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0101","description":"Ca screen;pelvic/breast exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEC0","description":"ICD-OKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDF1","description":"ICD-CDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69727","description":"Removal_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft sclp/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15220","description":"Skin full graft sclp/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXB1","description":"ICD-OBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDD0","description":"ICD-MEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pne not given norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9280","description":"Pne not given norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl bifocal over 12.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2214","description":"Lens sphcyl bifocal over 12.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC11","description":"ICD-2LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIE0","description":"ICD-NFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Static or dynami afo pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4396","description":"Static or dynami afo pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIE1","description":"ICD-ECIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dicom format image data availability not documented in final report due to medical reasons (eg_CT studies performed for radiation treatment planning or image-guided radiation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9328","description":"Dicom format image data availability not documented in final report due to medical reasons (eg_CT studies performed for radiation treatment planning or image-guided radiation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJD0","description":"ICD-BIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12B","description":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVB1","description":"ICD-JBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEF0","description":"ICD-BDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert pleural cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32550","description":"Insert pleural cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIA0","description":"ICD-NBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"12-24hr sealed lead acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0733","description":"12-24hr sealed lead acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65286","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLA0","description":"ICD-OHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANC0","description":"ICD-KANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOA0","description":"ICD-GCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot exam performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2028F","description":"Foot exam performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRB0","description":"ICD-GCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2101","description":"CDT-D2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHF1","description":"ICD-IAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1015T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","description":"CPT-1015T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOA0","description":"ICD-DEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00326","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","description":"CPT-00326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHB0","description":"ICD-JHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITF1","description":"ICD-EITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDF1","description":"ICD-GDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78710","description":"Kidney imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHD0","description":"ICD-AHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMA0","description":"ICD-FHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDB0","description":"ICD-OEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBF0","description":"ICD-NDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIB1","description":"ICD-EIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood product/irradiation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86945","description":"Blood product/irradiation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anabolic steroid 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80327","description":"Anabolic steroid 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEA1","description":"ICD-IGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHD0","description":"ICD-MHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44125","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise spinal cord vsls crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63250","description":"Revise spinal cord vsls crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCC1","description":"ICD-KDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKD0","description":"ICD-FEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand propeptide_ enzyme-linked immunosorbent assays (ELISA)_ plasma_ diagnostic report of von Willebrand factor (VWF) prop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0281U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand propeptide_ enzyme-linked immunosorbent assays (ELISA)_ plasma_ diagnostic report of von Willebrand factor (VWF) prop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOB0","description":"ICD-CEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVF0","description":"ICD-NLVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJE0","description":"ICD-ODJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0405","description":"HCPCS-B0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIC0","description":"ICD-OHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWE1","description":"ICD-HHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14D","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAD0","description":"ICD-BDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDE1","description":"ICD-IFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61867","description":"Implant neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRA1","description":"ICD-CBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0144","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJE0","description":"ICD-NJJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBC1","description":"ICD-GFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMD0","description":"ICD-MHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","description":"HCPCS-E1808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear rx oral admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79005","description":"Nuclear rx oral admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMD0","description":"ICD-ICMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58805","description":"Drainage of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQA0","description":"ICD-GDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27335","description":"Remove knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDE1","description":"ICD-CDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXE0","description":"ICD-GIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEF1","description":"ICD-MEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTD0","description":"ICD-JBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEF0","description":"ICD-BCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC20","description":"Very High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETA1","description":"ICD-OETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETD0","description":"ICD-AETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55815","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKF0","description":"ICD-JIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen_ qualitative; single drug class method (e.g._ immunoassay_ enzyme assay)_ each drug class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0431","description":"Drug screen_ qualitative; single drug class method (e.g._ immunoassay_ enzyme assay)_ each drug class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIF1","description":"ICD-ACIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASA0","description":"ICD-LASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLC1","description":"ICD-NGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20D","description":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25D","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFC0","description":"ICD-CCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDE0","description":"ICD-NLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Azathioprine oral 50mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7500","description":"Azathioprine oral 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33953","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYC0","description":"ICD-CEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHA0","description":"ICD-JCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9978","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAC1","description":"ICD-OAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA113","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETD0","description":"ICD-EETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGD0","description":"ICD-GFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3A","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adenoma(s) or colorectal cancer detected during screening colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9933","description":"Adenoma(s) or colorectal cancer detected during screening colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTA0","description":"ICD-FCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ acute myelogenous leukemia_ DNA analysis_ 194 genes_ interrogation for sequence variants_ copy number variants or rearrangements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0050U","description":"Targeted genomic sequence analysis panel_ acute myelogenous leukemia_ DNA analysis_ 194 genes_ interrogation for sequence variants_ copy number variants or rearrangements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA226","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trnslum dil eye canal w/stnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66175","description":"Trnslum dil eye canal w/stnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYC1","description":"ICD-DCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRE0","description":"ICD-KDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD256","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDB0","description":"ICD-GIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOF1","description":"ICD-CFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVF1","description":"ICD-OBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKA1","description":"ICD-FHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients Receiving Palliative Care During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0034","description":"Patients Receiving Palliative Care During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGA1","description":"ICD-BBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63086","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBF0","description":"ICD-MDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cranial surg nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21051","description":"Anesth cranial surg nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21247","description":"Reconstruct lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9538","description":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCB0","description":"ICD-EDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67801","description":"Remove eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Withdrawal of arterial blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36600","description":"Withdrawal of arterial blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXF0","description":"ICD-CEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXC0","description":"ICD-OBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB101","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMD1","description":"ICD-KFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNE1","description":"ICD-FBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice respite care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2044","description":"Hospice respite care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE226","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAF0","description":"ICD-OGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disease modif pharmacothxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4540F","description":"Disease modif pharmacothxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANA1","description":"ICD-BANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLE0","description":"ICD-FBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism intermountain clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1022","description":"Clinical decision support mechanism intermountain clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit enteral pump diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9342","description":"Hit enteral pump diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6068","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8E","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cataract surg w/iol 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66983","description":"Cataract surg w/iol 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trichinella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86784","description":"Trichinella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDD0","description":"ICD-ODDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXC0","description":"ICD-NKXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40845","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXB1","description":"ICD-NCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPF0","description":"ICD-JGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNC0","description":"ICD-BBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24B","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compres burn garment jacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6509","description":"Compres burn garment jacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLD1","description":"ICD-IBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bile tract surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47999","description":"Bile tract surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent leadless pacemaker_ ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0388T","description":"Transcatheter removal of permanent leadless pacemaker_ ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJC0","description":"ICD-BIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATD1","description":"ICD-AATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Principal illness navigation services_ additional 30 minutes per calendar month (list separately in addition to g0023)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0024","description":"Principal illness navigation services_ additional 30 minutes per calendar month (list separately in addition to g0023)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQA0","description":"ICD-CAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPA1","description":"ICD-BFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28E","description":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILF1","description":"ICD-EILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLC0","description":"ICD-GCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flex-walk sys low ext prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5981","description":"Flex-walk sys low ext prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYC0","description":"ICD-CDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGED0","description":"ICD-IGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAA0","description":"ICD-BFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAE0","description":"ICD-NKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0595U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","description":"CPT-0595U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWB1","description":"ICD-OJWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDB0","description":"ICD-JIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inlay porcelain/ceramic 1 su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2610","description":"Inlay porcelain/ceramic 1 su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18D","description":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFC0","description":"ICD-GCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cord blood-derived stem-cell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2142","description":"Cord blood-derived stem-cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ofloxacin_ 400 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0034","description":"Injection_ ofloxacin_ 400 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30160","description":"Removal of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWA1","description":"ICD-LAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQA1","description":"ICD-HAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUC0","description":"ICD-CFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1017T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","description":"CPT-1017T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILB0","description":"ICD-IILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB26","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGC0","description":"ICD-KAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCE0","description":"ICD-GDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection of sinus tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20500","description":"Injection of sinus tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPC1","description":"ICD-JHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJC1","description":"ICD-OGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWD1","description":"ICD-DDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amp reqd w/in 48h ieler proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9641","description":"Amp reqd w/in 48h ieler proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech threshold audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92555","description":"Speech threshold audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53230","description":"Removal of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay quant nos nonab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83520","description":"Immunoassay quant nos nonab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUD0","description":"ICD-OEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSC1","description":"ICD-OJSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunotherapy 2/> injections","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95125","description":"Immunotherapy 2/> injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture interm cmplt mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5811","description":"Denture interm cmplt mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHE1","description":"ICD-CAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAB0","description":"ICD-MDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay nonantibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83516","description":"Immunoassay nonantibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion detection_ characterization_ an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0866T","description":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion detection_ characterization_ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXB1","description":"ICD-JBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAME1","description":"ICD-OAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood/lymph system procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38999","description":"Blood/lymph system procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGF1","description":"ICD-KAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUA1","description":"ICD-JAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEB0","description":"ICD-EDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult speech aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5953","description":"Adult speech aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAE0","description":"ICD-MDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam thoracolmb 2/> vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72080","description":"X-ray exam thoracolmb 2/> vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab 10 mg and hyaluronidase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9311","description":"Injection_ rituximab 10 mg and hyaluronidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYC1","description":"ICD-GGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAD1","description":"ICD-BEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINB1","description":"ICD-OINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abscess imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78806","description":"Abscess imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lower extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93925","description":"Lower extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWC1","description":"ICD-CEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFA0","description":"ICD-OGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5C","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screen mammo doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3014F","description":"Screen mammo doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc prosth delayed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33886","description":"Endovasc prosth delayed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFC1","description":"ICD-KBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYE1","description":"ICD-DIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQC0","description":"ICD-GCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAA1","description":"ICD-EFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNC0","description":"ICD-OGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFA0","description":"ICD-CAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIC0","description":"ICD-AEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABC0","description":"ICD-NABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDF1","description":"ICD-NDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M.pneumon dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87580","description":"M.pneumon dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate inf turbinate submuc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30802","description":"Ablate inf turbinate submuc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Head control proximity switc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2330","description":"Head control proximity switc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hard protect helmet prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8001","description":"Hard protect helmet prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIID1","description":"ICD-KIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSE1","description":"ICD-GHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Access av dial grft for eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36147","description":"Access av dial grft for eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVF0","description":"ICD-BDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech/hearing therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92508","description":"Speech/hearing therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone biopsy trocar/needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20225","description":"Bone biopsy trocar/needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL13","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDE0","description":"ICD-JDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB21","description":"ICD-1HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEE1","description":"ICD-GGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic elbow hosmer swit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7170","description":"Electronic elbow hosmer swit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRE0","description":"ICD-ODRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYD0","description":"ICD-HGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML14","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28I","description":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9489","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hepatic shunt (tips)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37183","description":"Remove hepatic shunt (tips)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGB0","description":"ICD-NGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seven Standard Field Stereoscopic Photos With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2103","description":"Seven Standard Field Stereoscopic Photos With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Propulsion whl excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2224","description":"Propulsion whl excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair detachable foot r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1070","description":"Wheelchair detachable foot r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonpower mattress overlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0371","description":"Nonpower mattress overlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Establish access to aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36160","description":"Establish access to aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOD1","description":"ICD-CDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEC1","description":"ICD-FFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transparent film > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6259","description":"Transparent film > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBD0","description":"ICD-FGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vestibular rehab per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9476","description":"Vestibular rehab per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRF1","description":"ICD-DFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMA0","description":"ICD-CIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/o&w/dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8933","description":"Mra_ w/o&w/dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit cont antiemetic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9351","description":"Hit cont antiemetic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound filler gel/paste /oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6261","description":"Wound filler gel/paste /oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; each additional 30 minutes (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96139","description":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; each additional 30 minutes (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDB1","description":"ICD-KFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thumb fusion with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26820","description":"Thumb fusion with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATD0","description":"ICD-BATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ic lbw inf 1500-2500 g subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99479","description":"Ic lbw inf 1500-2500 g subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMC0","description":"ICD-GGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRF1","description":"ICD-PJRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACF1","description":"ICD-OACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIE1","description":"ICD-JBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL24","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB16","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ aicd_ endo dual coil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1895","description":"Lead_ aicd_ endo dual coil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTA0","description":"ICD-JHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient exhibits 2 or more risk factors for postoperative vomiting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9954","description":"Patient exhibits 2 or more risk factors for postoperative vomiting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUE0","description":"ICD-OCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCF1","description":"ICD-BHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPD0","description":"ICD-NEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXC0","description":"ICD-GAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHF0","description":"ICD-IGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMA1","description":"ICD-JCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 8.1 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9983","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 8.1 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion/graft of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25810","description":"Fusion/graft of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hzv vaccine live subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90736","description":"Hzv vaccine live subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1122","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lipid profile perf doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8725","description":"Lipid profile perf doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHE1","description":"ICD-ABHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pvb thoracic 2nd+ inj site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64462","description":"Pvb thoracic 2nd+ inj site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTA1","description":"ICD-MLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIE0","description":"ICD-OCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBA0","description":"ICD-EEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALD0","description":"ICD-CALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFF0","description":"ICD-NIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-H0052","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","description":"HCPCS-H0052","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPE0","description":"ICD-NKPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFB1","description":"ICD-FDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot insert silicone gel eac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3003","description":"Foot insert silicone gel eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genetic counseling 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96040","description":"Genetic counseling 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIC1","description":"ICD-NCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHD1","description":"ICD-OKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult foster care per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5141","description":"Adult foster care per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40702","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Halo cerv into milwaukee typ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0830","description":"Halo cerv into milwaukee typ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair lead pace-defib one","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33218","description":"Repair lead pace-defib one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWB0","description":"ICD-GGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUD1","description":"ICD-CCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIB0","description":"ICD-GGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clean & inspect rem dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9932","description":"Clean & inspect rem dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKE1","description":"ICD-NHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Management of established patient with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0527","description":"Management of established patient with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4385","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","description":"HCPCS-Q4385","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOF1","description":"ICD-GEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40701","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUE1","description":"ICD-AGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMF1","description":"ICD-OJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26670","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21423","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54110","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qty act card prev mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9677","description":"Qty act card prev mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUB1","description":"ICD-OGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDB1","description":"ICD-ABDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44340","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17283","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQE1","description":"ICD-DEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0545U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","description":"CPT-0545U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLB1","description":"ICD-GHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTA0","description":"ICD-NHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vit for macular pucker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67041","description":"Vit for macular pucker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trcath replace aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33366","description":"Trcath replace aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap inc hernia repair recur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49656","description":"Lap inc hernia repair recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQA1","description":"ICD-CFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPC1","description":"ICD-CCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUA1","description":"ICD-EFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of parathormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83970","description":"Assay of parathormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBF1","description":"ICD-JIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWA0","description":"ICD-PHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth neck vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35251","description":"Anesth neck vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sh","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB06","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8I","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHA1","description":"ICD-GDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHC1","description":"ICD-JDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth head/neck/ptrunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30051","description":"Anesth head/neck/ptrunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0576U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","description":"CPT-0576U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace denture teeth complt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5520","description":"Replace denture teeth complt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy lumb/sac facet jnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64635","description":"Destroy lumb/sac facet jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allergy patch tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95044","description":"Allergy patch tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6035","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","description":"HCPCS-L6035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAA1","description":"ICD-CCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWA0","description":"ICD-HBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYA0","description":"ICD-CFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLF0","description":"ICD-OLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQF0","description":"ICD-LEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBF0","description":"ICD-OHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0878","description":"Pwc gp4 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc face tum deep 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21014","description":"Exc face tum deep 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPE1","description":"ICD-GAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Buprenorphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0592","description":"Buprenorphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAE1","description":"ICD-BIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFB1","description":"ICD-NLFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36260","description":"Insertion of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oligoclonal bands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83916","description":"Oligoclonal bands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 50 MCG/0.5 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91313","description":"SARSCOV2 VACCINE BIVALENT 50 MCG/0.5 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHF0","description":"ICD-AHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUD1","description":"ICD-BIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect hip tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27075","description":"Resect hip tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJC0","description":"ICD-OGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59840","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJE0","description":"ICD-OCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXB1","description":"ICD-NAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALE1","description":"ICD-KALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56633","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDC1","description":"ICD-ECDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Refract not +/- 1.0 w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9520","description":"Refract not +/- 1.0 w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBB1","description":"ICD-MBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9777","description":"Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPB0","description":"ICD-BCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99492","description":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shorten radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25392","description":"Shorten radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mycoplasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87109","description":"Mycoplasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQE0","description":"ICD-LFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAB0","description":"ICD-CIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemorrhoidopexy by stapling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46947","description":"Hemorrhoidopexy by stapling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQE0","description":"ICD-OFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electric current therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97033","description":"Electric current therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOA0","description":"ICD-PGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9302","description":"HCPCS-C9302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6794","description":"Crown titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKA0","description":"ICD-CHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61606","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWA0","description":"ICD-DGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISE1","description":"ICD-LISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13A","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVD0","description":"ICD-CEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metaproterenol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7670","description":"Metaproterenol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1012T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","description":"CPT-1012T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPE0","description":"ICD-GEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cool quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0108T","description":"Cool quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7563","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7563","description":"HCPCS-C7563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Melanomaajcc stage 0 or ia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3322F","description":"Melanomaajcc stage 0 or ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25B","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33251","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWA0","description":"ICD-LEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Root surgery bicuspid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3421","description":"Root surgery bicuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PSYC GEN ALYS PANEL 14 GENES","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0173U","description":"PSYC GEN ALYS PANEL 14 GENES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vacc 3 dose ped/adol im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90744","description":"Hepb vacc 3 dose ped/adol im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27134","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27244","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain biopsy w/ct/mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61751","description":"Brain biopsy w/ct/mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ CROS_ in the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5170","description":"Hearing aid_ CROS_ in the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93970","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intend rpt card prev msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9673","description":"Intend rpt card prev msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB11","description":"ICD-1DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDD0","description":"ICD-FDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laundry serv_ext_prof_/order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5175","description":"Laundry serv_ext_prof_/order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing paternity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86910","description":"Blood typing paternity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD124","description":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by bulk acoustic wave biosensor immunoassay_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0408U","description":"Infectious agent antigen detection by bulk acoustic wave biosensor immunoassay_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove elbow bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24138","description":"Remove elbow bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair vessel defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33802","description":"Repair vessel defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE155","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise mandible lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21040","description":"Excise mandible lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7557","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIF1","description":"ICD-FCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSD0","description":"ICD-OCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disp fee inhal drugs/90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0514","description":"Disp fee inhal drugs/90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9687","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVA0","description":"ICD-CBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29847","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vaginal procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94051","description":"Anesth vaginal procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQA1","description":"ICD-HHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cochlear implt f/up exam <7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92601","description":"Cochlear implt f/up exam <7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYA0","description":"ICD-GEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pericardiocentesis_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33016","description":"Pericardiocentesis_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Consult slides prep elsewher","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0484","description":"Consult slides prep elsewher","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSD1","description":"ICD-KFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQB1","description":"ICD-GFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVC0","description":"ICD-CBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96164","description":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sleep study unatt&resp efft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95806","description":"Sleep study unatt&resp efft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLE0","description":"ICD-IDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1401","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1401","description":"CDT-D1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBA0","description":"ICD-KDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ phenylephrine ketorolac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9447","description":"Inj_ phenylephrine ketorolac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy face plate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4361","description":"Ostomy face plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVB1","description":"ICD-NLVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: abnormal neurologic exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2189","description":"Patients with clinical indications for imaging of the head: abnormal neurologic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALE1","description":"ICD-AALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rh-immunoglobulin order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8809","description":"Rh-immunoglobulin order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prefab porc/ceram crown pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2929","description":"Prefab porc/ceram crown pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXB0","description":"ICD-BGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exercise equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9300","description":"Exercise equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc thigh/knee les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27327","description":"Exc thigh/knee les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-BMI1_ CEP 164_ 3_-UTR-Ropporin_ Desmocollin_ AURKAIP-1_ CSNK2A2)_ multiplexed immunoassay and flow cy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0021U","description":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-BMI1_ CEP 164_ 3_-UTR-Ropporin_ Desmocollin_ AURKAIP-1_ CSNK2A2)_ multiplexed immunoassay and flow cy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/4.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2205","description":"Lens sphcy bifocal 4.00d/4.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0503","description":"HCPCS-C0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMF1","description":"ICD-KBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31237","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pertussis ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87265","description":"Pertussis ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKE1","description":"ICD-GCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transtracheal oxygen cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4608","description":"Transtracheal oxygen cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt pulse gen sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4638","description":"Repl batt pulse gen sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical home level 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9148","description":"Medical home level 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obinutuzumab inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9301","description":"Obinutuzumab inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36217","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEE0","description":"ICD-GAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24666","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXB0","description":"ICD-KGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWC0","description":"ICD-KIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIF1","description":"ICD-MIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUA1","description":"ICD-AGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKD0","description":"ICD-OLKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bekesy audiometry diagnosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92561","description":"Bekesy audiometry diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBC1","description":"ICD-IHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEE1","description":"ICD-BEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription digital behavioral therapy_ FDA-cleared_ per course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9291","description":"Prescription digital behavioral therapy_ FDA-cleared_ per course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUD1","description":"ICD-FGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region fracture at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1038","description":"Patients with a diagnosis of lumbar spine region fracture at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auricular replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5927","description":"Auricular replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0964T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","description":"CPT-0964T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hd trapeze bar free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0912","description":"Hd trapeze bar free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9963","description":"Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTF0","description":"ICD-OHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIF0","description":"ICD-BGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEF0","description":"ICD-OLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ melphalan (hepzato)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9248","description":"Injection_ melphalan (hepzato)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each multiplex probe stain p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0853T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each multiplex probe stain p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63286","description":"Bx/exc idrl imed lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42500","description":"Repair salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXB0","description":"ICD-NBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28755","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBF0","description":"ICD-NIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cult skin grft t/a/l addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15151","description":"Cult skin grft t/a/l addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imp/abut rem dent part mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6113","description":"Imp/abut rem dent part mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTB1","description":"ICD-BDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHF0","description":"ICD-GDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTE0","description":"ICD-NKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; initial single probe stain procedure (List separately in addition to code for prima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0848T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; initial single probe stain procedure (List separately in addition to code for prima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0496T","description":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28I","description":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUC0","description":"ICD-MDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATA1","description":"ICD-FATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIB0","description":"ICD-MDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELD0","description":"ICD-BELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bl draw <3 yrs scalp vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36405","description":"Bl draw <3 yrs scalp vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or ot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0734T","description":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or ot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9307","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9307","description":"HCPCS-C9307","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADA0","description":"ICD-FADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSD0","description":"ICD-KDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB156","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAID1","description":"ICD-AAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAD1","description":"ICD-ADAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHC0","description":"ICD-GCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cannula declotting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36861","description":"Cannula declotting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXA0","description":"ICD-BHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below knee cushion socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5646","description":"Below knee cushion socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0901","description":"HCPCS-A0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTA1","description":"ICD-BDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray bile duct dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74363","description":"X-ray bile duct dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL10","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOE0","description":"ICD-KAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31805","description":"Repair of windpipe injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic graft facial bones","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7995","description":"Synthetic graft facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCF1","description":"ICD-GDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIB1","description":"ICD-BIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB11","description":"ICD-3KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVD1","description":"ICD-BCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOF1","description":"ICD-PGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no ahi or rdi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8843","description":"Doc reas no ahi or rdi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of kidney/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50405","description":"Revision of kidney/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHA1","description":"ICD-MDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI w/cont_ breast_  bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8906","description":"MRI w/cont_ breast_  bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOF1","description":"ICD-ODOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icut allergy test drug/bug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95024","description":"Icut allergy test drug/bug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tract frame attach footboard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0870","description":"Tract frame attach footboard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMD1","description":"ICD-MIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC11","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDF1","description":"ICD-GEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAA1","description":"ICD-IGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD104","description":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCND1","description":"ICD-FCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTD1","description":"ICD-KDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTD0","description":"ICD-EHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBB1","description":"ICD-FIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB60","description":"Very High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFA1","description":"ICD-GHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI w/cont_ breast_  uni","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8903","description":"MRI w/cont_ breast_  uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUD1","description":"ICD-KGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGA0","description":"ICD-NFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repr per/vag pouch dbl proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46712","description":"Repr per/vag pouch dbl proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urokinase 250_000 iu inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3365","description":"Urokinase 250_000 iu inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQA0","description":"ICD-LHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct capt mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0381","description":"Cone beam ct capt mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIF1","description":"ICD-NEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD126","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD121","description":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leuprolide acetate /3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1950","description":"Leuprolide acetate /3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACA0","description":"ICD-FACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt care icu&vent w/in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4168F","description":"Pt care icu&vent w/in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy splenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38120","description":"Laparoscopy splenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained without concurrent CT examination of any structure contained in pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0721T","description":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained without concurrent CT examination of any structure contained in pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUE1","description":"ICD-MGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETD0","description":"ICD-OETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation handling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77790","description":"Radiation handling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIC0","description":"ICD-OIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin b-12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82607","description":"Vitamin b-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3386","description":"HCPCS-J3386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISF0","description":"ICD-LISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28E","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lang comp d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9161","description":"Lang comp d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21076","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC60","description":"High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc share dec prior proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9297","description":"No doc share dec prior proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22B","description":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDF1","description":"ICD-GIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81455","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLC1","description":"ICD-NKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18A","description":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00920","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","description":"CPT-00920","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Current tobacco smoker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1034F","description":"Current tobacco smoker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1484","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","description":"HCPCS-M1484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATC0","description":"ICD-IATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQD1","description":"ICD-OJQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abo rh blood typing docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3293F","description":"Abo rh blood typing docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARB1","description":"ICD-LARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemophilia clot factor noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7199","description":"Hemophilia clot factor noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide villus sampling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76945","description":"Echo guide villus sampling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote 30 day ecg rev/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93228","description":"Remote 30 day ecg rev/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACD1","description":"ICD-AACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo tib fx cast plaster mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2106","description":"Afo tib fx cast plaster mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX52","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITD0","description":"ICD-OITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Above knee cushion socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5648","description":"Above knee cushion socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50955","description":"Ureter endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFED1","description":"ICD-IFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB31","description":"ICD-2GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthroscop rotator cuff repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29827","description":"Arthroscop rotator cuff repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln part mand lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5761","description":"Denture reln part mand lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHE1","description":"ICD-NEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72146","description":"MRI chest spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQF1","description":"ICD-GFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Who w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3906","description":"Who w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43300","description":"Repair of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEE1","description":"ICD-MDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-evaluation of occupational therapy established plan of care_ requiring these components: An assessment of changes in patient functional or medical status with revised plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97168","description":"Re-evaluation of occupational therapy established plan of care_ requiring these components: An assessment of changes in patient functional or medical status with revised plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reuse diaper/brief any size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4539","description":"Reuse diaper/brief any size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11B","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compounded drug not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9977","description":"Compounded drug not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWE1","description":"ICD-GGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXD1","description":"ICD-CEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBD0","description":"ICD-NKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73115","description":"Contrast x-ray of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAD0","description":"ICD-EGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adj shoulder ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1840","description":"Adj shoulder ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Provisional splint extracoro","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4321","description":"Provisional splint extracoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWC0","description":"ICD-GGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ref to outpt card rehab prog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4500F","description":"Ref to outpt card rehab prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Serial salivary imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78231","description":"Serial salivary imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung volume reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32491","description":"Lung volume reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYE0","description":"ICD-LBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDD0","description":"ICD-BFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJE0","description":"ICD-CHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat recline mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1004","description":"Pwr seat recline mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWD0","description":"ICD-ODWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBE0","description":"ICD-MBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 1-4 ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64643","description":"Chemodenerv 1 extrem 1-4 ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81464","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75803","description":"Lymph vessel x-ray arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX20","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDB0","description":"ICD-OKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE120","description":"Clinically Complex _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Battery charger_ dual mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2367","description":"Battery charger_ dual mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWB0","description":"ICD-CFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1066T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1066T","description":"CPT-1066T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWF0","description":"ICD-HIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intestine transplnt cadaver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44135","description":"Intestine transplnt cadaver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOE0","description":"ICD-LGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correct finger deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26567","description":"Correct finger deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ RNA_ BCR/ABL1 major and minor breakpoint fusion transcripts_ quantitative PCR amplification_ blood or bone marrow_ report of fusion not de","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0016U","description":"Oncology (hematolymphoid neoplasia)_ RNA_ BCR/ABL1 major and minor breakpoint fusion transcripts_ quantitative PCR amplification_ blood or bone marrow_ report of fusion not de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penile vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93980","description":"Penile vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA31","description":"ICD-2LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained without diagnostic magnetic r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0723T","description":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained without diagnostic magnetic r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVB1","description":"ICD-OIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHB1","description":"ICD-NCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCE1","description":"ICD-OBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMC0","description":"ICD-MDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gi prophylaxis for nsaid rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4017F","description":"Gi prophylaxis for nsaid rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1307","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","description":"HCPCS-J1307","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEA1","description":"ICD-FBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPB0","description":"ICD-KIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of knee prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27488","description":"Removal of knee prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 60th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1177","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 60th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45005","description":"Drainage of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11462","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd balloon dil esoph30 mm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43233","description":"Egd balloon dil esoph30 mm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGB0","description":"ICD-GHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Children who were not screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9967","description":"Children who were not screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext h rate sz 15-30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0383T","description":"Ext h rate sz 15-30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ methotrexate (accord) not therapeutically equivalent to j9250 and j9260_ 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9255","description":"Injection_ methotrexate (accord) not therapeutically equivalent to j9250 and j9260_ 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEA1","description":"ICD-CFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"carePATCH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4236","description":"carePATCH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES244","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHD1","description":"ICD-AHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In ear binaural hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5130","description":"In ear binaural hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB21","description":"Low Rehab_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA210","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monitor elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0483","description":"Monitor elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ in the canal (ITC)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5172","description":"Hearing aid_ contralateral routing device_ monaural_ in the canal (ITC)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES204","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDB1","description":"ICD-KDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system_ with iterative adjustment of the implantable device to test the function of the device an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0650T","description":"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system_ with iterative adjustment of the implantable device to test the function of the device an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX40","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPD1","description":"ICD-JBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBE0","description":"ICD-NJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDA1","description":"ICD-OFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEE0","description":"ICD-JAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant temple bone w/stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69714","description":"Implant temple bone w/stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLB0","description":"ICD-FGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPA1","description":"ICD-NEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ elranatamab-bcmm_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9165","description":"Injection_ elranatamab-bcmm_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0607","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","description":"HCPCS-J0607","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv adduct vocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2341","description":"Chemodenerv adduct vocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37262","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","description":"CPT-37262","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERB0","description":"ICD-HERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXA1","description":"ICD-OBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray adrenal glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75842","description":"Vein x-ray adrenal glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip orthosis (HO)_ bilateral hip joints and thigh cuffs_ adjustable flexion_ extension_ abduction control of hip joint_ postoperative hip abduction type_ prefabricated item th","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1681","description":"Hip orthosis (HO)_ bilateral hip joints and thigh cuffs_ adjustable flexion_ extension_ abduction control of hip joint_ postoperative hip abduction type_ prefabricated item th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXD1","description":"ICD-OLXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11C","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRC0","description":"ICD-KIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKD0","description":"ICD-FGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Most recent tobacco status is tobacco free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9791","description":"Most recent tobacco status is tobacco free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pleurectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32656","description":"Thoracoscopy w/pleurectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self-help/peer svc per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0038","description":"Self-help/peer svc per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLD1","description":"ICD-OGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Serpina1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81332","description":"Serpina1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAD1","description":"ICD-EEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOB1","description":"ICD-DEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert drug implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11981","description":"Insert drug implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1273","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDC1","description":"ICD-MDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBC0","description":"ICD-ACBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine&cord 2 trx thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63197","description":"Incise spine&cord 2 trx thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUF0","description":"ICD-GBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC235","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise spine eltrd plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63664","description":"Revise spine eltrd plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of tibia nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28035","description":"Decompression of tibia nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level VI_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0755T","description":"Digitization of glass microscope slides for level VI_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55500","description":"Removal of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-heu tc-99m add-on/dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9969","description":"Non-heu tc-99m add-on/dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg all night recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95827","description":"Eeg all night recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMD0","description":"ICD-BDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory bp recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93786","description":"Ambulatory bp recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD254","description":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPC0","description":"ICD-JEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFA0","description":"ICD-KAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rubeola ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87283","description":"Rubeola ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10C","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAC1","description":"ICD-FGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKD0","description":"ICD-KFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replc vagus nerve pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0316T","description":"Replc vagus nerve pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction eyelid w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67912","description":"Correction eyelid w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDA1","description":"ICD-FHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMC1","description":"ICD-EFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj fe-based mr contrast_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9953","description":"Inj fe-based mr contrast_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJB1","description":"ICD-KIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pontic - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6243","description":"Pontic - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFA1","description":"ICD-JDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSD1","description":"ICD-HDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKF0","description":"ICD-OKKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manipulate finger w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26340","description":"Manipulate finger w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMA1","description":"ICD-FAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWE0","description":"ICD-LCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatric symptoms assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9742","description":"Psychiatric symptoms assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5142","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","description":"HCPCS-Q5142","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLF1","description":"ICD-GFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01202","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","description":"CPT-01202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKF1","description":"ICD-OHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intranasal reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30620","description":"Intranasal reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAF0","description":"ICD-GFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDD0","description":"ICD-CGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVC0","description":"ICD-OCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNF0","description":"ICD-KHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIE1","description":"ICD-KFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICC0","description":"ICD-OICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC30","description":"High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVF0","description":"ICD-KGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"So airplane w/wo joint cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3674","description":"So airplane w/wo joint cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBD1","description":"ICD-OBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47399","description":"Liver surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I131 tositumomab_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9545","description":"I131 tositumomab_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBA1","description":"ICD-ICBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ep & ablate supravent arrhyt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93653","description":"Ep & ablate supravent arrhyt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33254","description":"Ablate atria lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Motor function mapping ntms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0310T","description":"Motor function mapping ntms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0689U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689U","description":"CPT-0689U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjust finger ext/flex devc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1825","description":"Adjust finger ext/flex devc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAD0","description":"ICD-JIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHA1","description":"ICD-EGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB124","description":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADID0","description":"ICD-ADID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56152","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDF1","description":"ICD-FDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDF1","description":"ICD-FHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endodontic procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3999","description":"Endodontic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3B","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJC0","description":"ICD-GHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLF1","description":"ICD-CFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEF1","description":"ICD-FEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"22nf sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2361","description":"22nf sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immediate maxillary partial denture - flexible base (including any clasps_ rests and teeth)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5227","description":"Immediate maxillary partial denture - flexible base (including any clasps_ rests and teeth)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96132","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTD1","description":"ICD-BBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collect/review data from pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99091","description":"Collect/review data from pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISC1","description":"ICD-OISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fo nontorsion joint cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3935","description":"Fo nontorsion joint cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGE1","description":"ICD-OFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFF1","description":"ICD-JHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFC0","description":"ICD-NFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-dkst_ biosimilar_ (Ogivri)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5114","description":"Injection_ trastuzumab-dkst_ biosimilar_ (Ogivri)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress forearm 1 space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25020","description":"Decompress forearm 1 space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB255","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWE0","description":"ICD-PLWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFA0","description":"ICD-CIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYD0","description":"ICD-ODYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 4 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34844","description":"Endovasc visc aorta 4 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXA1","description":"ICD-OIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD221","description":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUC1","description":"ICD-MLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWA1","description":"ICD-OKWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLC0","description":"ICD-BHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Negative pressure ventilator;  portable or stationary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0460","description":"Negative pressure ventilator;  portable or stationary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSA0","description":"ICD-DDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGB1","description":"ICD-JIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABF1","description":"ICD-OABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAC1","description":"ICD-MBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99494","description":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXF0","description":"ICD-JCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gluc monitor rental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1031","description":"Gluc monitor rental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2251","description":"Injection_ midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUD0","description":"ICD-JEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21610","description":"Partial removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJE1","description":"ICD-KEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXB0","description":"ICD-FBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of creatinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82565","description":"Assay of creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99201","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0602","description":"Manual breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63091","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0805","description":"HCPCS-B0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAC1","description":"ICD-OEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/curett of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57454","description":"Bx/curett of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAB0","description":"ICD-CCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast gap flap reconst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2066","description":"Breast gap flap reconst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQA1","description":"ICD-KDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRD1","description":"ICD-HHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33813","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laa closure w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0281T","description":"Laa closure w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANF1","description":"ICD-KANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular disease_ quantification of advanced serum or plasma lipoprotein profile_ by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0377U","description":"Cardiovascular disease_ quantification of advanced serum or plasma lipoprotein profile_ by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECF0","description":"ICD-BECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWA0","description":"ICD-DEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUA1","description":"ICD-NFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHD1","description":"ICD-OEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis g dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87525","description":"Hepatitis g dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBB1","description":"ICD-OCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLD1","description":"ICD-GGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-77436","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","description":"CPT-77436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score le >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8655","description":"Fun stat score le >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVB1","description":"ICD-GDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9303","description":"HCPCS-C9303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWB1","description":"ICD-OEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc opioid tx 1x during ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9578","description":"Doc opioid tx 1x during ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99337","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44150","description":"Removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inhaled bronchodilator rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4025F","description":"Inhaled bronchodilator rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAE0","description":"ICD-MAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAE0","description":"ICD-MIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aortorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35560","description":"Art byp grft aortorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant semi-imp hear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2230","description":"Implant semi-imp hear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBD1","description":"ICD-IFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFB0","description":"ICD-GGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: positional headaches","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2191","description":"Patients with clinical indications for imaging of the head: positional headaches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove aneurysm sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61613","description":"Remove aneurysm sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electromyograph biofeedback","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0746","description":"Electromyograph biofeedback","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMD0","description":"ICD-GGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUF0","description":"ICD-EIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJD0","description":"ICD-JEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21B","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mini-prop remote joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2312","description":"Mini-prop remote joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair tear ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68700","description":"Repair tear ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUC0","description":"ICD-ABUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHF1","description":"ICD-JGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKE1","description":"ICD-ODKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hi enrgy eswt plantar fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28890","description":"Hi enrgy eswt plantar fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPF0","description":"ICD-KAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAB1","description":"ICD-GAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOB0","description":"ICD-DEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHD1","description":"ICD-KIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5158","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","description":"HCPCS-Q5158","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAB0","description":"ICD-BIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9703","description":"Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC13","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23625","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDF0","description":"ICD-MLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB32","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"F9 (coagulation factor IX) (eg_ hemophilia B)_ full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81238","description":"F9 (coagulation factor IX) (eg_ hemophilia B)_ full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00162","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","description":"CPT-00162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCE0","description":"ICD-BBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD205","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54322","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESE1","description":"ICD-DESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted to a SPU or and ASC for a procedure which could not be certified as medically necessary for that place of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0596","description":"Patient admitted to a SPU or and ASC for a procedure which could not be certified as medically necessary for that place of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOE0","description":"ICD-DDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVC0","description":"ICD-GIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDED0","description":"ICD-GDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMA0","description":"ICD-FBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder-vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57330","description":"Repair bladder-vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0605","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","description":"HCPCS-J0605","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFB0","description":"ICD-OCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNE1","description":"ICD-NBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTB1","description":"ICD-NJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0571U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","description":"CPT-0571U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp femoral-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35656","description":"Art byp femoral-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKF0","description":"ICD-BAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUE0","description":"ICD-NBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) and SMN2 (survival of motor neuron 2_ centromeric) (eg_ spinal muscular atrophy) full gene analysis_ including small sequence chan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0236U","description":"SMN1 (survival of motor neuron 1_ telomeric) and SMN2 (survival of motor neuron 2_ centromeric) (eg_ spinal muscular atrophy) full gene analysis_ including small sequence chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42845","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap enterolysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44180","description":"Lap enterolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIE1","description":"ICD-NJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye strands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67030","description":"Incise inner eye strands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5C","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHE0","description":"ICD-JIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ usin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0116U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ usin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHC1","description":"ICD-FHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAC1","description":"ICD-IHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Jaw motion rehab system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1700","description":"Jaw motion rehab system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESD0","description":"ICD-LESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No sent lymph node biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8882","description":"No sent lymph node biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFC0","description":"ICD-GFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIE1","description":"ICD-FBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPF1","description":"ICD-NDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cranial cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61000","description":"Remove cranial cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAA1","description":"ICD-CGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuromuscular electrical stimulator (nmes)_ disposable_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4560","description":"Neuromuscular electrical stimulator (nmes)_ disposable_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert temp bladder cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51702","description":"Insert temp bladder cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEA0","description":"ICD-FFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAF0","description":"ICD-JCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLF0","description":"ICD-ODLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKB0","description":"ICD-BIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRF0","description":"ICD-KCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESE1","description":"ICD-PESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intra-atrial recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93602","description":"Intra-atrial recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1823","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","description":"HCPCS-E1823","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOD1","description":"ICD-GGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTD0","description":"ICD-KCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEA0","description":"ICD-CCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBD1","description":"ICD-GGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21B","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16078","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16078","description":"CPT-16078","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFB1","description":"ICD-JBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHED1","description":"ICD-JHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUC1","description":"ICD-IEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"5%dextrose/0.45%saline1000ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5013","description":"5%dextrose/0.45%saline1000ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable canister for pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7000","description":"Disposable canister for pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ftrst lower extension tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0043","description":"Ftrst lower extension tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9812","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9812","description":"HCPCS-C9812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLD1","description":"ICD-MBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIE0","description":"ICD-GCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHE0","description":"ICD-KHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDF0","description":"ICD-JHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNA0","description":"ICD-NBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1130","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace part denture teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5640","description":"Replace part denture teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC11","description":"ICD-4DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSF0","description":"ICD-PGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28X","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIE0","description":"ICD-KDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of mesentery lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44820","description":"Excision of mesentery lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cardiac electrophys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53751","description":"Anesth cardiac electrophys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4384","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","description":"HCPCS-Q4384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBID0","description":"ICD-GBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUB1","description":"ICD-NKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADF1","description":"ICD-AADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA36","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRB0","description":"ICD-KGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASB0","description":"ICD-DASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIE1","description":"ICD-OCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUC0","description":"ICD-OEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETB0","description":"ICD-FETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWF1","description":"ICD-GFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDF1","description":"ICD-NKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMD0","description":"ICD-KFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNC0","description":"ICD-GGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received chemotherapy in the last 14 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9847","description":"Patient received chemotherapy in the last 14 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33406","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDE0","description":"ICD-OCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHC0","description":"ICD-IAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28I","description":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPA0","description":"ICD-BAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIF1","description":"ICD-ABIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0936T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","description":"CPT-0936T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEE1","description":"ICD-NJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Door to punc time <2hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9580","description":"Door to punc time <2hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRD1","description":"ICD-KDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYE1","description":"ICD-HCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTC1","description":"ICD-CFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTA0","description":"ICD-KCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJB0","description":"ICD-OFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMA0","description":"ICD-GEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rails bed side half length","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0305","description":"Rails bed side half length","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28730","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPE0","description":"ICD-BIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFC1","description":"ICD-GAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHE1","description":"ICD-KHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWC1","description":"ICD-HBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLB1","description":"ICD-JDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRA0","description":"ICD-PJRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIF1","description":"ICD-OFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLF1","description":"ICD-BHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAA1","description":"ICD-IFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11641","description":"Exc f/e/e/n/l mal+mrg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLA1","description":"ICD-KBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECD0","description":"ICD-JECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIF1","description":"ICD-NFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIB0","description":"ICD-BBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAB1","description":"ICD-KHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC141","description":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFA0","description":"ICD-FBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMA0","description":"ICD-IEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCF1","description":"ICD-AFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBD1","description":"ICD-OJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKB1","description":"ICD-CCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEB1","description":"ICD-KEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCE0","description":"ICD-IFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA17","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; 8 or more vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22837","description":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; 8 or more vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Face-To-Face Hh Nsg Vst Rhc/Fqhc Area Shtg Hha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0490","description":"Face-To-Face Hh Nsg Vst Rhc/Fqhc Area Shtg Hha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVD1","description":"ICD-NFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDC0","description":"ICD-GGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALD0","description":"ICD-OALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASB1","description":"ICD-DASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repr pul art unifocal w/cpb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33926","description":"Repr pul art unifocal w/cpb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC156","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIF1","description":"ICD-JDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML42","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHB1","description":"ICD-NGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Community health integration services_ each additional 30 minutes per calendar month (list separately in addition to g0019)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0022","description":"Community health integration services_ each additional 30 minutes per calendar month (list separately in addition to g0019)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWD1","description":"ICD-HHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suprv interfac trnsport addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99486","description":"Suprv interfac trnsport addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL26","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFA0","description":"ICD-KBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1371","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","description":"HCPCS-M1371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44100","description":"Biopsy of bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUC0","description":"ICD-ACUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCA0","description":"ICD-OCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB21","description":"ICD-2AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETC1","description":"ICD-CETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLA0","description":"ICD-CHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABE0","description":"ICD-JABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRA0","description":"ICD-CGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTD1","description":"ICD-AHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg_ thoracotomy_ transapical)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0484T","description":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg_ thoracotomy_ transapical)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRA1","description":"ICD-PBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEE0","description":"ICD-JBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVA1","description":"ICD-JDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegunigalsidase alfa-iwxj_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2508","description":"Injection_ pegunigalsidase alfa-iwxj_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKD0","description":"ICD-GEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kras gene variants exon 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81275","description":"Kras gene variants exon 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIA0","description":"ICD-OKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGED1","description":"ICD-OGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYF0","description":"ICD-LIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0675","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0675","description":"HCPCS-G0675","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBB0","description":"ICD-EIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUA1","description":"ICD-FBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0207","description":"Traumatic brain injury with Motor <22.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB13","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUB1","description":"ICD-NDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEB1","description":"ICD-MFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyperphenylalaninemia monitoring by patient-collected blood card sample_ quantitative measurement of phenylalanine and tyrosine_ liquid chromatography with tandem mass spectro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0382U","description":"Hyperphenylalaninemia monitoring by patient-collected blood card sample_ quantitative measurement of phenylalanine and tyrosine_ liquid chromatography with tandem mass spectro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conform band n/s w>=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6444","description":"Conform band n/s w>=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iliac revasc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37222","description":"Iliac revasc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening oxycodone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80365","description":"Drug screening oxycodone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXB0","description":"ICD-FDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24B","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC126","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33746","description":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relocation Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To Existing Dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0681T","description":"Relocation Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To Existing Dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In vivo lab service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88749","description":"In vivo lab service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision gastroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43848","description":"Revision gastroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score knee < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8648","description":"Fun stat score knee < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAED0","description":"ICD-GAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKC1","description":"ICD-CFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBE0","description":"ICD-MKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Melphalan oral 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8600","description":"Melphalan oral 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj multihance multipack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9578","description":"Inj multihance multipack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy thigh soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27323","description":"Biopsy thigh soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Advnc care plan in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1157F","description":"Advnc care plan in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC22","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGF0","description":"ICD-NGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1192","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKF0","description":"ICD-KGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHA1","description":"ICD-JBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0A","description":"Low Rehab_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51050","description":"Removal of bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDB0","description":"ICD-FHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat penis lesion graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54111","description":"Treat penis lesion graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01130","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","description":"CPT-01130","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVE0","description":"ICD-OIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood_ l/r_ froz/degly/wash","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9054","description":"Blood_ l/r_ froz/degly/wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Im admin 1st/only component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90460","description":"Im admin 1st/only component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB117","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No ster wd ifx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8572","description":"No ster wd ifx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mastectomy bra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8000","description":"Mastectomy bra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJF0","description":"ICD-KHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O2 saturation doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3028F","description":"O2 saturation doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUD0","description":"ICD-NEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv3 vacc no prsv 3 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90656","description":"Iiv3 vacc no prsv 3 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anemia plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0516F","description":"Anemia plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAE0","description":"ICD-AGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEB1","description":"ICD-ACEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJD0","description":"ICD-NCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonfamily homecare train/15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5115","description":"Nonfamily homecare train/15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXA0","description":"ICD-FEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove thyroid duct lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60281","description":"Remove thyroid duct lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immntx 5 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95134","description":"Immntx 5 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst base mtl 2 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6612","description":"Onlay cst base mtl 2 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOA0","description":"ICD-CEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES144","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBED1","description":"ICD-CBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pelvic abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45000","description":"Drainage of pelvic abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment Of Amblyopia Using An Online Digital Program; Device Supply_ Educational Set-Up_ And Initial Session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0687T","description":"Treatment Of Amblyopia Using An Online Digital Program; Device Supply_ Educational Set-Up_ And Initial Session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAB1","description":"ICD-EIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Wisconsin Card Sorting Test)_ administered by a computer_ with qualified health care professional interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96120","description":"Neuropsychological testing (eg_ Wisconsin Card Sorting Test)_ administered by a computer_ with qualified health care professional interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72158","description":"MRI lumbar spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIC1","description":"ICD-IGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intro windpipe wire/tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31730","description":"Intro windpipe wire/tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCC0","description":"ICD-NHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automated leukocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85048","description":"Automated leukocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso rem fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43194","description":"Esophagoscp rig trnso rem fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFA1","description":"ICD-NAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exam of vulva w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56820","description":"Exam of vulva w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Any patients who had no asthma controller medications dispensed during the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9808","description":"Any patients who had no asthma controller medications dispensed during the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt surv improv bsline tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9603","description":"Pt surv improv bsline tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complex drainage wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10180","description":"Complex drainage wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOF1","description":"ICD-LBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGE0","description":"ICD-KFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Critical care first hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99291","description":"Critical care first hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Group (2 Or More Individuals)_ At Least 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0593T","description":"Health And Well-Being Coaching Face-To-Face; Group (2 Or More Individuals)_ At Least 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1003","description":"HCPCS-B1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARF1","description":"ICD-PARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEB0","description":"ICD-IIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21454","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0505F","description":"Hemodialysis plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7531","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7531","description":"HCPCS-J7531","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3702","description":"Eo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOF1","description":"ICD-LDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGA0","description":"ICD-CAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLF1","description":"ICD-ABLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUD1","description":"ICD-MJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVC0","description":"ICD-OBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDF0","description":"ICD-EFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Youth size pull-on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4534","description":"Youth size pull-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEF0","description":"ICD-NCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVF1","description":"ICD-KFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMF0","description":"ICD-CCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPD0","description":"ICD-JEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01502","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","description":"CPT-01502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKD0","description":"ICD-JHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid trnso dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43191","description":"Esophagoscopy rigid trnso dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull/brain surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61735","description":"Incise skull/brain surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen non tlc devices","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80300","description":"Drug screen non tlc devices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWC0","description":"ICD-HEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUF1","description":"ICD-BAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46705","description":"Repair of anal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOF0","description":"ICD-LDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELE1","description":"ICD-FELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRA0","description":"ICD-KGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31030","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDF1","description":"ICD-FCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pm phone r-strip device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93293","description":"Pm phone r-strip device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWB1","description":"ICD-PAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens single vision not oth c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2199","description":"Lens single vision not oth c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMF1","description":"ICD-JGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLID1","description":"ICD-NLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISD0","description":"ICD-CISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Copd measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8898","description":"Copd measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWB0","description":"ICD-KBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUE1","description":"ICD-JAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWC1","description":"ICD-LCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMD0","description":"ICD-GHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Salicylate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80179","description":"Salicylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRF1","description":"ICD-LBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDD1","description":"ICD-JBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0302","description":"HCPCS-B0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMC1","description":"ICD-NLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28024","description":"Exploration of toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAE1","description":"ICD-NBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOE1","description":"ICD-HHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1087","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70150","description":"X-ray exam of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPD0","description":"ICD-KHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoplasty congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43313","description":"Esophagoplasty congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXD0","description":"ICD-KCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea sen ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0425T","description":"Insj/rplc nstim apnea sen ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTC0","description":"ICD-BBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBC0","description":"ICD-KFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressants class 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80334","description":"Antidepressants class 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDC0","description":"ICD-MLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSB1","description":"ICD-DFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUC0","description":"ICD-MAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOD0","description":"ICD-OCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Im admin each addl component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90461","description":"Im admin each addl component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0929T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","description":"CPT-0929T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE250","description":"Special Care High _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJC1","description":"ICD-ODJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1246","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aneurysm pressure sens study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93982","description":"Aneurysm pressure sens study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAA0","description":"ICD-AIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCE0","description":"ICD-FDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBB1","description":"ICD-BCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEF0","description":"ICD-NGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOF1","description":"ICD-GHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHA1","description":"ICD-GEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVE1","description":"ICD-NAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPA0","description":"ICD-GBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Typhoid vaccine_ heat- and phenol-inactivated (h-p)_ for subcutaneous orintradermal use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90692","description":"Typhoid vaccine_ heat- and phenol-inactivated (h-p)_ for subcutaneous orintradermal use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQE0","description":"ICD-HAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc medrsn no hist type rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9288","description":"Doc medrsn no hist type rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYF1","description":"ICD-OCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYA0","description":"ICD-DIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand interface joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2321","description":"Hand interface joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVF1","description":"ICD-NHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDD0","description":"ICD-OFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACF1","description":"ICD-GACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQD1","description":"ICD-CEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC11","description":"ICD-4BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTE0","description":"ICD-IHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXF0","description":"ICD-KFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAB1","description":"ICD-ECAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOE0","description":"ICD-PFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0552U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","description":"CPT-0552U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0504T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTE1","description":"ICD-ECTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty w/cp bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33403","description":"Valvuloplasty w/cp bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILE1","description":"ICD-EILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQA0","description":"ICD-DAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEC1","description":"ICD-EHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIA0","description":"ICD-KEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psych diagnostic evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90791","description":"Psych diagnostic evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHD0","description":"ICD-JDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRF1","description":"ICD-KBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal Endo Surg; Balln Dilat Eust T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9745","description":"Nasal Endo Surg; Balln Dilat Eust T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echocardiography contrast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9700","description":"Echocardiography contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILD0","description":"ICD-KILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDA1","description":"ICD-EEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Serum lvls ca/ipth/lpd ord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3278F","description":"Serum lvls ca/ipth/lpd ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25624","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLC0","description":"ICD-GBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTA0","description":"ICD-AHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYE0","description":"ICD-GEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject suprvlv aortography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93567","description":"Inject suprvlv aortography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMD1","description":"ICD-AEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neg press wound tx </=50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97605","description":"Neg press wound tx </=50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam l-s spine bending","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72114","description":"X-ray exam l-s spine bending","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBA0","description":"ICD-MKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test for blood flow in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15860","description":"Test for blood flow in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDA1","description":"ICD-GIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18I","description":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9732","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/thymus resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32673","description":"Thoracoscopy w/thymus resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01636","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","description":"CPT-01636","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB114","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGB0","description":"ICD-KGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFB1","description":"ICD-CBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; unilateral placement_ including cystoscopy and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0549T","description":"Transperineal periurethral balloon continence device; unilateral placement_ including cystoscopy and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKD0","description":"ICD-NJKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHE1","description":"ICD-NIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICD0","description":"ICD-GICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPE1","description":"ICD-NFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of a-v fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37607","description":"Ligation of a-v fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHE1","description":"ICD-AAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine process addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172T","description":"Lumbar spine process addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay porcelin 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2642","description":"Dental onlay porcelin 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAB1","description":"ICD-MBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens trifocal add over 3.25d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2320","description":"Lens trifocal add over 3.25d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove anal fist inter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46275","description":"Remove anal fist inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPF0","description":"ICD-CCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1476","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","description":"HCPCS-M1476","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve pedicle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64907","description":"Nerve pedicle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ 5 DNA regulatory markers by quantitative PCR_ whole blood_ algorithm_ including prostate-specific antigen_ reported as likelihood of cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0433U","description":"Oncology (prostate)_ 5 DNA regulatory markers by quantitative PCR_ whole blood_ algorithm_ including prostate-specific antigen_ reported as likelihood of cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOC0","description":"ICD-GCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physician standby services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99360","description":"Physician standby services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDC0","description":"ICD-KCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOB0","description":"ICD-KGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAE0","description":"ICD-OCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of support implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20680","description":"Removal of support implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWB1","description":"ICD-GBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQA1","description":"ICD-OEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVC1","description":"ICD-GEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACE1","description":"ICD-CACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20A","description":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEE0","description":"ICD-KBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATD0","description":"ICD-AATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - premolar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3472","description":"Surgical repair of root resorption - premolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1602","description":"HCPCS-A1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHB0","description":"ICD-GIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft fem-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35558","description":"Art byp grft fem-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0401","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0401","description":"CDT-D0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75891","description":"Vein x-ray liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVA0","description":"ICD-BFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd lesion ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43270","description":"Egd lesion ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous sti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33288","description":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous sti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proton trmt simple w/o comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77520","description":"Proton trmt simple w/o comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFE0","description":"ICD-NCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXF0","description":"ICD-KHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQD0","description":"ICD-KEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBB1","description":"ICD-OHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRC1","description":"ICD-OIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hgb <10g/dl_ med rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8975","description":"Hgb <10g/dl_ med rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABC1","description":"ICD-CABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36482","description":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2312","description":"Lens sphc trifo 7.25-12/2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMC1","description":"ICD-AIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNE0","description":"ICD-BBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-eval post-op visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0171","description":"Re-eval post-op visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB212","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect diaphragm complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39561","description":"Resect diaphragm complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUC0","description":"ICD-OCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEF1","description":"ICD-JHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0901","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0901","description":"CDT-D0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degree","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9772","description":"Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICB0","description":"ICD-AICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUB1","description":"ICD-CIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVC1","description":"ICD-NBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJF0","description":"ICD-CFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4433","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","description":"HCPCS-Q4433","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semen analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0027","description":"Semen analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWE1","description":"ICD-CDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXA1","description":"ICD-OJXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply multlay comprs upr leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29582","description":"Apply multlay comprs upr leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGA1","description":"ICD-OBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITF1","description":"ICD-OITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo frct swg & sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5718","description":"Knee-shin exo frct swg & sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVA1","description":"ICD-FFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXD0","description":"ICD-CCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQA0","description":"ICD-LDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBF0","description":"ICD-ADBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHE0","description":"ICD-NGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFC1","description":"ICD-JCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYB0","description":"ICD-HEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD101","description":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR MoAb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9841","description":"RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR MoAb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12D","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plastazote sandal each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3265","description":"Plastazote sandal each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDC1","description":"ICD-CCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMD0","description":"ICD-JIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22867","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRF0","description":"ICD-DCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFC0","description":"ICD-JCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of scrotum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55120","description":"Removal of scrotum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAA1","description":"ICD-OBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX30","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWF1","description":"ICD-GEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13A","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUD1","description":"ICD-CDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGD1","description":"ICD-JHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interprof phone/online 21-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99448","description":"Interprof phone/online 21-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65210","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCF0","description":"ICD-BGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKB1","description":"ICD-GDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESC1","description":"ICD-OESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0407","description":"Inpt/tele follow up 25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLB0","description":"ICD-MDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBD1","description":"ICD-AFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp <5 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99143","description":"Mod sedat phys/qhp <5 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKD1","description":"ICD-CDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ 10 mcg (Sinuva)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9122","description":"Mometasone furoate sinus implant_ 10 mcg (Sinuva)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCA0","description":"ICD-NBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGC1","description":"ICD-GDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUD0","description":"ICD-FFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo ablate liver tumor rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47370","description":"Laparo ablate liver tumor rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11C","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDA0","description":"ICD-MCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0013","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGA1","description":"ICD-BFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES320","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ infliximab-dyyb (Zymfentra)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1748","description":"Injection_ infliximab-dyyb (Zymfentra)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWD0","description":"ICD-GGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0575","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0575","description":"HCPCS-G0575","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHE0","description":"ICD-KFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0685","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0685","description":"HCPCS-G0685","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot longitud/metatarsal sup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3020","description":"Foot longitud/metatarsal sup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVE0","description":"ICD-KHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRA0","description":"ICD-HIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSE0","description":"ICD-OGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36557","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open aortoiliac prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34831","description":"Open aortoiliac prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aztreonam_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0073","description":"Injection_ aztreonam_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare heart-aorta conduit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33404","description":"Prepare heart-aorta conduit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQC1","description":"ICD-CCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEC0","description":"ICD-GCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth skull drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21451","description":"Anesth skull drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWC0","description":"ICD-LIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRA0","description":"ICD-CHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMF1","description":"ICD-AAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"intravenous moderate (conscious) sedation/analgesia each subsequent 15 minute increment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9243","description":"intravenous moderate (conscious) sedation/analgesia each subsequent 15 minute increment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nutrition/Dietician Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4017","description":"Nutrition/Dietician Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSA0","description":"ICD-LBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAD0","description":"ICD-GAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC205","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap close enterostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44227","description":"Lap close enterostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARC0","description":"ICD-OARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Provision splnt intracoronal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4320","description":"Provision splnt intracoronal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEE1","description":"ICD-MGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD146","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection Nusinersen 0.1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9489","description":"Injection Nusinersen 0.1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXC0","description":"ICD-BHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPA1","description":"ICD-CFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWA1","description":"ICD-LIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPF0","description":"ICD-JCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD104","description":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mast radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19305","description":"Mast radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYA1","description":"ICD-CEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1329","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGF1","description":"ICD-JGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENB1","description":"ICD-CENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy through stoma; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6019","description":"Colonoscopy through stoma; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD225","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD135","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acq_ interpretation_ and report; each additional lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0471T","description":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acq_ interpretation_ and report; each additional lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ho flex frejka w/cov pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1600","description":"Ho flex frejka w/cov pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove part of neck vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22100","description":"Remove part of neck vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no disc tx opt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9400","description":"Doc reas no disc tx opt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Technetium tc-99m teboroxime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9501","description":"Technetium tc-99m teboroxime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCED1","description":"ICD-GCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVE1","description":"ICD-CCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLF1","description":"ICD-CDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0903","description":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko double upright pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0902","description":"Ko double upright pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0369T","description":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIE0","description":"ICD-JDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL25","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Architect ecm px fx 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4147","description":"Architect ecm px fx 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBF1","description":"ICD-AFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOC1","description":"ICD-GCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUC1","description":"ICD-MBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQB0","description":"ICD-LBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental consultation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9310","description":"Dental consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSE0","description":"ICD-OHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyperbaric oxygen therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99183","description":"Hyperbaric oxygen therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJA0","description":"ICD-BCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneum walk boot pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4387","description":"Non-pneum walk boot pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67710","description":"Incision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPE1","description":"ICD-NHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQA0","description":"ICD-ODQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAA0","description":"ICD-FCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXE0","description":"ICD-BHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIA0","description":"ICD-NDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elb disart prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6450","description":"Elb disart prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLB0","description":"ICD-KDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25A","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ talimogene laherparepvec_ per 1 million plaque forming units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9325","description":"Injection_ talimogene laherparepvec_ per 1 million plaque forming units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC22","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ givosiran_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0223","description":"Injection_ givosiran_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTC1","description":"ICD-KFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo new ureter/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50947","description":"Laparo new ureter/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab_ 10 mg and hyaluronidase-oysk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9356","description":"Injection_ trastuzumab_ 10 mg and hyaluronidase-oysk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunofluor antb 1st stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88346","description":"Immunofluor antb 1st stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBE0","description":"ICD-NHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90851","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVB1","description":"ICD-NCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef calorie dense>/=1.5kcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4152","description":"Ef calorie dense>/=1.5kcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB11","description":"ICD-1KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVD1","description":"ICD-BFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood clot lysis time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85175","description":"Blood clot lysis time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0715T","description":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Special Meal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1764","description":"Home Delivered Meals-Special Meal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTD1","description":"ICD-OKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2391","description":"Solid caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLC1","description":"ICD-MGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEF0","description":"ICD-NAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy w/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31535","description":"Laryngoscopy w/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telehealth consultation_ critical care_ initial_ physicians typically spend 60 minutes communicating with the patient and providers via telehealth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0508","description":"Telehealth consultation_ critical care_ initial_ physicians typically spend 60 minutes communicating with the patient and providers via telehealth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOE1","description":"ICD-KCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27448","description":"Incision of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11306","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXA0","description":"ICD-GAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBA0","description":"ICD-CFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice/home hlth in asst lv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5002","description":"Hospice/home hlth in asst lv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No hepc rna after med no rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9211","description":"No hepc rna after med no rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHD1","description":"ICD-AEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Isch containmt/narrow m-l so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5649","description":"Isch containmt/narrow m-l so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84583","description":"Assay of urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTB1","description":"ICD-GFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1024T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","description":"CPT-1024T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFC1","description":"ICD-GEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PuraPly or PuraPly AM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4172","description":"PuraPly or PuraPly AM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 23+ tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP23","description":"Auto test panel pricing code_ 23+ tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pmkr_ single_ rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1786","description":"Pmkr_ single_ rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGC1","description":"ICD-CHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLB1","description":"ICD-KDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUD1","description":"ICD-NBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ first evalua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0835T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ first evalua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB20","description":"Medium Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUD0","description":"ICD-OAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denosumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0897","description":"Denosumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDB1","description":"ICD-OIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLC1","description":"ICD-IDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Docetaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9171","description":"Docetaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLF0","description":"ICD-JBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCD1","description":"ICD-JCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASA1","description":"ICD-KASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Buprenorphine implant_ 74.2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0570","description":"Buprenorphine implant_ 74.2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAD0","description":"ICD-NLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES225","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHE1","description":"ICD-EDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCD0","description":"ICD-NCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJB1","description":"ICD-NBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Free skin flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15757","description":"Free skin flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECD1","description":"ICD-IECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18F","description":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVC1","description":"ICD-OKVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ gastrointestinal pathogens_ 31 bacterial_ viral_ and parasitic organisms and identification of 21 associated antibiot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0369U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ gastrointestinal pathogens_ 31 bacterial_ viral_ and parasitic organisms and identification of 21 associated antibiot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJD1","description":"ICD-OEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine/uric acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84560","description":"Assay of urine/uric acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLD0","description":"ICD-KHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGB0","description":"ICD-OLGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHA0","description":"ICD-FDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Primatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4110","description":"Primatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHB0","description":"ICD-GDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54660","description":"Revision of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMB0","description":"ICD-GDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGC1","description":"ICD-NKGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13B","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOC1","description":"ICD-OCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUC1","description":"ICD-FBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0974T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","description":"CPT-0974T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain external ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69005","description":"Drain external ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTA1","description":"ICD-NLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX25","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95144","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAB0","description":"ICD-OBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUE0","description":"ICD-FEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87494","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","description":"CPT-87494","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGD0","description":"ICD-JFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening tapentadol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80372","description":"Drug screening tapentadol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dihydrotestosterone (DHT)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82642","description":"Dihydrotestosterone (DHT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clin tx mdd not comm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8960","description":"Clin tx mdd not comm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGC0","description":"ICD-GFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDB0","description":"ICD-BIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNF1","description":"ICD-BCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFME0","description":"ICD-FFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBD1","description":"ICD-IGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp iliofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35665","description":"Art byp iliofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; second physician or other qualifie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0821T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; second physician or other qualifie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOC1","description":"ICD-LIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX15","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQA1","description":"ICD-DCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ercp duct stent placement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43274","description":"Ercp duct stent placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGF1","description":"ICD-FIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPC1","description":"ICD-CGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWD1","description":"ICD-DIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJF1","description":"ICD-FFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74455","description":"X-ray urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC33","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast supplies (plaster)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4580","description":"Cast supplies (plaster)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse esophagus & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43341","description":"Fuse esophagus & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig med check","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8430","description":"Pt inelig med check","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINA1","description":"ICD-BINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQB1","description":"ICD-KGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFME1","description":"ICD-MFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLED1","description":"ICD-MLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEND0","description":"ICD-CEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIB0","description":"ICD-FGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33231","description":"Insrt pulse gen w/mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKD1","description":"ICD-JAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood collection tube/vacuum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4770","description":"Blood collection tube/vacuum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRF0","description":"ICD-GGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corneal hysteresis deter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92145","description":"Corneal hysteresis deter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Using A Catheter Continuously For Three Months Or Longer Under The Care Of The Same","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1026","description":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Using A Catheter Continuously For Three Months Or Longer Under The Care Of The Same","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01212","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","description":"CPT-01212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25C","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAB1","description":"ICD-NFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDB0","description":"ICD-KBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01432","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","description":"CPT-01432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHA0","description":"ICD-IHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRF1","description":"ICD-LIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on salivary glands_ including biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0113U","description":"Anesthesia for procedures on salivary glands_ including biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9362","description":"Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILC0","description":"ICD-KILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete removal of vulva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56625","description":"Complete removal of vulva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAB0","description":"ICD-GCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPE0","description":"ICD-OGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Motor speech current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8999","description":"Motor speech current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKC1","description":"ICD-JFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20B","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ includes placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0775T","description":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ includes placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBA1","description":"ICD-IHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKD0","description":"ICD-JGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVC1","description":"ICD-OLVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFF1","description":"ICD-OFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBA0","description":"ICD-NLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUF0","description":"ICD-FHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC115","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTA0","description":"ICD-IDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evaluate swallowing function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92610","description":"Evaluate swallowing function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo sing fre stirr thi/calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2000","description":"Kafo sing fre stirr thi/calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC12","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUD1","description":"ICD-KAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision and drainage of soft tissue abscess_ subfascial (ie_ involves the soft tissue below the deep fascia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20005","description":"Incision and drainage of soft tissue abscess_ subfascial (ie_ involves the soft tissue below the deep fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUE1","description":"ICD-FCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hm preeclamp per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9213","description":"Hm preeclamp per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arch supp att to shoe metata","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3080","description":"Arch supp att to shoe metata","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct colonography dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74261","description":"Ct colonography dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALF1","description":"ICD-CALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRD0","description":"ICD-GCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKD1","description":"ICD-OBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBE0","description":"ICD-CBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQE1","description":"ICD-OJQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJB0","description":"ICD-CCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBD1","description":"ICD-BDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood viscosity examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85810","description":"Blood viscosity examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWC0","description":"ICD-HHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76831","description":"Echo exam uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair ing hernia sliding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49525","description":"Repair ing hernia sliding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Main/clean max prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5993","description":"Main/clean max prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDF0","description":"ICD-BHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEB0","description":"ICD-IHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay porc 4/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2644","description":"Dental onlay porc 4/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tretinoin topical 5 g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0117","description":"Tretinoin topical 5 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teprotumumab-trbw_10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9061","description":"Injection_ teprotumumab-trbw_10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0950","description":"Tray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCB1","description":"ICD-GCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDB0","description":"ICD-BEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQE1","description":"ICD-OBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJF0","description":"ICD-FHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht hemodialysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9335","description":"Ht hemodialysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILF0","description":"ICD-OILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHA1","description":"ICD-IHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB23","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIF0","description":"ICD-GHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABE0","description":"ICD-OABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht muscle image spect sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78451","description":"Ht muscle image spect sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUB0","description":"ICD-BAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATB1","description":"ICD-FATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services for patient occurred any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9720","description":"Hospice services for patient occurred any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney function study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78725","description":"Kidney function study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93246","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen sng non","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8686","description":"Implt nrostm pls gen sng non","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo radical prostatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55866","description":"Laparo radical prostatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afamelanotide implant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7352","description":"Afamelanotide implant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; complex (eg_ leaflet extension_ leaflet resection_ leaflet reconstruction_ or annuloplasty)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33391","description":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; complex (eg_ leaflet extension_ leaflet resection_ leaflet reconstruction_ or annuloplasty)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASF1","description":"ICD-HASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHD0","description":"ICD-IGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res Uti  Bill Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9684","description":"Onsite Ac C Tx Nsg Fac Res Uti  Bill Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFD1","description":"ICD-CBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anti-mullerian hormone (AMH)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82166","description":"Anti-mullerian hormone (AMH)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYE1","description":"ICD-DGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac output measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93561","description":"Cardiac output measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEB0","description":"ICD-ODEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ single analyte_ quantitative_ single st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82543","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ single analyte_ quantitative_ single st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2101","description":"HCPCS-B2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55869","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","description":"CPT-55869","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision orbitofacial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21275","description":"Revision orbitofacial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alt long-term cntrl med rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4144F","description":"Alt long-term cntrl med rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brca1&2 seq & full dup/del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81162","description":"Brca1&2 seq & full dup/del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMD0","description":"ICD-BBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Positron emission tomography radiopharmaceutical_ diagnostic_ for tumor identification_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9597","description":"Positron emission tomography radiopharmaceutical_ diagnostic_ for tumor identification_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC31","description":"Medium Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPF1","description":"ICD-GDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITC1","description":"ICD-NITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3D","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX06","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Advanced life support mileag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0390","description":"Advanced life support mileag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMF0","description":"ICD-CGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28B","description":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDA0","description":"ICD-ODDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWD0","description":"ICD-DFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric suction pump hme mdl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2000","description":"Gastric suction pump hme mdl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQE1","description":"ICD-DAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impr med time edarr pain med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9426","description":"Impr med time edarr pain med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDD1","description":"ICD-CIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lurbinectedin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9223","description":"Injection_ lurbinectedin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocyte transformation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86353","description":"Lymphocyte transformation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ paliperidone palmitate extended release (invega hafyera_ or invega trinza)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2427","description":"Injection_ paliperidone palmitate extended release (invega hafyera_ or invega trinza)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOD0","description":"ICD-OBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYA1","description":"ICD-OEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGC1","description":"ICD-OEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMB0","description":"ICD-AEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAC0","description":"ICD-GBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGB1","description":"ICD-FIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22B","description":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFD1","description":"ICD-CAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSA0","description":"ICD-LFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWE0","description":"ICD-KBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cerclage suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59871","description":"Remove cerclage suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPC1","description":"ICD-NKPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPA1","description":"ICD-BAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBME1","description":"ICD-OBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical food oral 100% nutr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9433","description":"Medical food oral 100% nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVD0","description":"ICD-FFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDF0","description":"ICD-CEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFE1","description":"ICD-JAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g._ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9776","description":"Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g._ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGA0","description":"ICD-CHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood culture for bacteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87040","description":"Blood culture for bacteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chct for mal hyperthermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89049","description":"Chct for mal hyperthermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep c genotype prior to med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9207","description":"Hep c genotype prior to med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHF0","description":"ICD-JHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA31","description":"ICD-3LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLF0","description":"ICD-ICLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clin depres scrn no f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8511","description":"Clin depres scrn no f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA246","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 50-100","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88248","description":"Chromosome analysis 50-100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18I","description":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81301","description":"Microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33241","description":"Remove pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28760","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66160","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHA1","description":"ICD-JIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVF1","description":"ICD-NCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQE0","description":"ICD-PFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTF1","description":"ICD-NCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPB1","description":"ICD-GFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 1 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64490","description":"Inj paravert f jnt c/t 1 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDA0","description":"ICD-MEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUE0","description":"ICD-BBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occlusive device in vein art","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0269","description":"Occlusive device in vein art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFB1","description":"ICD-BFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove middle ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69676","description":"Remove middle ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHB0","description":"ICD-OHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Saliva test_ hormone level;","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3650","description":"Saliva test_ hormone level;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOC0","description":"ICD-KIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74246","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation_ including imaging guidance (eg_ ultrasound and/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7549","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation_ including imaging guidance (eg_ ultrasound and/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOD1","description":"ICD-DAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIE0","description":"ICD-CCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0C","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHC1","description":"ICD-FCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pin radioulnar dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25671","description":"Pin radioulnar dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAD0","description":"ICD-KEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjustment of custom sleep apnea appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9948","description":"Adjustment of custom sleep apnea appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj biperiden lactate/5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0190","description":"Inj biperiden lactate/5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEF1","description":"ICD-NAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX20","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB212","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRA0","description":"ICD-OLRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC256","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx of cervix w/scope leep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57460","description":"Bx of cervix w/scope leep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDC1","description":"ICD-KCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lowr extremity prosthes nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5999","description":"Lowr extremity prosthes nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smallpox and monkeypox vaccine_ attenuated vaccinia virus_ live_ non-replicating_ preservative free_ 0.5 mL dosage_ suspension_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90611","description":"Smallpox and monkeypox vaccine_ attenuated vaccinia virus_ live_ non-replicating_ preservative free_ 0.5 mL dosage_ suspension_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQD0","description":"ICD-HHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak 4 bar ling w/hydraul swig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5613","description":"Ak 4 bar ling w/hydraul swig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8I","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit routine device maint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5035","description":"Hit routine device maint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fludeoxyglucose f18 up to 15 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9609","description":"Fludeoxyglucose f18 up to 15 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEA0","description":"ICD-OLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O2 saturation >88%/pao>55 hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3037F","description":"O2 saturation >88%/pao>55 hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13B","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hernia repair w/mesh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49568","description":"Hernia repair w/mesh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Janssen Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1712","description":"Janssen Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fem/popl revasc stnt & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37227","description":"Fem/popl revasc stnt & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Local anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9215","description":"Local anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBED1","description":"ICD-IBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phys blood bank serv xmatch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86077","description":"Phys blood bank serv xmatch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDB0","description":"ICD-CHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVE0","description":"ICD-BHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNE0","description":"ICD-CBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGD1","description":"ICD-JBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc harness_ expand control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2313","description":"Pwc harness_ expand control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx platelet plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0232T","description":"Njx platelet plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPF1","description":"ICD-NCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFF1","description":"ICD-KBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","description":"HCPCS-J0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC15","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDE1","description":"ICD-ABDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES260","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYB0","description":"ICD-PIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18C","description":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow_ report of clinically s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0331U","description":"Oncology (hematolymphoid neoplasia)_ optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow_ report of clinically s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARF1","description":"ICD-CARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10121","description":"Remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of externally accessible nephroureteral catheter (eg_ external/internal stent) requiring fluoroscopic guidance_ with ureteral stricture balloon dilatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7546","description":"Removal and replacement of externally accessible nephroureteral catheter (eg_ external/internal stent) requiring fluoroscopic guidance_ with ureteral stricture balloon dilatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQA0","description":"ICD-CEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC16","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal hemoglobin assay qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83033","description":"Fetal hemoglobin assay qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBD1","description":"ICD-IHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sternal debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21627","description":"Sternal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPE0","description":"ICD-GCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOE0","description":"ICD-DHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whlchr stand fxd arm ft rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1130","description":"Whlchr stand fxd arm ft rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00160","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","description":"CPT-00160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ewho rigid w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3763","description":"Ewho rigid w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE224","description":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRF0","description":"ICD-DBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWE0","description":"ICD-PCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQE0","description":"ICD-HFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dissolve clot heart vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92977","description":"Dissolve clot heart vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE213","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correct skn color 6.1-20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11921","description":"Correct skn color 6.1-20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct interprete man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0365","description":"Cone beam ct interprete man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fall plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0518F","description":"Fall plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54340","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD212","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTF0","description":"ICD-JGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fld ped wc adjstabl w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1238","description":"Fld ped wc adjstabl w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYC1","description":"ICD-DHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGC0","description":"ICD-OEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILA0","description":"ICD-NILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmptr ophth dx img ant segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92132","description":"Cmptr ophth dx img ant segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDF1","description":"ICD-KFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD235","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJA1","description":"ICD-NCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGE0","description":"ICD-BEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adlt disp und/pull on abv xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4544","description":"Adlt disp und/pull on abv xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC234","description":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No 7d f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9407","description":"No 7d f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0805","description":"HCPCS-A0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKD0","description":"ICD-GCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWD0","description":"ICD-CGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47554","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92312","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise tendon(s) & muscle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23406","description":"Incise tendon(s) & muscle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC31","description":"ICD-1LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of tibia epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27730","description":"Repair of tibia epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64555","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWE1","description":"ICD-HBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBED1","description":"ICD-FBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYD0","description":"ICD-CAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50660","description":"Removal of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Long tongue stirrup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2265","description":"Long tongue stirrup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary rehab rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4033F","description":"Pulmonary rehab rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx cml chronic phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9123","description":"Onc dx cml chronic phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYF1","description":"ICD-PHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOF0","description":"ICD-HBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ex for speech device rx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92608","description":"Ex for speech device rx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temozolomide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9328","description":"Temozolomide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88147","description":"Cytopath c/v automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIA0","description":"ICD-MHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPD0","description":"ICD-OLPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood glucose/reagent strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4253","description":"Blood glucose/reagent strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe metatarsal bar between","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3410","description":"Shoe metatarsal bar between","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGF1","description":"ICD-CBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIF0","description":"ICD-CAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24800","description":"Fusion of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skilled services of a registered nurse (RN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0495","description":"Skilled services of a registered nurse (RN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRB1","description":"ICD-OLRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No life asst 2x same/decr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9636","description":"No life asst 2x same/decr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUD1","description":"ICD-GDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27087","description":"Remove hip foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"remove broken implant retaining screw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6096","description":"remove broken implant retaining screw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITD1","description":"ICD-AITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKE0","description":"ICD-FHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFE1","description":"ICD-OCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATF0","description":"ICD-NATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC216","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thyrotropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3240","description":"Thyrotropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADD0","description":"ICD-OADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAA0","description":"ICD-ICAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQE1","description":"ICD-OLQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITF0","description":"ICD-BITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mopath procedure level 9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81408","description":"Mopath procedure level 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alginate drsg >16 <=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6197","description":"Alginate drsg >16 <=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Second level cer diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22858","description":"Second level cer diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27000","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2042","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","description":"HCPCS-A2042","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13131","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAB1","description":"ICD-KBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBB0","description":"ICD-MLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBA1","description":"ICD-AFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWB0","description":"ICD-LIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61891","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBE0","description":"ICD-NDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No follow up pulm nod norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9347","description":"No follow up pulm nod norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQD1","description":"ICD-DDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWB1","description":"ICD-PEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33120","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMA0","description":"ICD-GCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTB1","description":"ICD-KHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20A","description":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIB1","description":"ICD-NDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9312","description":"Injection_ rituximab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNE0","description":"ICD-NDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAF0","description":"ICD-NIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronidase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3470","description":"Hyaluronidase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUC1","description":"ICD-KBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPB0","description":"ICD-FAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each additional single probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0852T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each additional single probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable sensor_ cgm sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9276","description":"Disposable sensor_ cgm sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPF1","description":"ICD-BAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLB0","description":"ICD-MFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECB0","description":"ICD-MECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0667","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","description":"HCPCS-G0667","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVA1","description":"ICD-NDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33364","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clofarabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9027","description":"Clofarabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBB0","description":"ICD-ABBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRA0","description":"ICD-GFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDND1","description":"ICD-KDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPB1","description":"ICD-NIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive brief counseling if identified as an unhealthy alcohol user_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2202","description":"Patient did not receive brief counseling if identified as an unhealthy alcohol user_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJD0","description":"ICD-NJJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJF1","description":"ICD-GBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ face-to-face with multiple patients_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97158","description":"Group adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ face-to-face with multiple patients_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast add us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19286","description":"Perq dev breast add us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66920","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARA0","description":"ICD-GARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXE0","description":"ICD-NKXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTD1","description":"ICD-IHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMC0","description":"ICD-KBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMB1","description":"ICD-JGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stereoisomer analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80374","description":"Stereoisomer analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITF0","description":"ICD-CITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTF1","description":"ICD-FBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intrvasc us noncoronary 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37252","description":"Intrvasc us noncoronary 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUF1","description":"ICD-BCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJD0","description":"ICD-JFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99214","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECD1","description":"ICD-BECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHE0","description":"ICD-OHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPD0","description":"ICD-BDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antibody detection nos if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87299","description":"Antibody detection nos if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28406","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNF1","description":"ICD-OFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-medical Transportation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6110","description":"Non-medical Transportation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML53","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75825","description":"Vein x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDE1","description":"ICD-NBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIC1","description":"ICD-ADIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIE0","description":"ICD-IFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cortisol free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82530","description":"Cortisol free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIC0","description":"ICD-BIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp carotid-vertebral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35642","description":"Art byp carotid-vertebral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28I","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRF0","description":"ICD-LDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9903","description":"Patient screened for tobacco use and identified as a tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5943","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5943","description":"CDT-D5943","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of face wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15828","description":"Removal of face wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral prescrip drug non chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8499","description":"Oral prescrip drug non chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMD1","description":"ICD-JIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHA1","description":"ICD-ACHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-jmdb_ biosimilar_ (Fulphila)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5108","description":"Injection_ pegfilgrastim-jmdb_ biosimilar_ (Fulphila)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWE0","description":"ICD-PBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEE0","description":"ICD-KHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multiple surgery abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49220","description":"Multiple surgery abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML02","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOC1","description":"ICD-GGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13B","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJF1","description":"ICD-CGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWA1","description":"ICD-HHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWB0","description":"ICD-OGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJB0","description":"ICD-ODJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTA1","description":"ICD-GHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cannabinoids synthetic 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80350","description":"Cannabinoids synthetic 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMB1","description":"ICD-FDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatric service/therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90899","description":"Psychiatric service/therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEC0","description":"ICD-FFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61304","description":"Open skull for exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rsv mab im 50mg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90378","description":"Rsv mab im 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXA0","description":"ICD-NBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67515","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEB0","description":"ICD-MKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esw wound healing addl wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0300T","description":"Esw wound healing addl wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26432","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBD1","description":"ICD-MEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQD0","description":"ICD-HEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGF0","description":"ICD-KGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIB1","description":"ICD-GFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEE1","description":"ICD-KBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIF0","description":"ICD-BAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1001","description":"Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKA0","description":"ICD-FEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brief alcohol misuse counsel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0443","description":"Brief alcohol misuse counsel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMF1","description":"ICD-MIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost skn barr convex <=4 sq i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4409","description":"Ost skn barr convex <=4 sq i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25B","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDD1","description":"ICD-MLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0559","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","description":"HCPCS-G0559","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAA0","description":"ICD-FBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUB0","description":"ICD-EDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9186","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9186","description":"HCPCS-J9186","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA21","description":"ICD-1HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXA0","description":"ICD-OKXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPB0","description":"ICD-BIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFA0","description":"ICD-NJFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transferase (ast) (sgot)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84450","description":"Transferase (ast) (sgot)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hdr elctrnc skn surf brchytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0394T","description":"Hdr elctrnc skn surf brchytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFA1","description":"ICD-KBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHC0","description":"ICD-JEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Sublocade)_ less than or equal to 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9991","description":"Injection_ buprenorphine extended-release (Sublocade)_ less than or equal to 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA05","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMA0","description":"ICD-FDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWD1","description":"ICD-KCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ melphalan flufenamide hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9080","description":"Injection_ melphalan flufenamide hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0564","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0564","description":"HCPCS-G0564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol hepatic fream","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5200","description":"Parenteral sol hepatic fream","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5251","description":"Hearing aid_ prog_ bin_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0106","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0106","description":"CDT-D0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUC1","description":"ICD-OBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thrombolytic venous therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37212","description":"Thrombolytic venous therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUC0","description":"ICD-ADUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRC1","description":"ICD-KDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDF1","description":"ICD-JCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWD1","description":"ICD-OHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC151","description":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGF0","description":"ICD-JDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB255","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYE0","description":"ICD-OHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYB0","description":"ICD-KBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYB1","description":"ICD-CFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRF1","description":"ICD-HIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTB0","description":"ICD-CGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLA0","description":"ICD-IGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allergen specific IgE; quantitative or semiquantitative_ recombinant or purified component_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86008","description":"Allergen specific IgE; quantitative or semiquantitative_ recombinant or purified component_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVE0","description":"ICD-OEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHB0","description":"ICD-MLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 1 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90381","description":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 1 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLE0","description":"ICD-AFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extrnl beam other than prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4201F","description":"Extrnl beam other than prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPB0","description":"ICD-CDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep renal graft/arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50328","description":"Prep renal graft/arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBB0","description":"ICD-FIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professiona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93792","description":"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epinephrine (belcher) not therapeutically equivalent to j0171_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0173","description":"Injection_ epinephrine (belcher) not therapeutically equivalent to j0171_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOD0","description":"ICD-GCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHD0","description":"ICD-EAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-81515","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","description":"CPT-81515","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACA1","description":"ICD-BACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJC1","description":"ICD-JAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYF1","description":"ICD-GBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prefabricated abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6056","description":"Prefabricated abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRF0","description":"ICD-HHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOD0","description":"ICD-DCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0561U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","description":"CPT-0561U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBD1","description":"ICD-MBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCD1","description":"ICD-IHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound prep addl 100 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15003","description":"Wound prep addl 100 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXA1","description":"ICD-FDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGE1","description":"ICD-OJGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRB0","description":"ICD-CDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10A","description":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid propulsion tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2220","description":"Solid propulsion tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot </4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64890","description":"Nerve graft hand/foot </4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29830","description":"Elbow arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWC1","description":"ICD-GGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTA1","description":"ICD-OCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPF1","description":"ICD-CGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAE1","description":"ICD-IFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8000","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8000","description":"HCPCS-C8000","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMD1","description":"ICD-GAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94762","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPC0","description":"ICD-CCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSC0","description":"ICD-HFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIA1","description":"ICD-IAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTC1","description":"ICD-AGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA60","description":"Low Rehab_ ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spkt/v greater than or equal to 1. 2 (single-pool clearance of urea [kt] / volume [v])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8713","description":"Spkt/v greater than or equal to 1. 2 (single-pool clearance of urea [kt] / volume [v])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXC1","description":"ICD-OGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54699","description":"Laparoscope proc testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOE1","description":"ICD-GHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker variable wheel resist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0147","description":"Walker variable wheel resist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB44","description":"Medium Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2B","description":"Ultra High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scalp cooling_ mechanical; initial measurement and calibration of cap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0662T","description":"Scalp cooling_ mechanical; initial measurement and calibration of cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLC0","description":"ICD-OJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKA0","description":"ICD-OEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Testicular imaging w/flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78761","description":"Testicular imaging w/flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKB0","description":"ICD-KDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEA1","description":"ICD-NAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special radiation dosimetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77331","description":"Special radiation dosimetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0234","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","description":"HCPCS-M0234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental film skull/facial bon","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0290","description":"Dental film skull/facial bon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBE1","description":"ICD-KHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJB1","description":"ICD-FFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluid pressure muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20950","description":"Fluid pressure muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMC1","description":"ICD-FGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBF1","description":"ICD-AHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQC0","description":"ICD-OKQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIF0","description":"ICD-OKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTE1","description":"ICD-EFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ventilating tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69424","description":"Remove ventilating tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAA0","description":"ICD-ADAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19350","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEB0","description":"ICD-KFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace ureter by bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50840","description":"Replace ureter by bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA117","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIC0","description":"ICD-KFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative screen metals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83018","description":"Quantitative screen metals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert palate implants","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9727","description":"Insert palate implants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periodontal scaling 1-3teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4342","description":"Periodontal scaling 1-3teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQD1","description":"ICD-LDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWC0","description":"ICD-KBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBF0","description":"ICD-NGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc (ovarian) biocheml assays of five proteins (apolipoprotein A-1_ CA 125 II_ follicle stimulating hormone_ human epididymis protein 4_ transferrin)_ utilizing serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003U","description":"Onc (ovarian) biocheml assays of five proteins (apolipoprotein A-1_ CA 125 II_ follicle stimulating hormone_ human epididymis protein 4_ transferrin)_ utilizing serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDF1","description":"ICD-EGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; initial electrode arra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64596","description":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; initial electrode arra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Desipramine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6032","description":"Desipramine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m bicisate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9557","description":"Tc99m bicisate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFB0","description":"ICD-CAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3D","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; by instrument chemistry analyzers (eg_ utilizing immunoassay [eg_ EIA_ ELISA_ EMIT_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80307","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; by instrument chemistry analyzers (eg_ utilizing immunoassay [eg_ EIA_ ELISA_ EMIT_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1107","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below knee suction socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5647","description":"Below knee suction socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCB1","description":"ICD-JCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFD0","description":"ICD-KFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGD1","description":"ICD-OKGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUC1","description":"ICD-MEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE110","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNE1","description":"ICD-BDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBA0","description":"ICD-OEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMF1","description":"ICD-OLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25B","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"D & c after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59160","description":"D & c after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rn services up to 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1002","description":"Rn services up to 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAA0","description":"ICD-NBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special eye exam initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92225","description":"Special eye exam initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSE1","description":"ICD-DHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDB0","description":"ICD-MLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28A","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23C","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA17","description":"Default_ /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Porcelain/ceramic inlay 2srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6600","description":"Porcelain/ceramic inlay 2srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKE1","description":"ICD-KIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise sublingual gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42450","description":"Excise sublingual gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4351","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","description":"HCPCS-Q4351","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postsurgical obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5932","description":"Postsurgical obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPB1","description":"ICD-BIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC241","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTF1","description":"ICD-MBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGE1","description":"ICD-FHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTA0","description":"ICD-CDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ire abltj 1+tum organ perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0600T","description":"Ire abltj 1+tum organ perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0442T","description":"Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg cerebral death only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95824","description":"Eeg cerebral death only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFD1","description":"ICD-BGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99374","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thiopurine S-methyltransferase (TPMT)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84433","description":"Thiopurine S-methyltransferase (TPMT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAID1","description":"ICD-KAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPF0","description":"ICD-CEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of residual cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57540","description":"Removal of residual cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTD0","description":"ICD-ABTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96202","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28666","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sirolimus_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7520","description":"Sirolimus_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"One-way allow prorated trip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9604","description":"One-way allow prorated trip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD260","description":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC11","description":"ICD-3EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ carfilzomib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9047","description":"Injection_ carfilzomib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAD1","description":"ICD-NGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOB0","description":"ICD-DBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPA0","description":"ICD-BIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA224","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sc ther infusion reset pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96371","description":"Sc ther infusion reset pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair wide w/ foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1093","description":"Wheelchair wide w/ foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBF1","description":"ICD-MCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUA1","description":"ICD-KEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB250","description":"Special Care High _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYE1","description":"ICD-PBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/2.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2208","description":"Lens sphcy bifocal 4.25-7/2.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61684","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0217T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20979","description":"Us bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUC1","description":"ICD-BGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPD0","description":"ICD-BBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0503T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNE0","description":"ICD-BDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18E","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGF0","description":"ICD-ODGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX02","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0150U","description":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA244","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNF0","description":"ICD-NKNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJB1","description":"ICD-JGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tamoxifen/ai prescribed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4179F","description":"Tamoxifen/ai prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMB1","description":"ICD-GHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITD0","description":"ICD-GITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (bluepoint) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9322","description":"Injection_ pemetrexed (bluepoint) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXC0","description":"ICD-CBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSB0","description":"ICD-LDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIE1","description":"ICD-OGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJB1","description":"ICD-NIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWA1","description":"ICD-KFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPC0","description":"ICD-JCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18B","description":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam establish patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92012","description":"Eye exam establish patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23605","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0461","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0461","description":"CDT-D0461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iloprost non-comp unit dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4074","description":"Iloprost non-comp unit dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQA0","description":"ICD-DDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0538","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","description":"HCPCS-G0538","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27702","description":"Reconstruct ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Expired gas collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94250","description":"Expired gas collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQB1","description":"ICD-CDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep c rna 4to12 wk after med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9209","description":"Hep c rna 4to12 wk after med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap rmvl gastr adj all parts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43774","description":"Lap rmvl gastr adj all parts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBC0","description":"ICD-BIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5D","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC226","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHF1","description":"ICD-EDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDD1","description":"ICD-MGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical procedures that included the use of silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9756","description":"Surgical procedures that included the use of silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBC0","description":"ICD-CBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJB0","description":"ICD-BEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUA1","description":"ICD-MJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUE0","description":"ICD-FCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18A","description":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove radius bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24136","description":"Remove radius bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19125","description":"Excision breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENE0","description":"ICD-NENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFB1","description":"ICD-NEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRC0","description":"ICD-HIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC50","description":"Ultra High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAB0","description":"ICD-CFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNC1","description":"ICD-JFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMA0","description":"ICD-OLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Instillation_ Bupivacaine And Meloxicam_ 1 Mg/0.03 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9088","description":"Instillation_ Bupivacaine And Meloxicam_ 1 Mg/0.03 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJA1","description":"ICD-FHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEA1","description":"ICD-BFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Copd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8757","description":"Copd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lev 1 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0380","description":"Lev 1 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13B","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analyze neurostim simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95971","description":"Analyze neurostim simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHA0","description":"ICD-MCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cva device obstruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75901","description":"Remove cva device obstruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEA1","description":"ICD-KCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFF0","description":"ICD-BEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQC0","description":"ICD-LBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Did Not Receive Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2159","description":"Patient Did Not Receive Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70482","description":"Ct orbit/ear/fossa w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Athletic train eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97005","description":"Athletic train eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL30","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADF0","description":"ICD-GADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker crutch attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0157","description":"Walker crutch attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKE0","description":"ICD-KHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28490","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC50","description":"High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJC0","description":"ICD-JAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIE0","description":"ICD-BEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hfo flexion glove pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3912","description":"Hfo flexion glove pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKD1","description":"ICD-FDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIA0","description":"ICD-ECIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKE1","description":"ICD-FHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHB0","description":"ICD-GFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQA0","description":"ICD-PHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRC1","description":"ICD-OHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGB1","description":"ICD-NGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFED1","description":"ICD-GFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLF0","description":"ICD-CBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLF0","description":"ICD-GBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intrinsic factor antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86340","description":"Intrinsic factor antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJD1","description":"ICD-FEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHC0","description":"ICD-GFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism persivia clinical decision support_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1023","description":"Clinical decision support mechanism persivia clinical decision support_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBC1","description":"ICD-OGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25924","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41105","description":"Biopsy of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYF1","description":"ICD-LIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27654","description":"Repair of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYC1","description":"ICD-PKYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVD1","description":"ICD-OBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJE1","description":"ICD-GBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive prostate cancer estimation map_ derived from augmentative analysis of image-guided fusion biopsy and pathology_ including visualization of margin volume and locati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0898T","description":"Noninvasive prostate cancer estimation map_ derived from augmentative analysis of image-guided fusion biopsy and pathology_ including visualization of margin volume and locati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visc & infraren abd 1 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34845","description":"Visc & infraren abd 1 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAC0","description":"ICD-MIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla i & ii typing lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81370","description":"Hla i & ii typing lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sp bone algrft struct add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20931","description":"Sp bone algrft struct add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTA1","description":"ICD-JHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interdiscal perq aspir dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62267","description":"Interdiscal perq aspir dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB205","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUA1","description":"ICD-IGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syst bp >/= 140 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3077F","description":"Syst bp >/= 140 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVB0","description":"ICD-NCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSD1","description":"ICD-HHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44950","description":"Appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABB1","description":"ICD-KABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLD0","description":"ICD-MBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig for ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8561","description":"Pt inelig for ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject l ventr/atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93565","description":"Inject l ventr/atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOD1","description":"ICD-GDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24126","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"repair resin partial denture base_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5611","description":"repair resin partial denture base_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1701","description":"HCPCS-A1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICD0","description":"ICD-OICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ plasminogen_ human-tvmh_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2998","description":"Injection_ plasminogen_ human-tvmh_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ground mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0425","description":"Ground mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXE1","description":"ICD-ODXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNA0","description":"ICD-JDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQA1","description":"ICD-DGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLE0","description":"ICD-OKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXB0","description":"ICD-CBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx beta-lactam abx therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9558","description":"Tx beta-lactam abx therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dihydrotestosterone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6047","description":"Dihydrotestosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 50MCG/0.25MLBST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0064A","description":"ADM SARSCOV2 50MCG/0.25MLBST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients With Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2151","description":"Patients With Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis be antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86707","description":"Hepatitis be antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIB1","description":"ICD-JAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1456","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","description":"HCPCS-M1456","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAC1","description":"ICD-OFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14B","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home vent non-invasive inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0466","description":"Home vent non-invasive inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42225","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Protein c concentrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2724","description":"Protein c concentrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUE1","description":"ICD-MEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumo imm status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1022F","description":"Pneumo imm status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASB0","description":"ICD-PASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHD0","description":"ICD-GBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFA1","description":"ICD-JGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPD0","description":"ICD-NJPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald transmitter microphone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5290","description":"Ald transmitter microphone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIA0","description":"ICD-IBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg2 no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9064","description":"Onc dx nsclc stg2 no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB30","description":"Ultra High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE150","description":"Reduced Physical Function _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWC0","description":"ICD-DCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma plan of care not documented_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1222","description":"Glaucoma plan of care not documented_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDF0","description":"ICD-JDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pure tone hearing test air","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92551","description":"Pure tone hearing test air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj arthroscopy lysis adhesn","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7873","description":"Tmj arthroscopy lysis adhesn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37254","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","description":"CPT-37254","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWC1","description":"ICD-KIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMD0","description":"ICD-JFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAE0","description":"ICD-BDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBE1","description":"ICD-NHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28D","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCC1","description":"ICD-MGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJF0","description":"ICD-BCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEB1","description":"ICD-BBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJF0","description":"ICD-OBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUB1","description":"ICD-MDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEC0","description":"ICD-MBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUF0","description":"ICD-IHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo supramalleolar custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1907","description":"Afo supramalleolar custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No interv req for leak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9305","description":"No interv req for leak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine SCmethyltransferase) (eg drug metabolism) gene analysis common variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0169U","description":"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine SCmethyltransferase) (eg drug metabolism) gene analysis common variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKB1","description":"ICD-KFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXD0","description":"ICD-JDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFND0","description":"ICD-FFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGME0","description":"ICD-NGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit int pain per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9327","description":"Hit int pain per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0678T","description":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc t cabg s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9604","description":"Perc d-e cor revasc t cabg s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOC0","description":"ICD-DEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of finger abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26011","description":"Drainage of finger abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMB1","description":"ICD-ECMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1938","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","description":"HCPCS-J1938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMF0","description":"ICD-MFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKF1","description":"ICD-CHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amiodarone hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0282","description":"Amiodarone hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEF1","description":"ICD-GHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGF1","description":"ICD-KHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cervical traction equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0855","description":"Cervical traction equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0406T","description":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNF1","description":"ICD-OBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special childcare waiver/d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2026","description":"Special childcare waiver/d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBE1","description":"ICD-IIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXC1","description":"ICD-OKXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28E","description":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Certified nurse midwife mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0064","description":"Certified nurse midwife mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genome","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9032","description":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of spleen total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38100","description":"Removal of spleen total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLD0","description":"ICD-CDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOA1","description":"ICD-HDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXE0","description":"ICD-FIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prp i/hern init reduc >5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49505","description":"Prp i/hern init reduc >5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOB1","description":"ICD-CEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDF0","description":"ICD-GBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38724","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKED0","description":"ICD-MKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHA1","description":"ICD-CEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIA1","description":"ICD-ADIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluorodopa f-18_ diagnostic_ per mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9602","description":"Fluorodopa f-18_ diagnostic_ per mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9173","description":"HCPCS-C9173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self-care ed provided to pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4450F","description":"Self-care ed provided to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKF0","description":"ICD-KAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJF1","description":"ICD-BBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermacyte Amniotic Membrane Allograft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4248","description":"Dermacyte Amniotic Membrane Allograft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDB0","description":"ICD-GDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOA1","description":"ICD-PFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUA0","description":"ICD-NJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom fab w/c back cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2617","description":"Custom fab w/c back cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBC0","description":"ICD-ABBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB31","description":"ICD-1KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Refused To Participate At Admission And/Or Discharge; Patient Unable To Complete The Neck Fs Prom At Admission Or Discharge Due To Cognitive Deficit_ Visual Deficit_ M","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2166","description":"Patient Refused To Participate At Admission And/Or Discharge; Patient Unable To Complete The Neck Fs Prom At Admission Or Discharge Due To Cognitive Deficit_ Visual Deficit_ M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAF1","description":"ICD-MIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lubricant per ounce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4402","description":"Lubricant per ounce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB106","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Specimen site not prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8798","description":"Specimen site not prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debridement_ bone (includes epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed); first 20 sq cm or less with manual preparation and insertion of drug-d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7561","description":"Debridement_ bone (includes epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed); first 20 sq cm or less with manual preparation and insertion of drug-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHB0","description":"ICD-KCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5212","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ torso and shoulder_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6568","description":"Gradient compression garment_ torso and shoulder_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHC1","description":"ICD-NFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect neck thorax tumor<5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21557","description":"Resect neck thorax tumor<5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUC0","description":"ICD-GAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFA0","description":"ICD-BDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54505","description":"Biopsy of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen class list a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80301","description":"Drug screen class list a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKE0","description":"ICD-NCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTD1","description":"ICD-AGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology hrt trnspl mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81595","description":"Cardiology hrt trnspl mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm receiver_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5287","description":"Ald fm/dm receiver_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIF1","description":"ICD-JAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBA0","description":"ICD-ACBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25690","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALD0","description":"ICD-JALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD136","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMC0","description":"ICD-OAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFF0","description":"ICD-FEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJB0","description":"ICD-FGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cbt 1st hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94644","description":"Cbt 1st hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ glove_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6520","description":"Gradient compression garment_ glove_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILB1","description":"ICD-NILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRA1","description":"ICD-LIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1404","description":"HCPCS-B1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQE1","description":"ICD-DFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPD1","description":"ICD-BHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADC1","description":"ICD-EADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21C","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCD1","description":"ICD-NFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTA1","description":"ICD-OGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHC1","description":"ICD-MFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for ankle x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27648","description":"Injection for ankle x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESE0","description":"ICD-DESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNF1","description":"ICD-KFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHA0","description":"ICD-JHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESC1","description":"ICD-LESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAF1","description":"ICD-ICAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDF1","description":"ICD-KGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit blood products diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9538","description":"Hit blood products diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sedative hypnotics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80368","description":"Sedative hypnotics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUF1","description":"ICD-MJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NPM1 (nucleophosmin) (eg_ acute myeloid leukemia) gene analysis_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0049U","description":"NPM1 (nucleophosmin) (eg_ acute myeloid leukemia) gene analysis_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNB1","description":"ICD-BHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOF1","description":"ICD-DEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKME0","description":"ICD-NKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKB0","description":"ICD-OEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mod solid food suppl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9434","description":"Mod solid food suppl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLC1","description":"ICD-MBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc first line amox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9315","description":"Doc first line amox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rad resect hand tumor < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26117","description":"Rad resect hand tumor < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt talk eval hlthwkr re mdd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2060F","description":"Pt talk eval hlthwkr re mdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evasc prlng admn rx agnt 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61650","description":"Evasc prlng admn rx agnt 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECD1","description":"ICD-AECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETE0","description":"ICD-FETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ coronary venous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1900","description":"Lead_ coronary venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMA1","description":"ICD-IBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDF0","description":"ICD-GFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJA0","description":"ICD-OGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDA1","description":"ICD-AEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel new rubber standar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3460","description":"Shoe heel new rubber standar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCB1","description":"ICD-CHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQB0","description":"ICD-OLQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDC0","description":"ICD-FBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHE1","description":"ICD-KEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arm tendon lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24305","description":"Arm tendon lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81258","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA21","description":"High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4359","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","description":"HCPCS-Q4359","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRA1","description":"ICD-PDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC21","description":"ICD-1HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGME0","description":"ICD-GGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLA0","description":"ICD-AFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1802","description":"HCPCS-A1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perphenazine injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3310","description":"Perphenazine injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0C","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLD0","description":"ICD-OHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXD0","description":"ICD-CEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINF1","description":"ICD-GINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAF1","description":"ICD-GGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cesarean delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59515","description":"Cesarean delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGF1","description":"ICD-CEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4479","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","description":"HCPCS-A4479","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aicd_ single chamber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1722","description":"Aicd_ single chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10D","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEF1","description":"ICD-KHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC201","description":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2209","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carecoordination prenatal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1002","description":"Carecoordination prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALF0","description":"ICD-MALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sho insert w arch toe filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5000","description":"Sho insert w arch toe filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGA1","description":"ICD-JFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport wheelch van","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0130","description":"Noner transport wheelch van","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXB1","description":"ICD-JAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOF1","description":"ICD-KBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNC1","description":"ICD-OBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPE0","description":"ICD-JGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB21","description":"ICD-1LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGB1","description":"ICD-KAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Card tamp w/in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9408","description":"Card tamp w/in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC31","description":"ICD-1DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glucagon hydrochloride (fresenius kabi)_ not therapeutically equivalent to j1610_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1611","description":"Injection_ glucagon hydrochloride (fresenius kabi)_ not therapeutically equivalent to j1610_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDC1","description":"ICD-BFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWC1","description":"ICD-PBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJA1","description":"ICD-JGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene major bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81206","description":"Bcr/abl1 gene major bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supp maint employ_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2025","description":"Supp maint employ_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9764","description":"Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8B","description":"Very High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin most rapid 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5551","description":"Insulin most rapid 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular blood flow measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0198T","description":"Ocular blood flow measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCB0","description":"ICD-BCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAC1","description":"ICD-GCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNF1","description":"ICD-NCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARB0","description":"ICD-DARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Not initial eval for cond","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1501F","description":"Not initial eval for cond","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJA1","description":"ICD-BEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brca2 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81217","description":"Brca2 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of knee 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73562","description":"X-ray exam of knee 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24560","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8C","description":"Medium Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt has symp&signs neuropathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3753F","description":"Pt has symp&signs neuropathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHA1","description":"ICD-JDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEA0","description":"ICD-NKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74290","description":"Contrast x-ray gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gerd symps assessed 12 month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1118F","description":"Gerd symps assessed 12 month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXD1","description":"ICD-KBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture aerobic quant other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87071","description":"Culture aerobic quant other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELA1","description":"ICD-BELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid met imaging body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78018","description":"Thyroid met imaging body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHF0","description":"ICD-EEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fertility cycle (contraception & conception) tracking software application_ fda cleared_ per month_ includes accessories (e.g._ thermometer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9293","description":"Fertility cycle (contraception & conception) tracking software application_ fda cleared_ per month_ includes accessories (e.g._ thermometer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEC0","description":"ICD-MFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1)_ serum_ reported as positive or negative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0059U","description":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1)_ serum_ reported as positive or negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41006","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage abdom abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49020","description":"Drainage abdom abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical place mini implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6013","description":"Surgical place mini implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRA1","description":"ICD-OFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLC0","description":"ICD-NFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27227","description":"Treat hip fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVC1","description":"ICD-FIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1027T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1027T","description":"CPT-1027T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonpneumatic compression controller with sequential calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1024","description":"Nonpneumatic compression controller with sequential calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx pancreatc p r1/r2 no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9106","description":"Onc dx pancreatc p r1/r2 no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Betadine/iodine swabs/wipes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4247","description":"Betadine/iodine swabs/wipes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg) Continuous Recording_ With Video When Performed_ Setup_ Patient Education_ And Takedown When Performed_ Administered In Person By Eeg Technologist_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95700","description":"Electroencephalogram (Eeg) Continuous Recording_ With Video When Performed_ Setup_ Patient Education_ And Takedown When Performed_ Administered In Person By Eeg Technologist_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUE1","description":"ICD-FGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace chst cmprss sys hose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7026","description":"Replace chst cmprss sys hose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWA0","description":"ICD-LBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPD1","description":"ICD-CHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKA0","description":"ICD-CBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct scan for needle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77012","description":"Ct scan for needle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 5-10 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99421","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 5-10 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59857","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43410","description":"Repair esophagus wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSD0","description":"ICD-CHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert xdrl body thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63301","description":"Remove vert xdrl body thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srs spinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63620","description":"Srs spinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINB1","description":"ICD-FINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOC1","description":"ICD-CHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28X","description":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat dental ridge fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21440","description":"Treat dental ridge fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAB1","description":"ICD-KAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWE1","description":"ICD-OBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64469","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","description":"CPT-64469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg cast chg elb dis/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6382","description":"Postop dsg cast chg elb dis/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXD1","description":"ICD-CFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOA0","description":"ICD-OAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPE0","description":"ICD-JCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTF1","description":"ICD-NLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBC1","description":"ICD-OCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteochondral knee allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27415","description":"Osteochondral knee allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise spinal cord ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63182","description":"Revise spinal cord ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of foot tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28222","description":"Release of foot tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIB0","description":"ICD-NBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA55","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWF0","description":"ICD-DBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMF0","description":"ICD-JDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLE0","description":"ICD-NLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0636U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0636U","description":"CPT-0636U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOB0","description":"ICD-HHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFF1","description":"ICD-BBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acesso AC_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4312","description":"Acesso AC_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","description":"HCPCS-J3403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental prophylaxis child","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1120","description":"Dental prophylaxis child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Musc tst done w/n tst nonext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95887","description":"Musc tst done w/n tst nonext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dynamic surface emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96002","description":"Dynamic surface emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18I","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIE0","description":"ICD-FAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOA0","description":"ICD-LBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMF1","description":"ICD-ICMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resin retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6549","description":"Resin retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLB0","description":"ICD-JCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mech remov tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36595","description":"Mech remov tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted maaa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81599","description":"Unlisted maaa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44382","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWF0","description":"ICD-GEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autologous Platelet Rich Plasma (Prp) For Diabetic Chronic Wounds/Ulcers_ Using An Fda-Cleared Device (Includes Administration_ Dressings_ Phlebotomy_ Centrifug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0465","description":"Autologous Platelet Rich Plasma (Prp) For Diabetic Chronic Wounds/Ulcers_ Using An Fda-Cleared Device (Includes Administration_ Dressings_ Phlebotomy_ Centrifug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trach supply noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8189","description":"Trach supply noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0670","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0670","description":"HCPCS-G0670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22B","description":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBD0","description":"ICD-KEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTE0","description":"ICD-NBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doppler echo exam heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93320","description":"Doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHD1","description":"ICD-NKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHA1","description":"ICD-JFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWA0","description":"ICD-KIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33902","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt scrnd unhlthy oh use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3016F","description":"Pt scrnd unhlthy oh use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66150","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDD1","description":"ICD-BDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHA0","description":"ICD-NFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glucose other fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82945","description":"Glucose other fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Protein e-phoresis serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84165","description":"Protein e-phoresis serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGB0","description":"ICD-OAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Powered pres-redu air mattrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0277","description":"Powered pres-redu air mattrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuroendoscopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62160","description":"Neuroendoscopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90482","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","description":"CPT-90482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRE1","description":"ICD-LFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYF0","description":"ICD-GIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of haptoglobins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83012","description":"Assay of haptoglobins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0025","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC11","description":"ICD-3GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85415","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNC0","description":"ICD-NLNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAF1","description":"ICD-IIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL42","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42182","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAF1","description":"ICD-EEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDF1","description":"ICD-MCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPD0","description":"ICD-BGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQB1","description":"ICD-KBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wireless Skin Sensor Thermal Anisotropy Measurement(S) And Assessment Of Flow In Cerebrospinal Fluid Shunt_ Including Ultrasound Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0639T","description":"Wireless Skin Sensor Thermal Anisotropy Measurement(S) And Assessment Of Flow In Cerebrospinal Fluid Shunt_ Including Ultrasound Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJB0","description":"ICD-NHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPF0","description":"ICD-NKPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPC1","description":"ICD-GCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE212","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVB0","description":"ICD-KHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDA0","description":"ICD-CIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARB1","description":"ICD-KARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures complete maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5110","description":"Dentures complete maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"D&c of cervical stump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57558","description":"D&c of cervical stump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28475","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl measr scales jaw motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1702","description":"Repl measr scales jaw motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELA0","description":"ICD-GELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27540","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUC0","description":"ICD-IFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALF0","description":"ICD-IALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval npgs apnea study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0436T","description":"Prgrmg eval npgs apnea study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNA1","description":"ICD-JDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc drug-el cor stent sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9600","description":"Perc drug-el cor stent sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct colonography dx w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74262","description":"Ct colonography dx w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25375","description":"Revise radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27303","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVA0","description":"ICD-NDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59151","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEE1","description":"ICD-EAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFME1","description":"ICD-BFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYB1","description":"ICD-GAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computer-aided detection_ including computer algorithm analysis of breast MRI image data for lesion detection/characterization_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8937","description":"Computer-aided detection_ including computer algorithm analysis of breast MRI image data for lesion detection/characterization_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXF1","description":"ICD-OHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ bal dil_ non-vascular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1726","description":"Cath_ bal dil_ non-vascular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHB0","description":"ICD-CBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc no wrong event","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8913","description":"Pt doc no wrong event","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial Plmt Drug Eluting Ocular Insert Uni/Bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0444T","description":"Initial Plmt Drug Eluting Ocular Insert Uni/Bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIE1","description":"ICD-BGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRB0","description":"ICD-HIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFA1","description":"ICD-JAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA11","description":"ICD-2IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWB1","description":"ICD-DGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYC0","description":"ICD-PFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Advncd care plan 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99497","description":"Advncd care plan 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKME0","description":"ICD-OKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42200","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADF1","description":"ICD-CADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjust knee ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1810","description":"Adjust knee ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cer post col occ/man sup adj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0180","description":"Cer post col occ/man sup adj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSC1","description":"ICD-OGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco use txmnt pharmacol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4001F","description":"Tobacco use txmnt pharmacol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLF1","description":"ICD-NGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement nasal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5926","description":"Replacement nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLE1","description":"ICD-EBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of bursa of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28001","description":"Drainage of bursa of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8C","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX36","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIC1","description":"ICD-NHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES106","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25600","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary pan-cancer (eg_ hereditary sarcomas_ hereditary endocrine tumors_ hereditary neuroendocrine tumors_ hereditary cutaneous melanoma)_ genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0474U","description":"Hereditary pan-cancer (eg_ hereditary sarcomas_ hereditary endocrine tumors_ hereditary neuroendocrine tumors_ hereditary cutaneous melanoma)_ genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay duodenal fluid trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84485","description":"Assay duodenal fluid trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMC1","description":"ICD-OIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC230","description":"Reduced Physical Function _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUB1","description":"ICD-MBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Provisional retainer crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6793","description":"Provisional retainer crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA40","description":"Ultra High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHD1","description":"ICD-CGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8C","description":"Very High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYE1","description":"ICD-KGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOD0","description":"ICD-DAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDF0","description":"ICD-EEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATF1","description":"ICD-GATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20C","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clean & inspect rem dent man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9933","description":"Clean & inspect rem dent man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGA1","description":"ICD-CHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Motion fluoroscopy/swallow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92611","description":"Motion fluoroscopy/swallow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSB0","description":"ICD-DBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sciatic nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64786","description":"Remove sciatic nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine phosphorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84105","description":"Assay of urine phosphorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stress breaker","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6940","description":"Stress breaker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCB1","description":"ICD-NCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6008","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0802","description":"HCPCS-C0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Store prev froz embryos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4027","description":"Store prev froz embryos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair vessel graft defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35870","description":"Repair vessel graft defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnio tri-core amniotic_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4295","description":"Amnio tri-core amniotic_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ trans atherec_rotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1724","description":"Cath_ trans atherec_rotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apexification/recalc final","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3353","description":"Apexification/recalc final","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUA1","description":"ICD-AIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTC1","description":"ICD-MKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYA0","description":"ICD-DDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASE0","description":"ICD-DASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of large bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44025","description":"Incision of large bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9561","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKA1","description":"ICD-NDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHC0","description":"ICD-GHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLA0","description":"ICD-OCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCA0","description":"ICD-ECCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBE1","description":"ICD-OLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTC0","description":"ICD-EDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFID0","description":"ICD-GFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg monitoring/function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95958","description":"Eeg monitoring/function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHF0","description":"ICD-ICHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous vertebral augmentations_ first thoracic and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7507","description":"Percutaneous vertebral augmentations_ first thoracic and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTA0","description":"ICD-ABTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release/revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50725","description":"Release/revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93317","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Idarubicin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9211","description":"Idarubicin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc foot/toe tum dep 1.5cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28041","description":"Exc foot/toe tum dep 1.5cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin reuse pen 1.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5560","description":"Insulin reuse pen 1.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHA0","description":"ICD-AHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Design custom breast implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19396","description":"Design custom breast implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKC0","description":"ICD-NIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36248","description":"Ins cath abd/l-ext art addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGA0","description":"ICD-BIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext ecg review and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0298T","description":"Ext ecg review and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of theophylline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80198","description":"Assay of theophylline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHF1","description":"ICD-CDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQC0","description":"ICD-HIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gr27 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2371","description":"Gr27 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHF0","description":"ICD-MGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA112","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trans shoe solid stirrup exi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3620","description":"Trans shoe solid stirrup exi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWD1","description":"ICD-PEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNE0","description":"ICD-OBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAC1","description":"ICD-NKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLF1","description":"ICD-MDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37271","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","description":"CPT-37271","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX55","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIA1","description":"ICD-MLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMA1","description":"ICD-BAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXB0","description":"ICD-NGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1111","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRD0","description":"ICD-OHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Romiplostim injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2796","description":"Romiplostim injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINB0","description":"ICD-CINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJE1","description":"ICD-CFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBE0","description":"ICD-JCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQC1","description":"ICD-OIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEF0","description":"ICD-IAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cabg w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56752","description":"Anesth cabg w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEA1","description":"ICD-KDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBF1","description":"ICD-FHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strep b dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87653","description":"Strep b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLC1","description":"ICD-GDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGF0","description":"ICD-OGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD131","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of salivary cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42409","description":"Drainage of salivary cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreservation embryo(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89258","description":"Cryopreservation embryo(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65850","description":"Incision of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGD0","description":"ICD-CIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHB1","description":"ICD-NLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99402","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8G","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ bivalent_ preservative free_ 10 mcg/0.2 mL dosa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91316","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ bivalent_ preservative free_ 10 mcg/0.2 mL dosa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83528","description":"Assay of intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breath hydrogen/methane test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91065","description":"Breath hydrogen/methane test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRB1","description":"ICD-LIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKE0","description":"ICD-JFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39541","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWB0","description":"ICD-PJWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDE0","description":"ICD-MGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral periapical first f","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0220","description":"Intraoral periapical first f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFE1","description":"ICD-FDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap impl electrode antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43647","description":"Lap impl electrode antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMA1","description":"ICD-GAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of glucosidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82963","description":"Assay of glucosidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rubeola antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86765","description":"Rubeola antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQF1","description":"ICD-LDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGD0","description":"ICD-FAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIC0","description":"ICD-GFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUE0","description":"ICD-OBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSD0","description":"ICD-GFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dicyclomine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0500","description":"Dicyclomine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0233","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","description":"HCPCS-M0233","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control_ including vascular access and closure_ right heart catherization_ venou","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9783","description":"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control_ including vascular access and closure_ right heart catherization_ venou","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNC0","description":"ICD-JHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10D","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILF1","description":"ICD-FILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALD0","description":"ICD-EALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLA1","description":"ICD-FBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYB1","description":"ICD-HBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMC1","description":"ICD-NJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth head vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21651","description":"Anesth head vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFND0","description":"ICD-OFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVF0","description":"ICD-BEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytp dx eval fna 1st ea site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88172","description":"Cytp dx eval fna 1st ea site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Vedolizumab_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9026","description":"Injection_ Vedolizumab_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICB0","description":"ICD-EICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDD0","description":"ICD-EDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABC0","description":"ICD-BABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGA1","description":"ICD-GHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13A","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMA1","description":"ICD-MKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of heel bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28300","description":"Incision of heel bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKF1","description":"ICD-OIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth kidney/ureter surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86251","description":"Anesth kidney/ureter surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJD0","description":"ICD-ODJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCC1","description":"ICD-ADCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQB0","description":"ICD-KAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXF0","description":"ICD-OAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBB1","description":"ICD-EGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFE0","description":"ICD-JAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88164","description":"Cytopath tbs c/v manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2313","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","description":"HCPCS-J2313","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opto-acoustic imaging_ breast_ unilateral_ including axilla when performed_ real-time with image documentation_ augmentative analysis and report (List separately in addition t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0857T","description":"Opto-acoustic imaging_ breast_ unilateral_ including axilla when performed_ real-time with image documentation_ augmentative analysis and report (List separately in addition t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1216","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00626","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","description":"CPT-00626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seat lift for pt furn-electr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0628","description":"Seat lift for pt furn-electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hfo without joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3924","description":"Hfo without joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITC1","description":"ICD-FITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1420","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","description":"HCPCS-M1420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01390","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","description":"CPT-01390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile_ tandem mass spectrometry (MS/MS)_ urine_ with algorithmic analysis and interpretive report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0256U","description":"Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile_ tandem mass spectrometry (MS/MS)_ urine_ with algorithmic analysis and interpretive report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score neck/ts >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8671","description":"Fun stat score neck/ts >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CT/MRI chest follup not rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9556","description":"CT/MRI chest follup not rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rehab system with interactive interface providing active assistance in rehabilitation therapy_ includes all components and accessories_ motors_ microprocessors_ sensors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0739","description":"Rehab system with interactive interface providing active assistance in rehabilitation therapy_ includes all components and accessories_ motors_ microprocessors_ sensors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISF0","description":"ICD-HISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYD1","description":"ICD-DFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33814","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEC0","description":"ICD-CDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIE0","description":"ICD-NAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTE0","description":"ICD-GHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVD0","description":"ICD-FHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide (Xipere)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3299","description":"Injection_ triamcinolone acetonide (Xipere)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair ventrl hern block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49566","description":"Rerepair ventrl hern block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTF0","description":"ICD-KBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dissolve clot heart vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92975","description":"Dissolve clot heart vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lactoferrin fecal (qual)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83630","description":"Lactoferrin fecal (qual)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGF1","description":"ICD-NAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIC1","description":"ICD-OBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cbc/diffwbc w/o platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0306","description":"Cbc/diffwbc w/o platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAD1","description":"ICD-EDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWD1","description":"ICD-KGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJD1","description":"ICD-KEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPA0","description":"ICD-NAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gi tract capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91110","description":"Gi tract capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALC1","description":"ICD-IALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove lung foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32151","description":"Remove lung foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCE1","description":"ICD-IHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1467","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","description":"HCPCS-M1467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAD1","description":"ICD-CHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEF1","description":"ICD-OEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEA0","description":"ICD-GEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQE1","description":"ICD-HDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEME1","description":"ICD-AEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKF0","description":"ICD-KIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ meloxicam_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1738","description":"Injection_ meloxicam_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFC1","description":"ICD-CFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limb nerve surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64783","description":"Limb nerve surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYB1","description":"ICD-CBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0661U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0661U","description":"CPT-0661U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMD0","description":"ICD-FCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAB0","description":"ICD-OAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65125","description":"Revise ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psa screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0103","description":"Psa screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQD1","description":"ICD-OAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert idrl body thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63305","description":"Remove vert idrl body thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLC1","description":"ICD-FDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crutch underarm each wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0113","description":"Crutch underarm each wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWC1","description":"ICD-ODWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50630","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lower extremity orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2999","description":"Lower extremity orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0825","description":"Pwc gp 2 hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDD0","description":"ICD-FFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSC1","description":"ICD-OLSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temozolomide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8700","description":"Temozolomide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB21","description":"ICD-3CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0501U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","description":"CPT-0501U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16070","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16070","description":"CPT-16070","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect hip/pelv tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27049","description":"Resect hip/pelv tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove lumb artif disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164T","description":"Remove lumb artif disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of foot tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28230","description":"Incision of foot tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGC1","description":"ICD-GIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELF0","description":"ICD-BELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD215","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQC0","description":"ICD-OJQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHF0","description":"ICD-IDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0589U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","description":"CPT-0589U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEE0","description":"ICD-CFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement Of Lost Or Broken Retainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8704","description":"Replacement Of Lost Or Broken Retainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLA0","description":"ICD-KFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBE1","description":"ICD-MCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAME1","description":"ICD-BAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIF0","description":"ICD-MLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFA0","description":"ICD-CBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPF0","description":"ICD-OKPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00542","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","description":"CPT-00542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81185","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Was Not Prescribed_ Reason Not","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2096","description":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Was Not Prescribed_ Reason Not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina wall complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57110","description":"Remove vagina wall complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation_ including dissection and removal of surrounding soft tissues and preparat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0668T","description":"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation_ including dissection and removal of surrounding soft tissues and preparat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Matrion_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4201","description":"Matrion_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eltrd/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33243","description":"Remove eltrd/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41252","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICB1","description":"ICD-BICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Persist asthma medicine ctrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4015F","description":"Persist asthma medicine ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Planar back for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2291","description":"Planar back for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYE1","description":"ICD-PJYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUB0","description":"ICD-EGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytotoxic antibody screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86807","description":"Cytotoxic antibody screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1359","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWB1","description":"ICD-PBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orion_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4276","description":"Orion_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAB1","description":"ICD-EAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Circumcision w/regionl block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54150","description":"Circumcision w/regionl block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous Visible Light Hyperspectral Imaging Measurement Of Oxyhemoglobin_ Deoxyhemoglobin_ And Tissue Oxygenation_ With Interpretation And Report_ Per Extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0631T","description":"Transcutaneous Visible Light Hyperspectral Imaging Measurement Of Oxyhemoglobin_ Deoxyhemoglobin_ And Tissue Oxygenation_ With Interpretation And Report_ Per Extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUF0","description":"ICD-CBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Community/work reintegration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97537","description":"Community/work reintegration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRD1","description":"ICD-GGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGA0","description":"ICD-NEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCF1","description":"ICD-BGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERD0","description":"ICD-KERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"G6pc gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81250","description":"G6pc gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous islet celltrans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0341","description":"Percutaneous islet celltrans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUE0","description":"ICD-EHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRE1","description":"ICD-KDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMC1","description":"ICD-OKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHE1","description":"ICD-OGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occlusion analysis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9950","description":"Occlusion analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mech amb infusion pump <8hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0780","description":"Mech amb infusion pump <8hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 2 shl symphys-stern cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0460","description":"Tlso 2 shl symphys-stern cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBC1","description":"ICD-BHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAB0","description":"ICD-ACAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implnt_bon void filler-strip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9362","description":"Implnt_bon void filler-strip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29710","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOC1","description":"ICD-DBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatorrhaphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48545","description":"Pancreatorrhaphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Depression screen annual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0444","description":"Depression screen annual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEC1","description":"ICD-OJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTE0","description":"ICD-AFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corplex P_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4231","description":"Corplex P_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with computer-assisted image-guided navigation_ incl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7511","description":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with computer-assisted image-guided navigation_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL56","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFD0","description":"ICD-FEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interstitial radiation source application; intermediate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77777","description":"Interstitial radiation source application; intermediate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRA0","description":"ICD-OKRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Narcosynthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90865","description":"Narcosynthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDB0","description":"ICD-AFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB31","description":"ICD-1JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEA0","description":"ICD-FBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove abdominal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38747","description":"Remove abdominal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOE0","description":"ICD-PIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL11","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGC0","description":"ICD-BGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0238","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","description":"HCPCS-M0238","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUB1","description":"ICD-BIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITA0","description":"ICD-KITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise reconst elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24370","description":"Revise reconst elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIB0","description":"ICD-BDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPC1","description":"ICD-JCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKF1","description":"ICD-BHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Actin (Smooth Muscle) Antibody (Asma)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86015","description":"Actin (Smooth Muscle) Antibody (Asma)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBC0","description":"ICD-EIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of inf vena cava","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37619","description":"Ligation of inf vena cava","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVD0","description":"ICD-NGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIID1","description":"ICD-AIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ moderate complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes an expanded review of","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97166","description":"Occupational therapy evaluation_ moderate complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes an expanded review of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBED1","description":"ICD-OBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35476","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78835","description":"Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33237","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast 1st us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19285","description":"Perq dev breast 1st us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKF0","description":"ICD-OIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21A","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental cephalometric film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0340","description":"Dental cephalometric film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICA1","description":"ICD-JICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTC0","description":"ICD-GBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLA1","description":"ICD-KCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJE0","description":"ICD-JEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA21","description":"ICD-3FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXF0","description":"ICD-GDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sinusitis intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9463","description":"Sinusitis intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46910","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB40","description":"High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRB1","description":"ICD-KGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97002","description":"Pt re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPE0","description":"ICD-CAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92629","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","description":"CPT-92629","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESA1","description":"ICD-CESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50693","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heparin neutralization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85525","description":"Heparin neutralization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOF0","description":"ICD-ODOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 vhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0853","description":"Pwc gp 3 vhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARF0","description":"ICD-LARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRF1","description":"ICD-KGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Brain)_ Spheroid Cell Culture In A 3D Microenvironment_ 12 Drug Panel_ Tumor-Response Prediction For Each Drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0248U","description":"Oncology (Brain)_ Spheroid Cell Culture In A 3D Microenvironment_ 12 Drug Panel_ Tumor-Response Prediction For Each Drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNC1","description":"ICD-KGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gatifloxacin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1590","description":"Gatifloxacin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJF1","description":"ICD-JCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rare constitutional and other heritable disorders_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0267U","description":"Rare constitutional and other heritable disorders_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXE0","description":"ICD-FBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22B","description":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of iliopsoas muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27111","description":"Transfer of iliopsoas muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSA1","description":"ICD-KCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHF1","description":"ICD-OJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMB1","description":"ICD-MHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAD1","description":"ICD-JGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPE1","description":"ICD-CCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHF0","description":"ICD-OEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLA0","description":"ICD-NCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOF0","description":"ICD-CCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRD0","description":"ICD-KBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGF0","description":"ICD-BEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Symes type poster opening so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5634","description":"Symes type poster opening so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOF1","description":"ICD-OBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stnd wt pwr whlchr w control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0011","description":"Stnd wt pwr whlchr w control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFC0","description":"ICD-CIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRC1","description":"ICD-KFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKD1","description":"ICD-NFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFA1","description":"ICD-CDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not achieve flat retinas six months post surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9379","description":"Patient did not achieve flat retinas six months post surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANC0","description":"ICD-BANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVE1","description":"ICD-FGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electro hearng aid tst both","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92595","description":"Electro hearng aid tst both","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRE0","description":"ICD-OIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Distal/proximal wedge proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4274","description":"Distal/proximal wedge proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDID1","description":"ICD-NDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1073","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","description":"HCPCS-J1073","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJB0","description":"ICD-GAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPD1","description":"ICD-KFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/dxa results document","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8399","description":"Pt w/dxa results document","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemophilus influenza b vaccine (hib)_ hboc conjugate (4 dose schedule)_for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90645","description":"Hemophilus influenza b vaccine (hib)_ hboc conjugate (4 dose schedule)_for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0077","description":"Injection_ clindamycin phosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Mrna_ Gene Expression Profiling By Rt-Pcr Of 12 Genes (8 Content And 4 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81522","description":"Oncology (Breast)_ Mrna_ Gene Expression Profiling By Rt-Pcr Of 12 Genes (8 Content And 4 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIA1","description":"ICD-OCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9766","description":"Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPB1","description":"ICD-BHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq cardiac angio addl art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92921","description":"Prq cardiac angio addl art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61682","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQA1","description":"ICD-DFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUB0","description":"ICD-NIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCC0","description":"ICD-FFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28C","description":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor IX (antihemophilic factor_ recombinant)_ glycopegylated_ Rebinyn_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9468","description":"Injection_ Factor IX (antihemophilic factor_ recombinant)_ glycopegylated_ Rebinyn_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYB0","description":"ICD-CHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKC0","description":"ICD-CAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3B","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX45","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress spinal cord thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63064","description":"Decompress spinal cord thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Annual gynecological examina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0610","description":"Annual gynecological examina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTE0","description":"ICD-MHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILF1","description":"ICD-IILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNF0","description":"ICD-NJNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKD0","description":"ICD-OCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCE1","description":"ICD-FCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m disofenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9510","description":"Tc99m disofenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA240","description":"Clinically Complex _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4A","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBD0","description":"ICD-MHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close nephrovisceral fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50525","description":"Close nephrovisceral fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHD1","description":"ICD-NAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alkaloids_ urine_ quantitative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6041","description":"Alkaloids_ urine_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFF0","description":"ICD-JEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRA1","description":"ICD-LCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILE1","description":"ICD-KILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9907","description":"Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace vad intra w/bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33983","description":"Replace vad intra w/bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"West nile virus ab igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86788","description":"West nile virus ab igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVB0","description":"ICD-CDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph imped function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91037","description":"Esoph imped function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWA0","description":"ICD-PKWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syst bp ge 130 - 139mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3075F","description":"Syst bp ge 130 - 139mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt/caregiver queried falls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6080F","description":"Pt/caregiver queried falls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB226","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24C","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCND0","description":"ICD-CCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYC1","description":"ICD-GBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC03","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0547U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","description":"CPT-0547U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBE0","description":"ICD-BDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAA0","description":"ICD-AEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLE0","description":"ICD-JDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTC1","description":"ICD-BDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKF0","description":"ICD-OHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Centerbased day care perdiem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5105","description":"Centerbased day care perdiem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJE0","description":"ICD-FGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA20","description":"Medium Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amantadine hcl oral brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9033","description":"Amantadine hcl oral brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSA0","description":"ICD-HCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22226","description":"Revise extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4353","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","description":"HCPCS-Q4353","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNA0","description":"ICD-CFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAID1","description":"ICD-MAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDD0","description":"ICD-BDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUC1","description":"ICD-CIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISE1","description":"ICD-DISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart-vein defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33732","description":"Repair heart-vein defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJD0","description":"ICD-OLJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDA1","description":"ICD-BIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIME1","description":"ICD-NIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAC0","description":"ICD-BDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJF0","description":"ICD-NDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOB0","description":"ICD-CGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLD0","description":"ICD-GHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQD0","description":"ICD-HDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat/graft heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28420","description":"Treat/graft heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE201","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation by ocularist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9150","description":"Evaluation by ocularist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQB0","description":"ICD-OEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73615","description":"Contrast x-ray of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQD0","description":"ICD-LBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pemetrexed injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9305","description":"Pemetrexed injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXD1","description":"ICD-CIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1299","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","description":"HCPCS-J1299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3d-crt/imrt received","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4165F","description":"3d-crt/imrt received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHC0","description":"ICD-MAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ S100A8 and S100A9_ by enzyme-linked immunosorbent assay (ELISA)_ tear fluid with age_ algorithm reported as a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0458U","description":"Oncology (breast cancer)_ S100A8 and S100A9_ by enzyme-linked immunosorbent assay (ELISA)_ tear fluid with age_ algorithm reported as a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD217","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHED1","description":"ICD-AHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18X","description":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intro/sheath_strble_non-peel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1766","description":"Intro/sheath_strble_non-peel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUA0","description":"ICD-MAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx contour defects 1 cc/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11950","description":"Tx contour defects 1 cc/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bpci home visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9187","description":"Bpci home visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65865","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g._ ulcerative colitis_ crohn_s disease)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1182","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g._ ulcerative colitis_ crohn_s disease)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNC1","description":"ICD-NJNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUC1","description":"ICD-EDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay malate dehydrogenase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83775","description":"Assay malate dehydrogenase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj vocal cord bulking agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8607","description":"Inj vocal cord bulking agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide ova aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76948","description":"Echo guide ova aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGA1","description":"ICD-FGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRB0","description":"ICD-CIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27217","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYF0","description":"ICD-DBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWF0","description":"ICD-KDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWA0","description":"ICD-CAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autogenous Av Fistula Received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8530","description":"Autogenous Av Fistula Received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXB0","description":"ICD-OBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVF0","description":"ICD-FEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEE1","description":"ICD-FCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radical resect abd tumor<5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22904","description":"Radical resect abd tumor<5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Legionella micdadei ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87277","description":"Legionella micdadei ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOB1","description":"ICD-HBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine_ entire_ survey study_ anteroposterior an lateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72010","description":"Radiologic examination_ spine_ entire_ survey study_ anteroposterior an lateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0607","description":"Repl batt for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9010","description":"Mccd_ risk adj_ level 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCF0","description":"ICD-CCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAA0","description":"ICD-KDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA14","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEB1","description":"ICD-IGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHA1","description":"ICD-ADHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDD0","description":"ICD-NEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJF1","description":"ICD-KBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFB1","description":"ICD-FGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHD1","description":"ICD-MFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLD0","description":"ICD-FBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathology lab procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89240","description":"Pathology lab procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHD1","description":"ICD-ECHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJA0","description":"ICD-BBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYA1","description":"ICD-DFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy orchiopexy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54692","description":"Laparoscopy orchiopexy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAB1","description":"ICD-OCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9947","description":"Leg pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEF0","description":"ICD-NHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINE1","description":"ICD-CINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0542T","description":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9309","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9309","description":"HCPCS-C9309","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vertebroplasty addl inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22512","description":"Vertebroplasty addl inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBC0","description":"ICD-KGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2D","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC156","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTB0","description":"ICD-GGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt infosys alarm 4 nxt mammo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7025F","description":"Pt infosys alarm 4 nxt mammo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1903","description":"HCPCS-B1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABF0","description":"ICD-FABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEB0","description":"ICD-NJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYB0","description":"ICD-OHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWA1","description":"ICD-PDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quant nonher2 ihc brst cx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3395F","description":"Quant nonher2 ihc brst cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL01","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRD1","description":"ICD-GCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIA0","description":"ICD-BEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAD1","description":"ICD-ICAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reticyte/hgb concentrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85046","description":"Reticyte/hgb concentrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAC0","description":"ICD-EFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq card stent/ath/angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92934","description":"Prq card stent/ath/angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUB1","description":"ICD-FFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immed man part denture resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5222","description":"Immed man part denture resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"P-mastectomy w/ln removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19302","description":"P-mastectomy w/ln removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23802","description":"Fusion of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFB1","description":"ICD-CEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTA0","description":"ICD-IHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBC1","description":"ICD-BBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport case worker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0160","description":"Noner transport case worker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLF0","description":"ICD-MFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXF0","description":"ICD-GHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQF0","description":"ICD-PFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHC0","description":"ICD-IBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISC1","description":"ICD-HISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subs visit for episode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0526F","description":"Subs visit for episode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELD1","description":"ICD-FELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPB1","description":"ICD-JHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWE0","description":"ICD-DBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJA1","description":"ICD-FEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Removal Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0679T","description":"Laparoscopic Removal Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12A","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJD0","description":"ICD-NKJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEF1","description":"ICD-IAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRC1","description":"ICD-KBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYC0","description":"ICD-OKYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIE0","description":"ICD-OHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJD1","description":"ICD-CHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVF0","description":"ICD-KHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFA0","description":"ICD-JFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20690","description":"Apply bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthesis_ penile_ non-inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2622","description":"Prosthesis_ penile_ non-inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNB0","description":"ICD-FCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27257","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTE0","description":"ICD-NLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNB1","description":"ICD-BCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBB0","description":"ICD-IIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Md recertification hha pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0179","description":"Md recertification hha pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQB1","description":"ICD-LHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemorrhoidectomy_ Internal_ By Transanal Hemorrhoidal Dearterialization_ 2 Or More Hemorrhoid Columns/Groups_ Including Ultrasound Guidance_ With Mucopexy_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46948","description":"Hemorrhoidectomy_ Internal_ By Transanal Hemorrhoidal Dearterialization_ 2 Or More Hemorrhoid Columns/Groups_ Including Ultrasound Guidance_ With Mucopexy_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLD0","description":"ICD-OLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUB1","description":"ICD-CDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAC1","description":"ICD-NLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGE0","description":"ICD-GGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVA1","description":"ICD-FHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB201","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl leath cuff kafo prox th","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4100","description":"Repl leath cuff kafo prox th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce eye wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67250","description":"Reinforce eye wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69662","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWB1","description":"ICD-DDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMC0","description":"ICD-OFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRA0","description":"ICD-GIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKC1","description":"ICD-BCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX32","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rec cortico>60d or 1rx 600mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9469","description":"Rec cortico>60d or 1rx 600mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cipaglucosidase alfa-atga_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1203","description":"Injection_ cipaglucosidase alfa-atga_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj common digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64632","description":"N block inj common digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Av fistula revision open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36832","description":"Av fistula revision open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Verify pt site pxd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6100F","description":"Verify pt site pxd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxytocin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2590","description":"Oxytocin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIA1","description":"ICD-NKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBME1","description":"ICD-NBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trach/laryn tube non-cuffed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7520","description":"Trach/laryn tube non-cuffed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPA1","description":"ICD-NAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mans shoe oxford brace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3225","description":"Mans shoe oxford brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genetic test brugada","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3861","description":"Genetic test brugada","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vacsular emobolization or occlusion procedure with use of pressure-generation catheter (e.g._ one-way_ intermittentrly occluding)_ inclusive of all radiological supervision an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9797","description":"Vacsular emobolization or occlusion procedure with use of pressure-generation catheter (e.g._ one-way_ intermittentrly occluding)_ inclusive of all radiological supervision an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB151","description":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13C","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKF0","description":"ICD-BEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFE1","description":"ICD-BCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrolyte panel this panel must include the following: carbon dioxide (82374) chloride (82435) potassium (84132) sodium (84295)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80051","description":"Electrolyte panel this panel must include the following: carbon dioxide (82374) chloride (82435) potassium (84132) sodium (84295)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35460","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ant resin-based cmpst crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2390","description":"Ant resin-based cmpst crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYC0","description":"ICD-KCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOF0","description":"ICD-OCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESA0","description":"ICD-CESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDE0","description":"ICD-OLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEED0","description":"ICD-GEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJC0","description":"ICD-CEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKB0","description":"ICD-JCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulance response/treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0998","description":"Ambulance response/treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0737","description":"HCPCS-E0737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maxilla or mandible resectio","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7490","description":"Maxilla or mandible resectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9026","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","description":"HCPCS-J9026","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIB0","description":"ICD-FFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOC1","description":"ICD-CCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX53","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITC1","description":"ICD-OITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heterophile antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86308","description":"Heterophile antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYB1","description":"ICD-LDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHID0","description":"ICD-FHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Newborn metabolic screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3620","description":"Newborn metabolic screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB155","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAME0","description":"ICD-JAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXD1","description":"ICD-NDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bp not performed/doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8478","description":"Bp not performed/doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ non-duplicated gene when duplication/multip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0074U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ non-duplicated gene when duplication/multip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid skin barrier 6x6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5121","description":"Solid skin barrier 6x6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doxepin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6034","description":"Doxepin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25800","description":"Fusion of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1475","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","description":"HCPCS-M1475","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0093A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOC1","description":"ICD-KIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCA1","description":"ICD-MLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosphate_ 300 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0736","description":"Injection_ clindamycin phosphate_ 300 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUF0","description":"ICD-OCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEE1","description":"ICD-OFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGC1","description":"ICD-CIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFF1","description":"ICD-GIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"C/o for orthotic/prosth use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97762","description":"C/o for orthotic/prosth use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOC1","description":"ICD-LAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNE0","description":"ICD-NJNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped term dev_ hook_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6712","description":"Ped term dev_ hook_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of eye water bath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76513","description":"Echo exam of eye water bath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGND0","description":"ICD-JGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing id_ digit_ mon_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5254","description":"Hearing id_ digit_ mon_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBA0","description":"ICD-IGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prostate biopsy_ any mthd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0416","description":"Prostate biopsy_ any mthd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYA0","description":"ICD-KFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVE1","description":"ICD-JGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFF1","description":"ICD-KGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acoustic refl threshold tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92568","description":"Acoustic refl threshold tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise inferior turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30130","description":"Excise inferior turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLB1","description":"ICD-EFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp fem-ant-post tib/prl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35666","description":"Art byp fem-ant-post tib/prl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Community Transition Svcs (House Hold Suppl)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7332","description":"Community Transition Svcs (House Hold Suppl)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB46","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remov/replc penis pros comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54411","description":"Remov/replc penis pros comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28106","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAD1","description":"ICD-FHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB154","description":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"End of life counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0257","description":"End of life counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMD1","description":"ICD-ACMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug screenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0003","description":"Alcohol and/or drug screenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDC0","description":"ICD-KEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEID1","description":"ICD-JEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt nephrostomy catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50432","description":"Plmt nephrostomy catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLC1","description":"ICD-ADLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D6049","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6049","description":"CDT-D6049","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUB0","description":"ICD-IGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANF1","description":"ICD-BANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUC1","description":"ICD-BHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of wrist prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25250","description":"Removal of wrist prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD151","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic compression controller without calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0681","description":"Non-pneumatic compression controller without calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA254","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amalgam one surface permanen","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2140","description":"Amalgam one surface permanen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC120","description":"Special Care High _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo intralesional over 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96406","description":"Chemo intralesional over 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQD1","description":"ICD-PHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXA0","description":"ICD-GBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUA0","description":"ICD-IDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCME1","description":"ICD-GCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTA1","description":"ICD-ODTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB03","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDB0","description":"ICD-MJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAE0","description":"ICD-AAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4350","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","description":"HCPCS-Q4350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enteral ng tubing w/o stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4082","description":"Enteral ng tubing w/o stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNC0","description":"ICD-FFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYF0","description":"ICD-OCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTB1","description":"ICD-AFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFD0","description":"ICD-FGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFE1","description":"ICD-BAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-49190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","description":"CPT-49190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autologous prp for ulcers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0460","description":"Autologous prp for ulcers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBA1","description":"ICD-EHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVE1","description":"ICD-KAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMC1","description":"ICD-NGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJB1","description":"ICD-BHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVC1","description":"ICD-JEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9577","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSA0","description":"ICD-GFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBD1","description":"ICD-ECBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUF0","description":"ICD-ADUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC56","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUD0","description":"ICD-KDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0301","description":"HCPCS-C0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of magnesium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83735","description":"Assay of magnesium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcath emboliz microspher","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2095","description":"Transcath emboliz microspher","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0674","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0674","description":"HCPCS-G0674","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGA1","description":"ICD-KIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJE0","description":"ICD-FEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Facility-based respite_ 24-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0531","description":"Facility-based respite_ 24-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDC0","description":"ICD-AEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWF0","description":"ICD-GCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXE1","description":"ICD-JBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMC0","description":"ICD-IHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0561","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","description":"HCPCS-G0561","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYB0","description":"ICD-DAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWF0","description":"ICD-PFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTB1","description":"ICD-NHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multidisciplinary care plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0580F","description":"Multidisciplinary care plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81173","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Max ultrasound capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0370","description":"Max ultrasound capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1023","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAC0","description":"ICD-IGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99219","description":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xenon xe-129 hyperpolarized gas_ diagnostic_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9150","description":"Xenon xe-129 hyperpolarized gas_ diagnostic_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spirometry up to 2 yrs old","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94011","description":"Spirometry up to 2 yrs old","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial strain imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0399T","description":"Myocardial strain imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL55","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periodic Assessment; Assessing Periodically By Qualified Personnel To Determine The Most Appropriate Combination Of Services And Treatment (Provision Of The Services By A Medi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2077","description":"Periodic Assessment; Assessing Periodically By Qualified Personnel To Determine The Most Appropriate Combination Of Services And Treatment (Provision Of The Services By A Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQC1","description":"ICD-GDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aminolevulinic acid hcl for topical administration_ 10% gel_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7345","description":"Aminolevulinic acid hcl for topical administration_ 10% gel_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMC0","description":"ICD-JIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKA0","description":"ICD-GHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGA1","description":"ICD-NIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNA1","description":"ICD-KBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13C","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYD0","description":"ICD-GBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auditory osseointegrated device_ external sound processor_ excludes transducer/actuator_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8691","description":"Auditory osseointegrated device_ external sound processor_ excludes transducer/actuator_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNB1","description":"ICD-JDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54620","description":"Suspension of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5B","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Division of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58605","description":"Division of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOB0","description":"ICD-HIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHID0","description":"ICD-JHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXC1","description":"ICD-OLXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGB1","description":"ICD-FHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACB1","description":"ICD-GACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDA0","description":"ICD-FDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQF0","description":"ICD-DHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62180","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWF0","description":"ICD-GAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83718","description":"Assay of lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gen w/c cushion wdth < 22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2601","description":"Gen w/c cushion wdth < 22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct neck spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72126","description":"Ct neck spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Composite drsg >16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6204","description":"Composite drsg >16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Developmental screen w/score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96110","description":"Developmental screen w/score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUC0","description":"ICD-AEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRE0","description":"ICD-DHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOD0","description":"ICD-OKOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQF0","description":"ICD-LHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reusable underpad bed size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4537","description":"Reusable underpad bed size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANC1","description":"ICD-NANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ra measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8490","description":"Ra measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy salpingostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58673","description":"Laparoscopy salpingostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk flex inner socket ext fra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5645","description":"Bk flex inner socket ext fra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUC1","description":"ICD-AEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKF1","description":"ICD-KHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAA1","description":"ICD-GFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYA1","description":"ICD-GFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9037","description":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUE1","description":"ICD-ACUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDND0","description":"ICD-GDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semen anal vol/count/mot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89320","description":"Semen anal vol/count/mot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGA1","description":"ICD-OJGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58960","description":"Exploration of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJB1","description":"ICD-NLJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934]_ rs6560711 [WDR37]_ rs3735222 [SCIN/LOC10798676","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0439U","description":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934]_ rs6560711 [WDR37]_ rs3735222 [SCIN/LOC10798676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB24","description":"Very High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKB1","description":"ICD-OHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQF0","description":"ICD-HHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEF0","description":"ICD-EGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5A","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surg on vag/urethral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94251","description":"Anesth surg on vag/urethral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL03","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQB1","description":"ICD-OIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) W","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2141","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUA0","description":"ICD-OAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplant ureter to skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50860","description":"Transplant ureter to skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2188","description":"Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd us exam duodenum/jejunum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43259","description":"Egd us exam duodenum/jejunum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYD0","description":"ICD-HCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23460","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of feces for trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84490","description":"Assay of feces for trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rvw meds by rx/dr in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1160F","description":"Rvw meds by rx/dr in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10A","description":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0917T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","description":"CPT-0917T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tremelimumab-actl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9347","description":"Injection_ tremelimumab-actl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38222","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKB1","description":"ICD-KAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHA1","description":"ICD-KDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cygnus dual_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4282","description":"Cygnus dual_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infusion supplies with pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4222","description":"Infusion supplies with pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8F","description":"High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYA1","description":"ICD-OGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERB1","description":"ICD-HERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOC0","description":"ICD-GGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47720","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKB0","description":"ICD-GFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asthma risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2016F","description":"Asthma risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUC1","description":"ICD-CBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release encircling material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67115","description":"Release encircling material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cine/vid x-ray throat/esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74230","description":"Cine/vid x-ray throat/esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXB1","description":"ICD-CBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ob us < 14 wks single fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76801","description":"Ob us < 14 wks single fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp ea 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99145","description":"Mod sedat phys/qhp ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1 (breast cancer 1) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie_ exon 13 del 3.835kb_ exo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81214","description":"BRCA1 (breast cancer 1) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie_ exon 13 del 3.835kb_ exo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thorac cont paraspinal uprig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2670","description":"Thorac cont paraspinal uprig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIA1","description":"ICD-CFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMF1","description":"ICD-CCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB135","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Middle ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69799","description":"Middle ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mw therapy for breast tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0301T","description":"Mw therapy for breast tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0968T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","description":"CPT-0968T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1502","description":"HCPCS-A1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64832","description":"Repair nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGA0","description":"ICD-ODGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYC1","description":"ICD-PIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drugs unclassified injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3490","description":"Drugs unclassified injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVB0","description":"ICD-OGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUA0","description":"ICD-NKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDD1","description":"ICD-EIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA30","description":"Default_ /30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of arm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23930","description":"Drainage of arm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9011","description":"Mccd_ risk adj_ level 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC21","description":"ICD-2CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDF0","description":"ICD-JIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYD0","description":"ICD-GIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAF0","description":"ICD-ODAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAB1","description":"ICD-AAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRE1","description":"ICD-LGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIA1","description":"ICD-MBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES104","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","description":"HCPCS-Q4405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rib(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32900","description":"Removal of rib(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLA0","description":"ICD-JGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDA1","description":"ICD-KEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDF0","description":"ICD-JFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPA0","description":"ICD-BEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit hydra total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9373","description":"Hit hydra total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYE1","description":"ICD-GCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLA1","description":"ICD-EFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAED1","description":"ICD-NAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFB0","description":"ICD-OKFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBF1","description":"ICD-BGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27827","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRC0","description":"ICD-CDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWB0","description":"ICD-KEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAE1","description":"ICD-JDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIE0","description":"ICD-IAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMF1","description":"ICD-EFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAD1","description":"ICD-NIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAA1","description":"ICD-OJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOC0","description":"ICD-DAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYF0","description":"ICD-GFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITC1","description":"ICD-EITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFC1","description":"ICD-NDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFE0","description":"ICD-CDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRB0","description":"ICD-OLRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPA0","description":"ICD-BBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRE1","description":"ICD-DBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obstetric panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80055","description":"Obstetric panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain bladder by trocar/cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51101","description":"Drain bladder by trocar/cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTA0","description":"ICD-IBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81462","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0633U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0633U","description":"CPT-0633U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anes spine tranthor w/o vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62559","description":"Anes spine tranthor w/o vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUD1","description":"ICD-JIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAE0","description":"ICD-BBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Audit/dast 15-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99408","description":"Audit/dast 15-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPF0","description":"ICD-GDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin barrier solid 4x4 equiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4372","description":"Skin barrier solid 4x4 equiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHB1","description":"ICD-FDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIA0","description":"ICD-GGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSD1","description":"ICD-PLSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOA0","description":"ICD-OGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDE1","description":"ICD-JBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"P2y inhib not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9439","description":"P2y inhib not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHF1","description":"ICD-FCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sewho erbs palsey design abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3962","description":"Sewho erbs palsey design abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIE0","description":"ICD-CEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Right ventricular recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93603","description":"Right ventricular recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Malig tumor exc to 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7440","description":"Malig tumor exc to 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE115","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWE0","description":"ICD-OIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psori tool doc w/benchmk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9649","description":"Psori tool doc w/benchmk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYD1","description":"ICD-CIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRB0","description":"ICD-PHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urtr inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9631","description":"Urtr inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ bilateral (List sep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93573","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ bilateral (List sep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No pap prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8850","description":"No pap prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGB1","description":"ICD-KHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLF1","description":"ICD-NHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0137U","description":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQA1","description":"ICD-OIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES210","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Valvotomy pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33471","description":"Valvotomy pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASF1","description":"ICD-PASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAC0","description":"ICD-KIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lyse chest fibrin init day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32561","description":"Lyse chest fibrin init day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVB1","description":"ICD-GCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18E","description":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1263","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin w/noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6722","description":"Crown resin w/noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFC0","description":"ICD-CAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKB0","description":"ICD-NDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQE0","description":"ICD-OCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEB1","description":"ICD-KDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDF1","description":"ICD-NIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKB0","description":"ICD-KBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMD0","description":"ICD-OFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal t1-3_n1-2noprg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9092","description":"Onc dx rectal t1-3_n1-2noprg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTF0","description":"ICD-GCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIE1","description":"ICD-OLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAF0","description":"ICD-KAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHF0","description":"ICD-BEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKD0","description":"ICD-NIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8G","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRF0","description":"ICD-CCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWE0","description":"ICD-GDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve palsy microsurg graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15842","description":"Nerve palsy microsurg graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corneal tissue transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65767","description":"Corneal tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii (porcine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7191","description":"Factor viii (porcine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCED0","description":"ICD-BCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62280","description":"Treat spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24116","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Polysom 6/>yrs cpap 4/> parm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95811","description":"Polysom 6/>yrs cpap 4/> parm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFA0","description":"ICD-GFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUB1","description":"ICD-BBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMF0","description":"ICD-ECMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKB1","description":"ICD-FCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUB0","description":"ICD-KBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHA1","description":"ICD-JGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVF0","description":"ICD-FFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIF0","description":"ICD-BIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICD1","description":"ICD-NICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAC1","description":"ICD-CIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLE0","description":"ICD-IFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Airways surgical procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31899","description":"Airways surgical procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKE0","description":"ICD-GCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB106","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXA0","description":"ICD-BIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJA0","description":"ICD-NLJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programming Device Evaluation (In-Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0683T","description":"Programming Device Evaluation (In-Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Er- or pr- breast cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3316F","description":"Er- or pr- breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA06","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flex/ext wrist w/wo friction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6621","description":"Flex/ext wrist w/wo friction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASD0","description":"ICD-OASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGD0","description":"ICD-GAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Battery charger_ single mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2366","description":"Battery charger_ single mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA154","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95834","description":"Body muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hib-mency vaccine 4 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90644","description":"Hib-mency vaccine 4 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conform band s w >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6447","description":"Conform band s w >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Padding for comprssn bdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8430","description":"Padding for comprssn bdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGE0","description":"ICD-BDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise wrist tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25118","description":"Excise wrist tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITF1","description":"ICD-IITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFE0","description":"ICD-NIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPB1","description":"ICD-GCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRC0","description":"ICD-PDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ non-lypohilized (e.g. liquid)_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9065","description":"Injection_ romidepsin_ non-lypohilized (e.g. liquid)_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth 60 min/> as docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4255F","description":"Anesth 60 min/> as docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOF1","description":"ICD-KAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup gauntlet fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4014","description":"Cast sup gauntlet fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEE1","description":"ICD-IHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVA0","description":"ICD-JGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUA1","description":"ICD-FGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy remove myoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58561","description":"Hysteroscopy remove myoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANC1","description":"ICD-FANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESA1","description":"ICD-PESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5166","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5166","description":"HCPCS-Q5166","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Term dev mech hand vol close","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6709","description":"Term dev mech hand vol close","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00702","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","description":"CPT-00702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHB0","description":"ICD-EHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct chest spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72129","description":"Ct chest spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCB0","description":"ICD-IDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATB0","description":"ICD-GATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBA0","description":"ICD-FHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic myomectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58545","description":"Laparoscopic myomectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAME0","description":"ICD-MAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ imipenem 4mg_ cilastatin 4 mg and relebactam 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0742","description":"Injection_ imipenem 4mg_ cilastatin 4 mg and relebactam 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB210","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTB0","description":"ICD-FGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUF0","description":"ICD-MIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93985","description":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home mgmt preterm labor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9208","description":"Home mgmt preterm labor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc antibody identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86870","description":"Rbc antibody identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB21","description":"ICD-2KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair arm rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0994","description":"Wheelchair arm rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENE0","description":"ICD-JENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy dx sep proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58555","description":"Hysteroscopy dx sep proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQC0","description":"ICD-PAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRD1","description":"ICD-DIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKC1","description":"ICD-FGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFB0","description":"ICD-OFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of finger tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26474","description":"Fusion of finger tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCA1","description":"ICD-NCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIA1","description":"ICD-MAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASE1","description":"ICD-CASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRF0","description":"ICD-KBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42507","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pca3 testing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3721","description":"Pca3 testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINA0","description":"ICD-CINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automated diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85004","description":"Automated diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEF1","description":"ICD-MFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTE0","description":"ICD-OBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin (lyumjev) for administration through dme (i.e._ insulin pump) per 50 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1813","description":"Insulin (lyumjev) for administration through dme (i.e._ insulin pump) per 50 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18G","description":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block_ with frozen section(s)_ single specimen (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0841T","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block_ with frozen section(s)_ single specimen (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDC0","description":"ICD-OLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHF0","description":"ICD-MHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery-vein autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36825","description":"Artery-vein autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gait training therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97116","description":"Gait training therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthesis modification","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5875","description":"Prosthesis modification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETE0","description":"ICD-NETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35303","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJB1","description":"ICD-JCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99226","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESB0","description":"ICD-OESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20610","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPD0","description":"ICD-KEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEE1","description":"ICD-IGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNF0","description":"ICD-GBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQA1","description":"ICD-LIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tubing (oxygen) per foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4616","description":"Tubing (oxygen) per foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1291","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICF1","description":"ICD-GICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOC0","description":"ICD-HAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Camp overnite waiver/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2036","description":"Camp overnite waiver/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMF1","description":"ICD-CAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental gold foil two surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2420","description":"Dental gold foil two surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOE0","description":"ICD-OKOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAC0","description":"ICD-NLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMF0","description":"ICD-IIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITE0","description":"ICD-AITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUB1","description":"ICD-JBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q9999","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","description":"HCPCS-Q9999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply intrcav radiat simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77761","description":"Apply intrcav radiat simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHND0","description":"ICD-CHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCME0","description":"ICD-JCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDA0","description":"ICD-KBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99217","description":"Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst nbl mtl 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6614","description":"Onlay cst nbl mtl 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYD1","description":"ICD-PCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTE1","description":"ICD-FDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; placement_ manipulation of transducer_ and image acquisition only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76988","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; placement_ manipulation of transducer_ and image acquisition only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 20-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88264","description":"Chromosome analysis 20-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoglobulin paraprotein (M-protein)_ qualitative_ immunoprecipitation and mass spectrometry_ blood or urine_ including isotype","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0077U","description":"Immunoglobulin paraprotein (M-protein)_ qualitative_ immunoprecipitation and mass spectrometry_ blood or urine_ including isotype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lithium batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4235","description":"Lithium batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUC1","description":"ICD-NKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20962","description":"Other bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHME1","description":"ICD-FHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKC1","description":"ICD-KHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy consultation performed prior to a screening colonoscopy procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0285","description":"Colonoscopy consultation performed prior to a screening colonoscopy procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUE0","description":"ICD-IBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Packing strips_ non-impreg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6407","description":"Packing strips_ non-impreg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTB0","description":"ICD-CHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1502","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1502","description":"CDT-D1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10 mg and hyaluronidase-fihj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9144","description":"Injection_ daratumumab_ 10 mg and hyaluronidase-fihj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray upper gi&small intest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74245","description":"X-ray upper gi&small intest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIB1","description":"ICD-GGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBA0","description":"ICD-GEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drop lock retainer each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2785","description":"Drop lock retainer each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise intestine lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44110","description":"Excise intestine lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac Tx Nsg Fac Res W/Skn Inf Bill Sid-Bnef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9682","description":"Onsite Ac Tx Nsg Fac Res W/Skn Inf Bill Sid-Bnef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ketamine and norketamine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80357","description":"Ketamine and norketamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALA1","description":"ICD-FALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at 12 months as demons","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1020","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at 12 months as demons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"reline custom sleep apnea appliance (indirect)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9953","description":"reline custom sleep apnea appliance (indirect)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01522","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","description":"CPT-01522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADB1","description":"ICD-GADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKF0","description":"ICD-FGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWD1","description":"ICD-HDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESB0","description":"ICD-LESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC156","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIME0","description":"ICD-EIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQB1","description":"ICD-LCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vit for macular hole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67042","description":"Vit for macular hole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBE0","description":"ICD-BFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug hotline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0030","description":"Alcohol and/or drug hotline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASC0","description":"ICD-CASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"T3 reverse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84482","description":"T3 reverse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACD1","description":"ICD-JACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pml/raralpha 1 breakpoint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81316","description":"Pml/raralpha 1 breakpoint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Twin zygosity_ genomic targeted sequence analysis of chromosome 2_ using circulating cell-free fetal DNA in maternal blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0060U","description":"Twin zygosity_ genomic targeted sequence analysis of chromosome 2_ using circulating cell-free fetal DNA in maternal blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Creatine isoforms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82554","description":"Creatine isoforms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBA0","description":"ICD-JHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUB0","description":"ICD-MJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDC1","description":"ICD-KBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQE1","description":"ICD-PFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2A","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGC1","description":"ICD-OBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOA0","description":"ICD-ODOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFA0","description":"ICD-GHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enter infusion pump w/o alrm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9000","description":"Enter infusion pump w/o alrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-91124","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","description":"CPT-91124","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCB1","description":"ICD-ACCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjst forearm pro/sup device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1802","description":"Adjst forearm pro/sup device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ natalizumab-sztn (tyruko)_ biosimilar_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5134","description":"Injection_ natalizumab-sztn (tyruko)_ biosimilar_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB101","description":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24505","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYF1","description":"ICD-DAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary leg or abdomen bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4358","description":"Urinary leg or abdomen bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESE1","description":"ICD-GESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of unstable kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27420","description":"Revision of unstable kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB221","description":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEB1","description":"ICD-CCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contour seat for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2294","description":"Contour seat for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoskeletal axial rotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5984","description":"Endoskeletal axial rotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEF0","description":"ICD-KGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lsh uterus 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58541","description":"Lsh uterus 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXD0","description":"ICD-OKXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB56","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27781","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIF0","description":"ICD-IAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOD1","description":"ICD-LBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOD0","description":"ICD-LEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPB1","description":"ICD-FDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVB1","description":"ICD-FIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVE1","description":"ICD-CDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rec ace/arb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8506","description":"Pt rec ace/arb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAD0","description":"ICD-GDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerv cancer screen docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3015F","description":"Cerv cancer screen docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLC1","description":"ICD-MHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99225","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLE1","description":"ICD-GHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFF1","description":"ICD-NDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tension based scoliosis orth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1005","description":"Tension based scoliosis orth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63283","description":"Bx/exc idrl spine lesn scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLC1","description":"ICD-CGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHA1","description":"ICD-ODHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMF0","description":"ICD-FIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29882","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGD0","description":"ICD-OFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNB1","description":"ICD-FGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCE1","description":"ICD-JCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj subq impltbl dfb elctrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33271","description":"Insj subq impltbl dfb elctrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous laser 1st vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36478","description":"Endovenous laser 1st vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8B","description":"High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEB1","description":"ICD-FFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anes mediascpy & dx thorscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52851","description":"Anes mediascpy & dx thorscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEF0","description":"ICD-OCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWE0","description":"ICD-OBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with invasive interface (e.g. tracheostomy tube)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0463","description":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with invasive interface (e.g. tracheostomy tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAC0","description":"ICD-MKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40816","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHND1","description":"ICD-JHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKC0","description":"ICD-BHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g._ spirometry equipment not available at the time of the encounter)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1217","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g._ spirometry equipment not available at the time of the encounter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOA0","description":"ICD-GIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYA1","description":"ICD-LDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXD1","description":"ICD-KEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWF1","description":"ICD-DHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYE1","description":"ICD-CHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close bronchial fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32815","description":"Close bronchial fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of silica","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84285","description":"Assay of silica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWD1","description":"ICD-GEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX17","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQA0","description":"ICD-GIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy finger joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26105","description":"Biopsy finger joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment_ history obtained from pati","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0505","description":"Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment_ history obtained from pati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect diaphragm simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39560","description":"Resect diaphragm simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTB0","description":"ICD-KGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Provider who referred the patient to another provider received a report from the provider to whom the patient was referred","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9969","description":"Provider who referred the patient to another provider received a report from the provider to whom the patient was referred","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval appros surg thxpy epi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5200F","description":"Eval appros surg thxpy epi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUB1","description":"ICD-IEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCF1","description":"ICD-KHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1A","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJC0","description":"ICD-NFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-ophthalmic fva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9733","description":"Non-ophthalmic fva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUE0","description":"ICD-KAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATF1","description":"ICD-FATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEA0","description":"ICD-NJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair pul venous stenosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33726","description":"Repair pul venous stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2003","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2003","description":"CDT-D2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISC0","description":"ICD-LISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBF1","description":"ICD-GDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA CRYPTOSPORIDIUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87328","description":"IAAD IA CRYPTOSPORIDIUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemolysin acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85475","description":"Hemolysin acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAB0","description":"ICD-IAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44408","description":"Colonoscopy w/decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTA1","description":"ICD-MJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair tooth socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41874","description":"Repair tooth socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5C","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE240","description":"Clinically Complex _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01780","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","description":"CPT-01780","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of spinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63173","description":"Drainage of spinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0516T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt w out cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9241","description":"Doc pt w out cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA11","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESA1","description":"ICD-LESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLD0","description":"ICD-KCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX02","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEE1","description":"ICD-GIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retainer Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6753","description":"Retainer Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUE1","description":"ICD-NDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no min inv dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8876","description":"Doc reas no min inv dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTD0","description":"ICD-CCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87594","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","description":"CPT-87594","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARE1","description":"ICD-KARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMB1","description":"ICD-MCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close kidney-skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50520","description":"Close kidney-skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLA1","description":"ICD-MJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"School-based iep ser bundled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1018","description":"School-based iep ser bundled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA11","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTA0","description":"ICD-CCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ hematolymphoid neoplasm or disorder_ 5-50 genes (eg_ BRAF_ CEBPA_ DNMT3A_ EZH2_ FLT3_ IDH1_ IDH2_ JAK2_ KIT_ KRAS_ MLL_ NOTCH1_ NPM1_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81451","description":"Targeted genomic sequence analysis panel_ hematolymphoid neoplasm or disorder_ 5-50 genes (eg_ BRAF_ CEBPA_ DNMT3A_ EZH2_ FLT3_ IDH1_ IDH2_ JAK2_ KIT_ KRAS_ MLL_ NOTCH1_ NPM1_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDF0","description":"ICD-CCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens_ >= 1.66 p/>=1.80 g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2783","description":"Lens_ >= 1.66 p/>=1.80 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diphtheria antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86648","description":"Diphtheria antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31256","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Motion test w/ft press meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96001","description":"Motion test w/ft press meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJD1","description":"ICD-NIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gauze > 48 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6221","description":"Gauze > 48 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAC0","description":"ICD-BAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"APOL1 (apolipoprotein L1) (eg_ chronic kidney disease)_ risk variants (G1_ G2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0355U","description":"APOL1 (apolipoprotein L1) (eg_ chronic kidney disease)_ risk variants (G1_ G2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGD1","description":"ICD-NKGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAE0","description":"ICD-GFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTA1","description":"ICD-OFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; Each Additional 30 Minutes Beyond The First 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2088","description":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; Each Additional 30 Minutes Beyond The First 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIF0","description":"ICD-NIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth spine manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64051","description":"Anesth spine manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQC0","description":"ICD-PIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESC0","description":"ICD-KESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J8522","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","description":"HCPCS-J8522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSD0","description":"ICD-LFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMC1","description":"ICD-JAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBED0","description":"ICD-FBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUE0","description":"ICD-CHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radio/surgical implant index","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6190","description":"Radio/surgical implant index","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDF1","description":"ICD-IGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGD0","description":"ICD-JGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx bronchoscope/brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31623","description":"Dx bronchoscope/brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPE0","description":"ICD-CEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICF0","description":"ICD-IICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36582","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKF0","description":"ICD-NGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ implantable aortic counte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0463T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ implantable aortic counte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUD1","description":"ICD-JHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWB1","description":"ICD-KCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC215","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIF0","description":"ICD-AIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATD0","description":"ICD-KATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24C","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27466","description":"Lengthening of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug scrn quan mycophenolate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80180","description":"Drug scrn quan mycophenolate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35301","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0521U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","description":"CPT-0521U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transseptal fiberotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7291","description":"Transseptal fiberotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77402","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDC0","description":"ICD-NLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Listeria monocytogenes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86723","description":"Listeria monocytogenes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPB0","description":"ICD-NHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJD1","description":"ICD-NBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDF1","description":"ICD-EEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autologous blood op salvage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86891","description":"Autologous blood op salvage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC25","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TOTAL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4330","description":"TOTAL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGD0","description":"ICD-OBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28B","description":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARA1","description":"ICD-PARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMF0","description":"ICD-GAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLB1","description":"ICD-GCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODND1","description":"ICD-ODND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC120","description":"Reduced Physical Function _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYA0","description":"ICD-PFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9146","description":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for shoulder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23350","description":"Injection for shoulder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1200","description":"Wheelchair amputee fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10D","description":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7504","description":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63101","description":"Remove vert body dcmprn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABD0","description":"ICD-GABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude organ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37243","description":"Vasc embolize/occlude organ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98004","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","description":"CPT-98004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOC0","description":"ICD-HFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31233","description":"Nasal/sinus endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWE1","description":"ICD-OFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heroin metabolite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80356","description":"Heroin metabolite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem nonodonto cyst to 1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7460","description":"Rem nonodonto cyst to 1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHE0","description":"ICD-ODHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zanamivir_ inh pwdr_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9034","description":"Zanamivir_ inh pwdr_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIF0","description":"ICD-AHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69420","description":"Incision of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMD0","description":"ICD-MFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debride nail 6 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11721","description":"Debride nail 6 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66987","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ betibeglogene autotemcel_ per treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3393","description":"Injection_ betibeglogene autotemcel_ per treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMC0","description":"ICD-MAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0683","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","description":"HCPCS-E0683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot </4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64895","description":"Nerve graft hand/foot </4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8F","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSF1","description":"ICD-OJSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt no hx act drain 90 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8562","description":"Pt no hx act drain 90 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJD1","description":"ICD-FCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLF1","description":"ICD-ADLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEB1","description":"ICD-ABEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aminolevulinic acid hcl top","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7308","description":"Aminolevulinic acid hcl top","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy flex biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43202","description":"Esophagoscopy flex biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ hymovis_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7322","description":"Hyaluronan or derivative_ hymovis_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens lenticular bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2215","description":"Lens lenticular bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icar ischm mntrng prgrm eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0305T","description":"Icar ischm mntrng prgrm eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27443","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKA1","description":"ICD-GAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWB1","description":"ICD-LBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"T cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86359","description":"T cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc acc_ lith-based battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2397","description":"Pwc acc_ lith-based battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; respiratory syncytial virus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87807","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; respiratory syncytial virus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biliary endo perq dx w/speci","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47552","description":"Biliary endo perq dx w/speci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation thru metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28805","description":"Amputation thru metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-anns_ biosimilar_ (kanjinti)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5117","description":"Injection_ trastuzumab-anns_ biosimilar_ (kanjinti)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0885T","description":"Colonoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt alive 3 mos post proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9540","description":"Pt alive 3 mos post proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETC1","description":"ICD-IETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPE0","description":"ICD-KFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBA1","description":"ICD-OGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj mepivacaine hcl/10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0670","description":"Inj mepivacaine hcl/10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJC0","description":"ICD-FHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQA0","description":"ICD-DEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of progesterone 17-d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83498","description":"Assay of progesterone 17-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHB0","description":"ICD-EDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"L colectomy/coloproctostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44207","description":"L colectomy/coloproctostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWA0","description":"ICD-OIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFC0","description":"ICD-NLFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64760","description":"Incision of vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB150","description":"Reduced Physical Function _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9277","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","description":"HCPCS-J9277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIA0","description":"ICD-JBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXB0","description":"ICD-FIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ furosemide (furoscix)_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1941","description":"Injection_ furosemide (furoscix)_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5655","description":"Socket insert below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLF1","description":"ICD-GCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSE0","description":"ICD-PBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEB0","description":"ICD-KGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX35","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSC1","description":"ICD-HBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNC1","description":"ICD-OCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECF0","description":"ICD-OECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILE1","description":"ICD-CILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPC0","description":"ICD-CGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJB1","description":"ICD-CGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC11","description":"ICD-2CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJC0","description":"ICD-JGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICED1","description":"ICD-ICED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETB1","description":"ICD-CETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Construct bowel bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50825","description":"Construct bowel bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGE0","description":"ICD-FGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart muscle imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78459","description":"Heart muscle imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFA0","description":"ICD-CHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMA1","description":"ICD-FCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAF0","description":"ICD-GAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFA0","description":"ICD-OIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC11","description":"ICD-3FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94851","description":"Anesth repair of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home modifications per serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5165","description":"Home modifications per serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLND1","description":"ICD-OLND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAB0","description":"ICD-JHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMB0","description":"ICD-MGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0841","description":"Pwc gp2 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA42","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDC0","description":"ICD-NEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAD0","description":"ICD-CFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHA1","description":"ICD-MIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAB1","description":"ICD-MDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPF0","description":"ICD-KHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9329","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","description":"HCPCS-J9329","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHB1","description":"ICD-BHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFE1","description":"ICD-BFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0638U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0638U","description":"CPT-0638U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBB1","description":"ICD-ECBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAF0","description":"ICD-OBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8H","description":"Very High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parasymp&symp hrt rate test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95943","description":"Parasymp&symp hrt rate test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUE1","description":"ICD-FAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0923T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","description":"CPT-0923T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNA0","description":"ICD-OHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28I","description":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); open_ from cadaver donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0664T","description":"Donor hysterectomy (including cold preservation); open_ from cadaver donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASA0","description":"ICD-KASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMC1","description":"ICD-FDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iop down >15% of pre-svc lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3284F","description":"Iop down >15% of pre-svc lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB42","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKE1","description":"ICD-GHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSA0","description":"ICD-PKSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25365","description":"Revise radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive Full Body Computer-Based Markerless 3D Kinematic And Kinetic Motion Analysis And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0693T","description":"Comprehensive Full Body Computer-Based Markerless 3D Kinematic And Kinetic Motion Analysis And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64659","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","description":"CPT-64659","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLB0","description":"ICD-FCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBC1","description":"ICD-MEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interscap-thor myoelectronic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6975","description":"Interscap-thor myoelectronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAC0","description":"ICD-CGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICD1","description":"ICD-OICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRB0","description":"ICD-LIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLC1","description":"ICD-FFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0701","description":"HCPCS-A0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUF0","description":"ICD-MGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/stone remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52352","description":"Cystouretero w/stone remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25450","description":"Revision of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Appendectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44955","description":"Appendectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tetanus ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90389","description":"Tetanus ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOF1","description":"ICD-LCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec stim cancer treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0766","description":"Elec stim cancer treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18X","description":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHB1","description":"ICD-OEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIB0","description":"ICD-MAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCB1","description":"ICD-IFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUE0","description":"ICD-KGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEB1","description":"ICD-MAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWF0","description":"ICD-PBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTC0","description":"ICD-EHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX42","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0D","description":"Medium Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSB0","description":"ICD-CCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBD0","description":"ICD-NDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","description":"HCPCS-M1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESB1","description":"ICD-OESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIB1","description":"ICD-KHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Driver pneumatic vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0480","description":"Driver pneumatic vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPE1","description":"ICD-JIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Root amputation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3450","description":"Root amputation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ace/arb thxpy for mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4210F","description":"Ace/arb thxpy for mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENF1","description":"ICD-GENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mrs disc pain transmis data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0610T","description":"Mrs disc pain transmis data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRE1","description":"ICD-PFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAD0","description":"ICD-AFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Csf shunt reprogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62252","description":"Csf shunt reprogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6541","description":"Gc stocking waistlngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWB1","description":"ICD-GHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hbot_ full body chamber_ 30m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0277","description":"Hbot_ full body chamber_ 30m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHF0","description":"ICD-OFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye photodynamic ther add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67225","description":"Eye photodynamic ther add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELA1","description":"ICD-OELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWE0","description":"ICD-OEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/ coronary artery stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4561F","description":"Pt w/ coronary artery stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 2.6-7.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12032","description":"Intmd rpr s/a/t/ext 2.6-7.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11424","description":"Exc h-f-nk-sp b9+marg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ertapenem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1335","description":"Ertapenem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERB0","description":"ICD-KERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIF1","description":"ICD-MHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYB1","description":"ICD-GFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOF0","description":"ICD-LAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDB1","description":"ICD-EEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0B","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6003","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-op service lvrs complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0302","description":"Pre-op service lvrs complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYB0","description":"ICD-GCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYD1","description":"ICD-CAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDA1","description":"ICD-IEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35092","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLF0","description":"ICD-AFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACE0","description":"ICD-KACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24900","description":"Amputation of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Battery chrgr six volt otto","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7362","description":"Battery chrgr six volt otto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRD1","description":"ICD-PLRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-qyyp_ biosimilar_ (trazimera)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5116","description":"Injection_ trastuzumab-qyyp_ biosimilar_ (trazimera)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0360T","description":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing loss dup/del analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81431","description":"Hearing loss dup/del analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGD0","description":"ICD-JBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACE0","description":"ICD-EACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYB0","description":"ICD-KAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla class i high defin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86832","description":"Hla class i high defin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0952T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","description":"CPT-0952T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBE0","description":"ICD-EFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15012","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","description":"CPT-15012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Care coord at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9477","description":"Care coord at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE145","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOE0","description":"ICD-GCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge base metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6211","description":"Bridge base metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRA0","description":"ICD-GBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32609","description":"Thoracoscopy w/bx pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEE1","description":"ICD-IBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc stom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43659","description":"Laparoscope proc stom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJA1","description":"ICD-KFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHD0","description":"ICD-AFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKB1","description":"ICD-JFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBA0","description":"ICD-OIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSF1","description":"ICD-ODSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIA1","description":"ICD-EAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXE1","description":"ICD-NIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOD1","description":"ICD-CHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXB0","description":"ICD-BHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile ele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0335U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile ele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28635","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKB1","description":"ICD-FHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0773T","description":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWC1","description":"ICD-OLWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of phenytoin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80185","description":"Assay of phenytoin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGD0","description":"ICD-NJGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med list docd in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1159F","description":"Med list docd in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCA1","description":"ICD-ADCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPC1","description":"ICD-CIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUA1","description":"ICD-IHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJD0","description":"ICD-OGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ercp w/optical endomicroscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0397T","description":"Ercp w/optical endomicroscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep c antiviral started","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9205","description":"Hep c antiviral started","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ copanlisib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9030","description":"Injection_ copanlisib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0522T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXA0","description":"ICD-OJXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGA1","description":"ICD-KDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bld glucose monitor w voice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2100","description":"Bld glucose monitor w voice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise head/neck of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27179","description":"Revise head/neck of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVB0","description":"ICD-NLVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ triluron_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7332","description":"Hyaluronan or derivative_ triluron_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOF1","description":"ICD-HBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo pos solid ank plastic mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1960","description":"Afo pos solid ank plastic mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8C","description":"Low Rehab_ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41120","description":"Partial removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVE1","description":"ICD-OLVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB30","description":"Low Rehab_ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMF1","description":"ICD-CEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1904","description":"HCPCS-C1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGME0","description":"ICD-IGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate t3b-t4noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9079","description":"Onc dx prostate t3b-t4noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWF0","description":"ICD-GFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXA1","description":"ICD-CDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEE0","description":"ICD-MHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKD1","description":"ICD-CGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNA0","description":"ICD-BFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin ext jnts fld swg e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5726","description":"Knee-shin ext jnts fld swg e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conz of cervix w/scope leep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57461","description":"Conz of cervix w/scope leep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGB0","description":"ICD-FFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDB0","description":"ICD-OCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVD1","description":"ICD-GAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA21","description":"ICD-4JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRB1","description":"ICD-GGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTD1","description":"ICD-GCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLE0","description":"ICD-OJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXD1","description":"ICD-BBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suture small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44603","description":"Suture small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTF0","description":"ICD-ICTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIC1","description":"ICD-IFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAE1","description":"ICD-MJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIE1","description":"ICD-OEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Encephaltis west eqne antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86654","description":"Encephaltis west eqne antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRD1","description":"ICD-CDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lightweight wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0003","description":"Lightweight wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJD0","description":"ICD-BHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23D","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ levoleucovorin_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9043","description":"Injection_ levoleucovorin_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0504","description":"HCPCS-C0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q3h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9497","description":"Hit antibiotic q3h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam ribs bil 3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71110","description":"X-ray exam ribs bil 3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC115","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJC1","description":"ICD-CAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJD0","description":"ICD-KBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plate pheres leukoredu irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9037","description":"Plate pheres leukoredu irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYD1","description":"ICD-PKYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTA0","description":"ICD-FGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery w/tunnel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33505","description":"Repair artery w/tunnel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCC1","description":"ICD-ABCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAF0","description":"ICD-KHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee orthosis (KO)_ single upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1851","description":"Knee orthosis (KO)_ single upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQF0","description":"ICD-HFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHC0","description":"ICD-AFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXD0","description":"ICD-CFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVF0","description":"ICD-NGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYE1","description":"ICD-HGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXF1","description":"ICD-BCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calculus analysis qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82355","description":"Calculus analysis qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant radiation dosimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4650","description":"Implant radiation dosimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Throat muscle surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43030","description":"Throat muscle surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAE0","description":"ICD-NBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D6196","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6196","description":"CDT-D6196","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt asst re end life issues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4553F","description":"Pt asst re end life issues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13A","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAC1","description":"ICD-FDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJED0","description":"ICD-NJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB53","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOD0","description":"ICD-DEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSE1","description":"ICD-PGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLD0","description":"ICD-GBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation_ comprehensive_ with review of records and specimens_ with report on referred material (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0840T","description":"Digitization of glass microscope slides for consultation_ comprehensive_ with review of records and specimens_ with report on referred material (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood/lymph nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78199","description":"Blood/lymph nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKD1","description":"ICD-FCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRD0","description":"ICD-LFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic type socket molde","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2350","description":"Prosthetic type socket molde","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1274","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph endoscopy dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43226","description":"Esoph endoscopy dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHF1","description":"ICD-NGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLC1","description":"ICD-BFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Campylobacter antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86625","description":"Campylobacter antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGD0","description":"ICD-BDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1030","description":"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPF1","description":"ICD-NFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0677U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677U","description":"CPT-0677U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immune admin oral/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90473","description":"Immune admin oral/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6123","description":"Implant Supported Retainer For Metal Fpd - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCE1","description":"ICD-GCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ inclisiran_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1306","description":"Injection_ inclisiran_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4207","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4207","description":"HCPCS-Q4207","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATB1","description":"ICD-JATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHA0","description":"ICD-IEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOC0","description":"ICD-LHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of urethra abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53060","description":"Drainage of urethra abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25425","description":"Repair/graft radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDE0","description":"ICD-BBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEA0","description":"ICD-NCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10C","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-pbbk (fylnetra)_ biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5130","description":"Injection_ pegfilgrastim-pbbk (fylnetra)_ biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHD1","description":"ICD-OBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parathyroid planar imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78070","description":"Parathyroid planar imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOA0","description":"ICD-PIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEME0","description":"ICD-MEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolong e&m/psyctx serv o/p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99354","description":"Prolong e&m/psyctx serv o/p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inlay titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6624","description":"Inlay titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC31","description":"ICD-4AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAC1","description":"ICD-KGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frame depth 22 to 25 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2204","description":"Frame depth 22 to 25 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDA0","description":"ICD-IIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01520","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","description":"CPT-01520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALF0","description":"ICD-AALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ldl-c 100-129 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3049F","description":"Ldl-c 100-129 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1203","description":"HCPCS-A1203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9822","description":"Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDB1","description":"ICD-KEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLB0","description":"ICD-OBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBE1","description":"ICD-MIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD244","description":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKE1","description":"ICD-KFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTF1","description":"ICD-MKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOE1","description":"ICD-OAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOA1","description":"ICD-GDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIB0","description":"ICD-CCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0875T","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"West nile virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86789","description":"West nile virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 5-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99441","description":"Phone e/m phys/qhp 5-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOD1","description":"ICD-GAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPF1","description":"ICD-OBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23929","description":"Shoulder surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0904","description":"HCPCS-B0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1304","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITF0","description":"ICD-OITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEC0","description":"ICD-OAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEA0","description":"ICD-BDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug admin & hemodynmic meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93463","description":"Drug admin & hemodynmic meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23C","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYC1","description":"ICD-LAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUD1","description":"ICD-ADUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures adjust cmplt maxil","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5410","description":"Dentures adjust cmplt maxil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid lined custom fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0482","description":"Tlso rigid lined custom fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth face/skull bone surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19051","description":"Anesth face/skull bone surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair palate pharynx/uvula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42145","description":"Repair palate pharynx/uvula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYB0","description":"ICD-GIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Outer ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69399","description":"Outer ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBB0","description":"ICD-OFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egfr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81235","description":"Egfr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB156","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27618","description":"Exc leg/ankle tum < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES115","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with destruction by radiofrequency ablation_ posterior nasal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31242","description":"Nasal/sinus endoscopy_ surgical; with destruction by radiofrequency ablation_ posterior nasal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25D","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures adjust part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5422","description":"Dentures adjust part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC17","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXD0","description":"ICD-CGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHC1","description":"ICD-CGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMA0","description":"ICD-CDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATE1","description":"ICD-EATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of implanted vestibular device_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0727T","description":"Removal and replacement of implanted vestibular device_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTB0","description":"ICD-NHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","description":"CPT-98014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40720","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGB0","description":"ICD-BFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Balance lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2700","description":"Balance lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq card stent w/angio addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92929","description":"Prq card stent w/angio addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAF1","description":"ICD-JAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVF1","description":"ICD-KHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9224","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9224","description":"CDT-D9224","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHD0","description":"ICD-FBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRD0","description":"ICD-PGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm transmitter ald","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5288","description":"Ald fm/dm transmitter ald","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE221","description":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHB1","description":"ICD-GCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASA0","description":"ICD-PASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apnea monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0618","description":"Apnea monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIA1","description":"ICD-IIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjust ankle ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1815","description":"Adjust ankle ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1380","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","description":"HCPCS-M1380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDA1","description":"ICD-FEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUA1","description":"ICD-OHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHA0","description":"ICD-OLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLD1","description":"ICD-CDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","description":"HCPCS-E1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDA1","description":"ICD-IIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22B","description":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUE1","description":"ICD-GCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIF0","description":"ICD-OEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; characterization of alleles (eg_ expanded size or me","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81204","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; characterization of alleles (eg_ expanded size or me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hizentra injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1559","description":"Hizentra injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICF0","description":"ICD-MICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clean out mastoid cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69220","description":"Clean out mastoid cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPC1","description":"ICD-FHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq transcath closure pda","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93582","description":"Perq transcath closure pda","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWD1","description":"ICD-OIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYB1","description":"ICD-OCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLF0","description":"ICD-OFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHE0","description":"ICD-FBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYC0","description":"ICD-DAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB126","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFB1","description":"ICD-NKFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical testimony","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99075","description":"Medical testimony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNA0","description":"ICD-NCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDE0","description":"ICD-IFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient is undergoing palliative dialysis with a catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9747","description":"Patient is undergoing palliative dialysis with a catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHC0","description":"ICD-GGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21A","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCA1","description":"ICD-NDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuragen nerve guide_ per cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9352","description":"Neuragen nerve guide_ per cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSC0","description":"ICD-PDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whirlpool tub_ walk-in_ portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1301","description":"Whirlpool tub_ walk-in_ portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDA0","description":"ICD-NBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBE1","description":"ICD-JGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transection or ligation_ carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61612","description":"Transection or ligation_ carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41899","description":"Dental surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCME0","description":"ICD-BCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAID1","description":"ICD-NAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDB0","description":"ICD-ACDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES154","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQF0","description":"ICD-DEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWF0","description":"ICD-OBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMF1","description":"ICD-OGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNF0","description":"ICD-BHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthro acetabuloplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29915","description":"Hip arthro acetabuloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAD1","description":"ICD-ABAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDA1","description":"ICD-OHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWA1","description":"ICD-CBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC144","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOC1","description":"ICD-OBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct urethra stage 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53425","description":"Reconstruct urethra stage 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9839","description":"Anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph egd dilation <30 mm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43249","description":"Esoph egd dilation <30 mm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKD0","description":"ICD-NDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPB1","description":"ICD-KEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBF1","description":"ICD-BDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARE1","description":"ICD-GARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ gemcitabine hydrochloride (accord)_ not therapeutically equivalent to j9201_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9196","description":"Injection_ gemcitabine hydrochloride (accord)_ not therapeutically equivalent to j9201_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation medicine (allograft rejection_ renal)_ measurement of donor and third-party-induced CD154+T-cytotoxic memory cells_ utilizing whole peripheral blood_ algorithm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0018M","description":"Transplantation medicine (allograft rejection_ renal)_ measurement of donor and third-party-induced CD154+T-cytotoxic memory cells_ utilizing whole peripheral blood_ algorithm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6751","description":"Crown porcelain base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQB0","description":"ICD-LIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21B","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC54","description":"High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay triiodothyronine (t3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84480","description":"Assay triiodothyronine (t3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Graftjacket xpress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4113","description":"Graftjacket xpress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVE1","description":"ICD-NGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colpopexy_ vaginal; minimally invasive extra-peritoneal approach (sacrospinous)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9778","description":"Colpopexy_ vaginal; minimally invasive extra-peritoneal approach (sacrospinous)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTA1","description":"ICD-NCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCF0","description":"ICD-OFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAID1","description":"ICD-GAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNB0","description":"ICD-JFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove jaw joint cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21060","description":"Remove jaw joint cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB40","description":"Ultra High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICC1","description":"ICD-JICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA213","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Basic vestibular evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92540","description":"Basic vestibular evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis_ copy number variants_ and micros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81463","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis_ copy number variants_ and micros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFE0","description":"ICD-FIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPB0","description":"ICD-OEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair accessory_ foot box_ any type_ includes attachment and mounting hardware_ each foot.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0954","description":"Wheelchair accessory_ foot box_ any type_ includes attachment and mounting hardware_ each foot.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMC0","description":"ICD-KGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBB0","description":"ICD-JBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITE1","description":"ICD-JITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAB1","description":"ICD-ACAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKF0","description":"ICD-GFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBB1","description":"ICD-BGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0602","description":"HCPCS-C0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable male external cat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4349","description":"Disposable male external cat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWC0","description":"ICD-CAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6035","description":"Gold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interferon alfa-n3 inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9215","description":"Interferon alfa-n3 inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWE0","description":"ICD-DGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24D","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMC1","description":"ICD-ABMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc recpt counsl vit d/calc+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4019F","description":"Doc recpt counsl vit d/calc+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXE1","description":"ICD-NBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXF1","description":"ICD-JFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJME1","description":"ICD-MJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amniocentesis therapeutic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59001","description":"Amniocentesis therapeutic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Birthing class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9442","description":"Birthing class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of metanephrines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83835","description":"Assay of metanephrines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22D","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eosinophil blood count","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3630","description":"Eosinophil blood count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mh clubhouse svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2031","description":"Mh clubhouse svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDF0","description":"ICD-AGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFED1","description":"ICD-CFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOC1","description":"ICD-PLOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWF0","description":"ICD-KGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB43","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETE1","description":"ICD-BETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCE1","description":"ICD-MCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1461","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","description":"HCPCS-M1461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMA0","description":"ICD-NFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sipuleucel-t auto cd54+","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2043","description":"Sipuleucel-t auto cd54+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQD1","description":"ICD-GFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYF1","description":"ICD-LCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD240","description":"Special Care High _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision_ benign lesion including margins_ except skin tag (unless listed elsewhere)_ trunk_ arms or legs; excised diameter 2.1 to 3.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11403","description":"Excision_ benign lesion including margins_ except skin tag (unless listed elsewhere)_ trunk_ arms or legs; excised diameter 2.1 to 3.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29819","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC21","description":"ICD-2JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Donor pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48550","description":"Donor pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fqhc visit_ mh new pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0469","description":"Fqhc visit_ mh new pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSA0","description":"ICD-HBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17281","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGD0","description":"ICD-JEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAE0","description":"ICD-JEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15936","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test one fiber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95872","description":"Muscle test one fiber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJD1","description":"ICD-OIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAA1","description":"ICD-JIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIF0","description":"ICD-ADIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17266","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech audiom thresh & recog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0211T","description":"Speech audiom thresh & recog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of arm artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34111","description":"Removal of arm artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHC0","description":"ICD-KCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thorax spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22327","description":"Treat thorax spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement diaphragm/fplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7502","description":"Replacement diaphragm/fplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scr unheal etoh w/counsel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9621","description":"Scr unheal etoh w/counsel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe molded plastazote cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3252","description":"Shoe molded plastazote cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat combo w/o shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1006","description":"Pwr seat combo w/o shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28A","description":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr any 30.1-60 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14301","description":"Tis trnfr any 30.1-60 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMA1","description":"ICD-JBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIA0","description":"ICD-IIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOE0","description":"ICD-LDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cad measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8489","description":"Cad measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat skull fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62000","description":"Treat skull fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMD1","description":"ICD-ADMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25B","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHD0","description":"ICD-MAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOE0","description":"ICD-KCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIE1","description":"ICD-BAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC154","description":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADD0","description":"ICD-CADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYD0","description":"ICD-OEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOA0","description":"ICD-DAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99252","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp 5yrs/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99144","description":"Mod sedat phys/qhp 5yrs/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKF0","description":"ICD-JAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDE0","description":"ICD-AIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLD1","description":"ICD-AGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAND0","description":"ICD-CAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dyphylline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1180","description":"Dyphylline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIB0","description":"ICD-KEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary cath leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4334","description":"Urinary cath leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXF1","description":"ICD-KCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMC1","description":"ICD-EIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0108","description":"Stroke with Motor <26.15 & Age >84.5_ without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysate conc pow per pack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4765","description":"Dialysate conc pow per pack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with transvenous sensing and stimulation leads","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1823","description":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with transvenous sensing and stimulation leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIB1","description":"ICD-NEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cancer treatment plan change","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0354","description":"Cancer treatment plan change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46900","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWB1","description":"ICD-OIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKE0","description":"ICD-BHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove elbow joint implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24160","description":"Remove elbow joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v auto rescreen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88148","description":"Cytopath c/v auto rescreen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of multivisc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2054","description":"Transplantation of multivisc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCC1","description":"ICD-AFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJC0","description":"ICD-BAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUB0","description":"ICD-FBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRA1","description":"ICD-HCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKC0","description":"ICD-KEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHB1","description":"ICD-KEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49000","description":"Exploration of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy treat blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31641","description":"Bronchoscopy treat blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPB0","description":"ICD-CIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21A","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom shoes depth inlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3230","description":"Custom shoes depth inlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; multi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36466","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; multi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28C","description":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33762","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69955","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC21","description":"ICD-1EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decalcify tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88311","description":"Decalcify tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ propofol_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2704","description":"Inj_ propofol_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEB0","description":"ICD-NDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decoronation or submergence of an erupted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3921","description":"Decoronation or submergence of an erupted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0531U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","description":"CPT-0531U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEE0","description":"ICD-OHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93241","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE110","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFE0","description":"ICD-CEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYC0","description":"ICD-OEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin alfa_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0885","description":"Epoetin alfa_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOC0","description":"ICD-GEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cilastatin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0743","description":"Cilastatin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXD1","description":"ICD-FDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGB1","description":"ICD-OGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-evaluation of physical therapy established plan of care_ requiring these components: An examination including a review of history and use of standardized tests and measures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97164","description":"Re-evaluation of physical therapy established plan of care_ requiring these components: An examination including a review of history and use of standardized tests and measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRE0","description":"ICD-CBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJC1","description":"ICD-JDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HER2/neu negative or undocumented/unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9825","description":"HER2/neu negative or undocumented/unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNE1","description":"ICD-OLNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional outcome assessment not documented as being performed_ documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8540","description":"Functional outcome assessment not documented as being performed_ documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVA0","description":"ICD-CCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGD0","description":"ICD-JHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA21","description":"ICD-2IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA05","description":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSF0","description":"ICD-GCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2516","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","description":"HCPCS-J2516","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA221","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contour back for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2293","description":"Contour back for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal cord puncture prenatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59012","description":"Fetal cord puncture prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUF0","description":"ICD-KFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIA0","description":"ICD-IHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver elastography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91200","description":"Liver elastography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRC0","description":"ICD-GBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rectum and colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45121","description":"Removal of rectum and colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit sing/m/fam couns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99510","description":"Home visit sing/m/fam couns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remov vert xdrl bdy lmbr/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63303","description":"Remov vert xdrl bdy lmbr/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic Small Intestine Follow-Through Study_ Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examinatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74248","description":"Radiologic Small Intestine Follow-Through Study_ Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examinatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23D","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10D","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAE1","description":"ICD-JBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCD1","description":"ICD-ABCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with non-invasive interface (e.g. mask)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0464","description":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with non-invasive interface (e.g. mask)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28104","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDC1","description":"ICD-OJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDE0","description":"ICD-AHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Performance Met: The Residual Change Score  Is Equal To Or Greater Than 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2152","description":"Performance Met: The Residual Change Score  Is Equal To Or Greater Than 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVB1","description":"ICD-OKVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB16","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVC0","description":"ICD-CIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recorder without 24 hour attended moni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0497T","description":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recorder without 24 hour attended moni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Belinostat_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9442","description":"Injection_ Belinostat_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKE0","description":"ICD-FBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-expandable controller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2375","description":"Non-expandable controller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24546","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTE1","description":"ICD-CBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18B","description":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMC0","description":"ICD-MBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYD0","description":"ICD-LGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy roof of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42100","description":"Biopsy roof of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73000","description":"X-ray exam of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSD0","description":"ICD-PBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast cancer dx min invsive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8875","description":"Breast cancer dx min invsive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calibrated microcap tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4651","description":"Calibrated microcap tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle(s) add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67320","description":"Revise eye muscle(s) add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mohs surg addl block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17315","description":"Mohs surg addl block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alveoplasty w/o extraction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7320","description":"Alveoplasty w/o extraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA112","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroretinography (ERG) with interpretation and report_ pattern (PERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0509T","description":"Electroretinography (ERG) with interpretation and report_ pattern (PERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXC0","description":"ICD-NBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt scrnd hgh-risk sex behav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4293F","description":"Pt scrnd hgh-risk sex behav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA11","description":"ICD-2JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNF0","description":"ICD-OHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUB0","description":"ICD-IAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIC0","description":"ICD-CFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42310","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCB0","description":"ICD-GFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRB1","description":"ICD-OJRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","description":"HCPCS-L6038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXA0","description":"ICD-GCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA11","description":"ICD-4KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin cartridge 150 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5565","description":"Insulin cartridge 150 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUB1","description":"ICD-EAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rad resect abd tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22905","description":"Rad resect abd tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBA1","description":"ICD-ABBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA22","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEB0","description":"ICD-CCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYF0","description":"ICD-OLYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Axolotl graft or axolotl dualgraft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4210","description":"Axolotl graft or axolotl dualgraft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSC1","description":"ICD-LBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2D","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDD1","description":"ICD-JCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAC0","description":"ICD-ADAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9066","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9066","description":"HCPCS-J9066","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00940","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","description":"CPT-00940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","description":"HCPCS-J2804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVD0","description":"ICD-NJVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA131","description":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61640","description":"Dilate ic vasospasm init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA101","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUA1","description":"ICD-CCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tibial arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29856","description":"Tibial arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILE0","description":"ICD-OILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric bypass incl small i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43847","description":"Gastric bypass incl small i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral mucoadhesive_ any type (liquid_ gel_ paste_ etc.)_ per 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9156","description":"Oral mucoadhesive_ any type (liquid_ gel_ paste_ etc.)_ per 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC11","description":"ICD-4HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41115","description":"Excision of tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQD0","description":"ICD-KIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt_ pn_ hist grade doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8721","description":"Pt_ pn_ hist grade doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate arrhythmia add on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93655","description":"Ablate arrhythmia add on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHE1","description":"ICD-FGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Delay flap arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15610","description":"Delay flap arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVB1","description":"ICD-OBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41018","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reposition gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43761","description":"Reposition gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBA1","description":"ICD-NBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMB1","description":"ICD-FIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVF1","description":"ICD-CBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGD1","description":"ICD-FEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACB1","description":"ICD-IACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ crotalidae immune F(ab_)2 (equine)_ 120 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0841","description":"Injection_ crotalidae immune F(ab_)2 (equine)_ 120 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited dental tx adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8040","description":"Limited dental tx adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUB1","description":"ICD-NAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUB0","description":"ICD-KHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIB0","description":"ICD-FIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB07","description":"Medium Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syst corticosteroids not rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4136F","description":"Syst corticosteroids not rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of rib fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21813","description":"Treatment of rib fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFE1","description":"ICD-KDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOC1","description":"ICD-OHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVA0","description":"ICD-FEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIF1","description":"ICD-NKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE121","description":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacemnt lithium ionbatter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7367","description":"Replacemnt lithium ionbatter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral nutrition additiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4216","description":"Parenteral nutrition additiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHID0","description":"ICD-KHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFID0","description":"ICD-FFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Space maintainer_ removable bilateral_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1527","description":"Space maintainer_ removable bilateral_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOA0","description":"ICD-DFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5938","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5938","description":"CDT-D5938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Humidifier heated used w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0562","description":"Humidifier heated used w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc w/tla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37228","description":"Tib/per revasc w/tla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPB0","description":"ICD-CGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist/elbow bowden cable mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6580","description":"Wrist/elbow bowden cable mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMA1","description":"ICD-AEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITE1","description":"ICD-MITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pancreatic)_ 59 methylation haplotype block markers_ next-generation sequencing_ plasma_ reported as cancer signal detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0405U","description":"Oncology (pancreatic)_ 59 methylation haplotype block markers_ next-generation sequencing_ plasma_ reported as cancer signal detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVE0","description":"ICD-FAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE116","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNB0","description":"ICD-NBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXA0","description":"ICD-BAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLA1","description":"ICD-JBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9707","description":"Patient received hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supra SDRM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2011","description":"Supra SDRM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ delafloxacin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9462","description":"Injection_ delafloxacin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNE0","description":"ICD-FCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECC0","description":"ICD-KECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYE1","description":"ICD-KFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINE0","description":"ICD-NINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAE0","description":"ICD-ICAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGF1","description":"ICD-NKGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMD1","description":"ICD-GEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria w/o bypass ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33255","description":"Ablate atria w/o bypass ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGC1","description":"ICD-BAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKA0","description":"ICD-CEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQF1","description":"ICD-HEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-pvc intravenous administ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1016","description":"Non-pvc intravenous administ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDA0","description":"ICD-KHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAA1","description":"ICD-AEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEE0","description":"ICD-AAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coordinated specialty care_ team-based_ for first episode psychosis_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2040","description":"Coordinated specialty care_ team-based_ for first episode psychosis_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHF1","description":"ICD-CBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gardner vag dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87511","description":"Gardner vag dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge porcelain nobel metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6242","description":"Bridge porcelain nobel metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX52","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collection of microorganisms","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0415","description":"Collection of microorganisms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLB1","description":"ICD-NCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54326","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIE1","description":"ICD-JHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHD0","description":"ICD-BDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAB1","description":"ICD-KFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4357","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","description":"HCPCS-Q4357","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIB0","description":"ICD-KBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX16","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASD0","description":"ICD-GASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUC1","description":"ICD-KGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine pch w ex wear bar conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4393","description":"Urine pch w ex wear bar conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adenoma(s) or colorectal cancer not detected during screening colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9935","description":"Adenoma(s) or colorectal cancer not detected during screening colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPC0","description":"ICD-FAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21436","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAME1","description":"ICD-KAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stent placemt ante carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37218","description":"Stent placemt ante carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enclosed walker w rear seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0144","description":"Enclosed walker w rear seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTD1","description":"ICD-EGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUB0","description":"ICD-NEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXE0","description":"ICD-OLXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXC1","description":"ICD-CFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA31","description":"ICD-1DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDF0","description":"ICD-BDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTB0","description":"ICD-IFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA111","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate clinical met","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9133","description":"Onc dx prostate clinical met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open tx septal fx w/wo stabj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21336","description":"Open tx septal fx w/wo stabj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33430","description":"Replacement of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCA0","description":"ICD-GDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAF0","description":"ICD-JGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGF0","description":"ICD-OFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJD0","description":"ICD-OFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGF0","description":"ICD-KBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFE1","description":"ICD-NIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBF1","description":"ICD-JBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPF0","description":"ICD-BFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped hospital bed_ manual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0328","description":"Ped hospital bed_ manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVC0","description":"ICD-JAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACB0","description":"ICD-JACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDD1","description":"ICD-KBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNA1","description":"ICD-OKNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair diaphragm laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39501","description":"Repair diaphragm laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA21","description":"ICD-3CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEF0","description":"ICD-NKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIF0","description":"ICD-FEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCB1","description":"ICD-IDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXF0","description":"ICD-BBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGA0","description":"ICD-NKGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQA0","description":"ICD-CBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid &","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4189","description":"Parenteral sol amino acid &","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine quadrivalent (IIV4)_ inactivated_ adjuvanted_ preservative free_ 0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90689","description":"Influenza virus vaccine quadrivalent (IIV4)_ inactivated_ adjuvanted_ preservative free_ 0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASB1","description":"ICD-CASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUA0","description":"ICD-FFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIE0","description":"ICD-GGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYE0","description":"ICD-OKYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJC0","description":"ICD-FCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36216","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interfyl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4171","description":"Interfyl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFB0","description":"ICD-GIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Evicore_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1001","description":"Clinical Decision Support Mechanism Evicore_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0953T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","description":"CPT-0953T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other pt/ot  d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8992","description":"Other pt/ot  d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27230","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOF0","description":"ICD-KCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone cutting body mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7945","description":"Bone cutting body mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lwr xtr vasc stdy bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93924","description":"Lwr xtr vasc stdy bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALB0","description":"ICD-EALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDD1","description":"ICD-NHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTC1","description":"ICD-ECTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOB1","description":"ICD-KGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92081","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10D","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58540","description":"Revision of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMA0","description":"ICD-MLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPD0","description":"ICD-NBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low-level laser therapy_ dynamic photonic and dynamic thermokinetic energies_ provided by a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0552T","description":"Low-level laser therapy_ dynamic photonic and dynamic thermokinetic energies_ provided by a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMF1","description":"ICD-KCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDA1","description":"ICD-NHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCF0","description":"ICD-IHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC21","description":"ICD-2FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No improve visual funct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0915","description":"No improve visual funct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Christian sci nurse visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9901","description":"Christian sci nurse visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWF1","description":"ICD-KIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"General anesthesia_ first 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9222","description":"General anesthesia_ first 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech therapy_ re-eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9152","description":"Speech therapy_ re-eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQE0","description":"ICD-OHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg3b-4 metasta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9066","description":"Onc dx nsclc stg3b-4 metasta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES246","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKB0","description":"ICD-GHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct pelvis w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72193","description":"Ct pelvis w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01714","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","description":"CPT-01714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWF1","description":"ICD-CAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKA1","description":"ICD-FCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD130","description":"Clinically Complex _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXC1","description":"ICD-GHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCB1","description":"ICD-KGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPD1","description":"ICD-BGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBA1","description":"ICD-GFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLE1","description":"ICD-EFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy removal of clots","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52001","description":"Cystoscopy removal of clots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonpectin based ostomy paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4405","description":"Nonpectin based ostomy paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove groin lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38765","description":"Remove groin lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIB1","description":"ICD-MIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTD0","description":"ICD-BDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAC1","description":"ICD-FFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXA0","description":"ICD-CFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of larynx & pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31390","description":"Removal of larynx & pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay clozapine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80159","description":"Drug assay clozapine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEE1","description":"ICD-AEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28E","description":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLF0","description":"ICD-BCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYE1","description":"ICD-LHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13C","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUA0","description":"ICD-OFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB31","description":"ICD-2BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCD1","description":"ICD-FFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETB1","description":"ICD-AETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTB0","description":"ICD-MFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPD1","description":"ICD-GAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18F","description":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18C","description":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy remove lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46612","description":"Anoscopy remove lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAD1","description":"ICD-OAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthroscopy of joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29999","description":"Arthroscopy of joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Great toe-hand transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26551","description":"Great toe-hand transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0960T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","description":"CPT-0960T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; smears with interpretation (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0827T","description":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; smears with interpretation (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD154","description":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVE0","description":"ICD-FDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMA1","description":"ICD-BDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Derm autograft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15131","description":"Derm autograft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSB0","description":"ICD-KDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAD0","description":"ICD-AEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLE0","description":"ICD-AGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagenase_ clost hist inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0775","description":"Collagenase_ clost hist inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revsc opn/prq tib/pero stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37234","description":"Revsc opn/prq tib/pero stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23A","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA06","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEA1","description":"ICD-JFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDE1","description":"ICD-MCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSF0","description":"ICD-HHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHE0","description":"ICD-MAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJA0","description":"ICD-OBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBD0","description":"ICD-IDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJF0","description":"ICD-BBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNC1","description":"ICD-KDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1128","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUB1","description":"ICD-ADUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITE1","description":"ICD-CITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFF0","description":"ICD-JHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43850","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIE0","description":"ICD-MHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M.tuberculo dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87555","description":"M.tuberculo dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGB0","description":"ICD-GBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67835","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epicord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4187","description":"Epicord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSF1","description":"ICD-OKSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBF1","description":"ICD-CDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC35","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1101T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1101T","description":"CPT-1101T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67882","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKF1","description":"ICD-JIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAF1","description":"ICD-ADAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFA1","description":"ICD-CIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Covid-19 vaccine admin inside a patient_s home; reported only once per individual home per date of service when only covid-19 vaccine admin is performed at the patients home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0201","description":"Covid-19 vaccine admin inside a patient_s home; reported only once per individual home per date of service when only covid-19 vaccine admin is performed at the patients home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD234","description":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tkr intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9234","description":"Tkr intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCF0","description":"ICD-KGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHA0","description":"ICD-IBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye mvmt alys w/o calbrj i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0615T","description":"Eye mvmt alys w/o calbrj i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRB1","description":"ICD-OKRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTD1","description":"ICD-CBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKE0","description":"ICD-NBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESB0","description":"ICD-KESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYD1","description":"ICD-HBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMA1","description":"ICD-BIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEA1","description":"ICD-AIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29365","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKC1","description":"ICD-JBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDF1","description":"ICD-IFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Not medically necessary svc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9986","description":"Not medically necessary svc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2115","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLD1","description":"ICD-ACLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIF0","description":"ICD-MBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHC1","description":"ICD-MKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMF0","description":"ICD-AHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJE1","description":"ICD-NGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUC0","description":"ICD-BIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUD1","description":"ICD-EDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve stimulator for tx n&v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0765","description":"Nerve stimulator for tx n&v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYD0","description":"ICD-OCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove carotid body lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60605","description":"Remove carotid body lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreserve testicular tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89335","description":"Cryopreserve testicular tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dm meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8494","description":"Dm meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX16","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis a antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86708","description":"Hepatitis a antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMF1","description":"ICD-FIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTD1","description":"ICD-KFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEC1","description":"ICD-GFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC255","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-53865","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","description":"CPT-53865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (cerebral folate deficiency)_ serum_ detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA)_ q","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0399U","description":"Neurology (cerebral folate deficiency)_ serum_ detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA)_ q","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNA1","description":"ICD-BBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMC0","description":"ICD-OIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical placement of craniofacial implant - extra oral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7993","description":"Surgical placement of craniofacial implant - extra oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close tear system fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68770","description":"Close tear system fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFD1","description":"ICD-GAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELB0","description":"ICD-GELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retr bone flap to fix skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62148","description":"Retr bone flap to fix skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain ovary abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58820","description":"Drain ovary abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pancreatic cancer)_ multiplex immunoassay of C5_ C4_ cystatin C_ factor B_ osteoprotegerin (OPG)_ gelsolin_ IGFBP3_ CA125 and multiplex electrochemiluminescent imm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0342U","description":"Oncology (pancreatic cancer)_ multiplex immunoassay of C5_ C4_ cystatin C_ factor B_ osteoprotegerin (OPG)_ gelsolin_ IGFBP3_ CA125 and multiplex electrochemiluminescent imm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXA0","description":"ICD-GEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETE1","description":"ICD-IETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ low complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes a brief history including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97165","description":"Occupational therapy evaluation_ low complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes a brief history including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEC1","description":"ICD-KFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAA1","description":"ICD-JHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGD1","description":"ICD-OEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl leath cuff kafo-afo cal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4110","description":"Repl leath cuff kafo-afo cal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4032","description":"Cast sup lng leg ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITE1","description":"ICD-NITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair muscles of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26591","description":"Repair muscles of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ear protector evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92596","description":"Ear protector evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ not otherwise specified_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9075","description":"Injection_ cyclophosphamide_ not otherwise specified_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Minocycline hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2265","description":"Minocycline hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18C","description":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc to have fall in asc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8910","description":"Pt doc to have fall in asc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDE1","description":"ICD-NFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2221","description":"Solid caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWD0","description":"ICD-DIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNA0","description":"ICD-KBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1410","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","description":"HCPCS-M1410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Waist belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2190","description":"Waist belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove forearm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25248","description":"Remove forearm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPF1","description":"ICD-OAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydroxychloroquine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80220","description":"Hydroxychloroquine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spec coll non-blood:a/d test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0048","description":"Spec coll non-blood:a/d test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine bacteria culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87088","description":"Urine bacteria culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indic for head ct valid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9531","description":"Indic for head ct valid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHC1","description":"ICD-MGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human papillomavirus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ 68)_ male urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0096U","description":"Human papillomavirus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ 68)_ male urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLD0","description":"ICD-EHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"L ventric pacing lead add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33225","description":"L ventric pacing lead add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQA1","description":"ICD-OGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQD1","description":"ICD-PKQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy gastrostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43653","description":"Laparoscopy gastrostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHE1","description":"ICD-CDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLA1","description":"ICD-NKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFD0","description":"ICD-BFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of foot at ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27888","description":"Amputation of foot at ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELD1","description":"ICD-IELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFB1","description":"ICD-BHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41825","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAD0","description":"ICD-JFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIF0","description":"ICD-BDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAA0","description":"ICD-FHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair anal fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46288","description":"Repair anal fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48154","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace prox & dist upright","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4070","description":"Replace prox & dist upright","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKD0","description":"ICD-OIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoglobulin Light Chains (Ie_ Kappa_ Lambda)_ Free_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83521","description":"Immunoglobulin Light Chains (Ie_ Kappa_ Lambda)_ Free_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0213T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIF0","description":"ICD-MFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ translumin_ drug-coat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2623","description":"Cath_ translumin_ drug-coat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARF0","description":"ICD-GARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16077","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27652","description":"Repair/graft achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIB1","description":"ICD-OGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL17","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEF1","description":"ICD-CFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open tx nose & septal fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21335","description":"Open tx nose & septal fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23A","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1904","description":"HCPCS-A1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Teniposide_ 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2017","description":"Teniposide_ 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMA1","description":"ICD-JGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administrat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0090","description":"Professional services_ initial visit_ for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj paracervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64435","description":"N block inj paracervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA30","description":"Very High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38525","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thumb tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26510","description":"Thumb tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEME1","description":"ICD-GEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUB0","description":"ICD-GHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUA0","description":"ICD-MGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOF0","description":"ICD-DFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIC0","description":"ICD-JGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmic endoscope add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66990","description":"Ophthalmic endoscope add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCC0","description":"ICD-KHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ loncastuximab tesirine-lpyl_ 0.075 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9359","description":"Injection_ loncastuximab tesirine-lpyl_ 0.075 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCE0","description":"ICD-FGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHC0","description":"ICD-ECHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFF1","description":"ICD-JAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of skull tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61564","description":"Excision of skull tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thromboxane urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84431","description":"Thromboxane urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOB0","description":"ICD-KEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIND1","description":"ICD-BIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy surg colpopexy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57425","description":"Laparoscopy surg colpopexy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evidence-based therapy was prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1227","description":"Evidence-based therapy was prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AJCC stage at breast cancer diagnosis = I (Ia or Ib) and T-stage at breast cancer diagnosis does not equal = T1_ T1a_ T1b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9832","description":"AJCC stage at breast cancer diagnosis = I (Ia or Ib) and T-stage at breast cancer diagnosis does not equal = T1_ T1a_ T1b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQC1","description":"ICD-PCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYF1","description":"ICD-KAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt asked re symp auto dysfxn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4326F","description":"Pt asked re symp auto dysfxn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair Accessory_ Dynamic Positioning Hardware For Back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2398","description":"Wheelchair Accessory_ Dynamic Positioning Hardware For Back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBB0","description":"ICD-JEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDD1","description":"ICD-IBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGD1","description":"ICD-OBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Space maintainer_ fixed_ bilateral_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1516","description":"Space maintainer_ fixed_ bilateral_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2753","description":"Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBE1","description":"ICD-ICBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26357","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGB1","description":"ICD-GDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOB1","description":"ICD-KBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo iv infusion addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96415","description":"Chemo iv infusion addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYD1","description":"ICD-PBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0090U","description":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLA0","description":"ICD-MKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARE1","description":"ICD-CARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuromuscular junction test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95937","description":"Neuromuscular junction test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTF0","description":"ICD-BDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1001","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1001","description":"CDT-D1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC206","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAE0","description":"ICD-NIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXD1","description":"ICD-CCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX23","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92250","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX34","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRA0","description":"ICD-KBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee control full kneecap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2795","description":"Knee control full kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37258","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","description":"CPT-37258","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEED1","description":"ICD-CEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0733","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med record copy per page","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9982","description":"Med record copy per page","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWE0","description":"ICD-CEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGE1","description":"ICD-JCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBA0","description":"ICD-BEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of tobramycin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80200","description":"Assay of tobramycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99411","description":"Preventive counseling group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOE1","description":"ICD-LIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEE1","description":"ICD-AIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9256","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","description":"HCPCS-J9256","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJE0","description":"ICD-OJJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPC1","description":"ICD-KGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq&ic allg test drugs/biol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95018","description":"Perq&ic allg test drugs/biol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGF1","description":"ICD-JHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-ionizing diagnostic procedure capable of quantifying_ monitoring_ and recording changes in structure of enamel_ dentin_ and cementum","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0600","description":"Non-ionizing diagnostic procedure capable of quantifying_ monitoring_ and recording changes in structure of enamel_ dentin_ and cementum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAC1","description":"ICD-IFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft head/neck >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64886","description":"Nerve graft head/neck >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB217","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACC1","description":"ICD-IACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJA0","description":"ICD-CAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMF0","description":"ICD-MAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0816T","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWC1","description":"ICD-PGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue localization-excision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1819","description":"Tissue localization-excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ischial bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27060","description":"Removal of ischial bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert self-contd prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54401","description":"Insert self-contd prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1448","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","description":"HCPCS-M1448","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUF0","description":"ICD-GFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALF1","description":"ICD-NALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCE0","description":"ICD-EGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0696T","description":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0123U","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOF0","description":"ICD-KEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRB1","description":"ICD-LCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWD1","description":"ICD-GCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELB1","description":"ICD-GELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp subclav-subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35612","description":"Art byp subclav-subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coombs test direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86880","description":"Coombs test direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ omadacycline_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0121","description":"Injection_ omadacycline_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99600","description":"Home visit nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCD1","description":"ICD-GFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone hexacetonl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3303","description":"Triamcinolone hexacetonl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLC0","description":"ICD-KCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBE1","description":"ICD-CDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7684","description":"Triamcinolone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGC1","description":"ICD-OLGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRE1","description":"ICD-OJRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1080T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1080T","description":"CPT-1080T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWD0","description":"ICD-GBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA16","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPC0","description":"ICD-GBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with dementia any time during the patient_s history through the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1164","description":"Patients with dementia any time during the patient_s history through the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCA0","description":"ICD-CBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKC1","description":"ICD-FDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meprobamate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6052","description":"Meprobamate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shrinker above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8460","description":"Shrinker above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c lateral trunk/hip suppor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0956","description":"W/c lateral trunk/hip suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTC1","description":"ICD-CHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEE0","description":"ICD-BCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRE0","description":"ICD-KFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJA1","description":"ICD-JBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYB0","description":"ICD-PCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place gastrostomy tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49440","description":"Place gastrostomy tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Windowing of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29730","description":"Windowing of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARE0","description":"ICD-OARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gamunex-c/gammaked","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1561","description":"Gamunex-c/gammaked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee lift loop drop lock rin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2492","description":"Knee lift loop drop lock rin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who have an order for or are receiving hospice or palliative care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1186","description":"Patients who have an order for or are receiving hospice or palliative care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDME1","description":"ICD-FDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD110","description":"Special Care High _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTC1","description":"ICD-AHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWA0","description":"ICD-PEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sagit rigid panel prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0635","description":"Lso sagit rigid panel prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDC0","description":"ICD-CHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJE1","description":"ICD-JBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documented reason for not screening or recommending a follow-up for high blood pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9745","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKE1","description":"ICD-CGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAD0","description":"ICD-CGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMF0","description":"ICD-AAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEID0","description":"ICD-KEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCD1","description":"ICD-JHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMF0","description":"ICD-KEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXD0","description":"ICD-BGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not conducting a search for DICOM format images for prior patient CT imaging studies completed at non-affiliated external healthcare facili","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9753","description":"Documentation of medical reason for not conducting a search for DICOM format images for prior patient CT imaging studies completed at non-affiliated external healthcare facili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAE1","description":"ICD-NIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKB1","description":"ICD-ODKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abdom aneurysm endovas rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75953","description":"Abdom aneurysm endovas rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone biopsy excisional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20245","description":"Bone biopsy excisional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision constricting tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26596","description":"Excision constricting tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXA1","description":"ICD-NBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPA1","description":"ICD-BCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA11","description":"ICD-1HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB216","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Odontics eposteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6040","description":"Odontics eposteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPD0","description":"ICD-JIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0609","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","description":"HCPCS-J0609","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB07","description":"Ultra High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHA0","description":"ICD-GGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEA1","description":"ICD-MGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTE1","description":"ICD-KCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLE0","description":"ICD-BHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1737","description":"HCPCS-C1737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPA1","description":"ICD-JHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHF1","description":"ICD-NIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTF0","description":"ICD-GGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo frict swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5712","description":"Knee-shin exo frict swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81416","description":"Exome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sbsq Plmt Drug Eluting Ocular Insert Uni/Bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0445T","description":"Sbsq Plmt Drug Eluting Ocular Insert Uni/Bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open tx compl front sinus fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21344","description":"Open tx compl front sinus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA106","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGE0","description":"ICD-NKGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACB0","description":"ICD-EACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9769","description":"Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolong service w/o contact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99358","description":"Prolong service w/o contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADA1","description":"ICD-EADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDC0","description":"ICD-AIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTF1","description":"ICD-NHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0104","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0104","description":"CDT-D0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUF0","description":"ICD-FDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair fem hernia reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49555","description":"Rerepair fem hernia reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBC0","description":"ICD-BBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Musculoskeletal nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78399","description":"Musculoskeletal nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/4.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2309","description":"Lens sphc trifocal 4.25-7/4.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cap bacterial assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012F","description":"Cap bacterial assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block cont infuse b plex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64416","description":"N block cont infuse b plex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1 med visit in 24mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9247","description":"1 med visit in 24mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXE1","description":"ICD-FGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ bra_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6589","description":"Gradient pressure wrap with adjustable straps_ bra_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPC1","description":"ICD-KBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUE1","description":"ICD-JCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXE0","description":"ICD-OAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHC1","description":"ICD-GGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Refill/maint pump/resvr syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96522","description":"Refill/maint pump/resvr syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJB1","description":"ICD-NGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC10","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sugars single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84378","description":"Sugars single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTF1","description":"ICD-NKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder-vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57320","description":"Repair bladder-vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAD1","description":"ICD-KGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11762","description":"Reconstruction of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA03","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01232","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","description":"CPT-01232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise knuckle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26530","description":"Revise knuckle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSC1","description":"ICD-PHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tendon lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26476","description":"Tendon lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKA1","description":"ICD-BBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neurostim arrays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61886","description":"Implant neurostim arrays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQA1","description":"ICD-KCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDA0","description":"ICD-CHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place needles pelvic for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55920","description":"Place needles pelvic for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27395","description":"Lengthening of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m sestamibi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9500","description":"Tc99m sestamibi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSF1","description":"ICD-PLSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE156","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJE1","description":"ICD-OJJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPC0","description":"ICD-CDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9957","description":"Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITC0","description":"ICD-OITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bl smear w/o diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85008","description":"Bl smear w/o diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXE0","description":"ICD-KCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or com","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99218","description":"Initial observation care_ per day_ for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or com","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECA0","description":"ICD-CECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNB0","description":"ICD-OLNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARD1","description":"ICD-GARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64451","description":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKA1","description":"ICD-OEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 81 Years Of Age And Older With A Evidence Of Frailty During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2118","description":"Patients 81 Years Of Age And Older With A Evidence Of Frailty During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIE0","description":"ICD-EGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQE1","description":"ICD-GAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSB1","description":"ICD-GFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risankizumab-rzaa_ intravenous_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2327","description":"Injection_ risankizumab-rzaa_ intravenous_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81186","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1702","description":"HCPCS-B1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENC0","description":"ICD-GENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHA0","description":"ICD-AEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pild/placebo control clin tr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0276","description":"Pild/placebo control clin tr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fracture frame attached to b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0920","description":"Fracture frame attached to b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compres burn garment panty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6511","description":"Compres burn garment panty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEF1","description":"ICD-CAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIID1","description":"ICD-GIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXF0","description":"ICD-NAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXD1","description":"ICD-BDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cephapirin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0710","description":"Cephapirin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MSH2 (mutS homolog 2) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0159U","description":"MSH2 (mutS homolog 2) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42420","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Burr hole for puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61120","description":"Burr hole for puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA120","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYE0","description":"ICD-OEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYB0","description":"ICD-DHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68110","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACD0","description":"ICD-MACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69552","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOD0","description":"ICD-GHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech lang current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9174","description":"Speech lang current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDC0","description":"ICD-EGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBC0","description":"ICD-NGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIA1","description":"ICD-OBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza a ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87276","description":"Influenza a ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct guide for tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77013","description":"Ct guide for tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLB0","description":"ICD-ABLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKA1","description":"ICD-BDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sio rig pnl pelv/sac pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0623","description":"Sio rig pnl pelv/sac pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALF1","description":"ICD-JALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHE1","description":"ICD-NBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVB0","description":"ICD-OJVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRD1","description":"ICD-DCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEE1","description":"ICD-KCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35206","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHC0","description":"ICD-CGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc rsn no preop assmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9616","description":"Doc rsn no preop assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA14","description":"Default_ /5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infusion ther other than che","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0081","description":"Infusion ther other than che","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1384","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","description":"HCPCS-M1384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interv req for leak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9306","description":"Interv req for leak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); common variant(s) (eg_ HbS_ HbC_ HbE)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81361","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); common variant(s) (eg_ HbS_ HbC_ HbE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22855","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Systemic antimicrobials prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9961","description":"Systemic antimicrobials prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYD1","description":"ICD-OEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31000","description":"Irrigation maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEB0","description":"ICD-KCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEA0","description":"ICD-CIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12B","description":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHF1","description":"ICD-NBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDC0","description":"ICD-NBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61863","description":"Implant neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQB0","description":"ICD-PAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62117","description":"Reduction of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSD0","description":"ICD-PLSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0801","description":"HCPCS-C0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLD1","description":"ICD-ADLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLA1","description":"ICD-GCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01938","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","description":"CPT-01938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27722","description":"Repair/graft of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mepolizumab_ 1 mg (Nucala)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9473","description":"Injection_ mepolizumab_ 1 mg (Nucala)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKB1","description":"ICD-OKKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx planar_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2645","description":"Brachytx planar_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLA1","description":"ICD-BGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYF1","description":"ICD-OGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Death_ permanent nursing home resident or receiving hospice or palliative care any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9433","description":"Death_ permanent nursing home resident or receiving hospice or palliative care any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD116","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The MDPP b eneficiary achieved at least 5% weight loss (WL) from his/he r baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9880","description":"The MDPP b eneficiary achieved at least 5% weight loss (WL) from his/he r baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQA0","description":"ICD-KCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJB0","description":"ICD-OAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDE1","description":"ICD-EBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVB1","description":"ICD-OCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ nonlyophilized_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9318","description":"Injection_ romidepsin_ nonlyophilized_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77412","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJA1","description":"ICD-OLJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE246","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0994T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","description":"CPT-0994T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXA0","description":"ICD-FFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Car seat/bed test + 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94781","description":"Car seat/bed test + 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD260","description":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICE1","description":"ICD-AICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBB1","description":"ICD-NEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPE0","description":"ICD-FCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPD1","description":"ICD-CGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small animal inoculation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87003","description":"Small animal inoculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body adbomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49402","description":"Remove foreign body adbomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDB0","description":"ICD-KGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Estradiol response panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80415","description":"Estradiol response panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYB1","description":"ICD-GHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve repair; with nerve allograft_ each additional strand (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64913","description":"Nerve repair; with nerve allograft_ each additional strand (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLD1","description":"ICD-MJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEE1","description":"ICD-EEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31081","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTC1","description":"ICD-KBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAF1","description":"ICD-NJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of inner eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67036","description":"Removal of inner eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43247","description":"Egd remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone cutting segmented","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7944","description":"Bone cutting segmented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Induction of vomiting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99175","description":"Induction of vomiting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve and glove combination_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6574","description":"Gradient compression arm sleeve and glove combination_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pmp22 gene dup/delet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81324","description":"Pmp22 gene dup/delet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQD1","description":"ICD-LFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXA1","description":"ICD-FIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9804","description":"HCPCS-C9804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYD1","description":"ICD-CDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUD0","description":"ICD-NLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAB1","description":"ICD-FGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Benesch boot pair child","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3213","description":"Benesch boot pair child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0683","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","description":"HCPCS-G0683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXF0","description":"ICD-NIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOF1","description":"ICD-OAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWF0","description":"ICD-OCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFC1","description":"ICD-BEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73100","description":"X-ray exam of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUE1","description":"ICD-MDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0500","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJD1","description":"ICD-GIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICD0","description":"ICD-MICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0526","description":"Management of established patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system_ including decannulation_ separation from the perfusion sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0494T","description":"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system_ including decannulation_ separation from the perfusion sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUE1","description":"ICD-AHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deb musc/fascia add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11046","description":"Deb musc/fascia add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYD0","description":"ICD-KGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMB1","description":"ICD-AAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES120","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System_ Remote Data Acquisition(S)_ Receipt Of Transmissions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0579T","description":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System_ Remote Data Acquisition(S)_ Receipt Of Transmissions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICD0","description":"ICD-IICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERB1","description":"ICD-PERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18B","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNF1","description":"ICD-GDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap sleeve gastrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43775","description":"Lap sleeve gastrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGE1","description":"ICD-KEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67935","description":"Repair eyelid wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"General Inpatient Care - A flat per diem rates before area wage adjustment for inpatient acute care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0605","description":"General Inpatient Care - A flat per diem rates before area wage adjustment for inpatient acute care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENA0","description":"ICD-FENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHF1","description":"ICD-NCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVF0","description":"ICD-NKVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYD1","description":"ICD-OKYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal non-stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59025","description":"Fetal non-stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKB0","description":"ICD-JDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDB0","description":"ICD-ECDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6537","description":"Gc stocking full lngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58950","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0658U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0658U","description":"CPT-0658U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDC1","description":"ICD-NJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSC0","description":"ICD-GBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVF1","description":"ICD-OIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSB0","description":"ICD-PJSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0680U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680U","description":"CPT-0680U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVF1","description":"ICD-FHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLD0","description":"ICD-OCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Device evaluation_ interrogation_ and initial programming of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ with iterative adjustment of the implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0472T","description":"Device evaluation_ interrogation_ and initial programming of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ with iterative adjustment of the implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixed prosthodontic proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6999","description":"Fixed prosthodontic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64818","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (Xellia)_ unrefrigerated_ not therapeutically equivalent to J0878 or J0873_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0872","description":"Injection_ daptomycin (Xellia)_ unrefrigerated_ not therapeutically equivalent to J0878 or J0873_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diab shoe w/metatarsal bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5505","description":"Diab shoe w/metatarsal bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35452","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3A","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRF1","description":"ICD-GHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autgrft implnt knee w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29866","description":"Autgrft implnt knee w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4318","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","description":"HCPCS-A4318","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L5827","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","description":"HCPCS-L5827","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indiv pdc > 0.8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9512","description":"Indiv pdc > 0.8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0817T","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1163","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMB1","description":"ICD-MGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVD0","description":"ICD-NDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKF1","description":"ICD-OEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEC1","description":"ICD-KBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWE1","description":"ICD-DIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUA0","description":"ICD-GFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art trnsposj subclav carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35694","description":"Art trnsposj subclav carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pump uninterrupted infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0455","description":"Pump uninterrupted infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm splint fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4022","description":"Cast sup sht arm splint fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATF0","description":"ICD-OATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYB0","description":"ICD-HHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATA0","description":"ICD-JATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86337","description":"Insulin antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1429","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","description":"HCPCS-M1429","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBD1","description":"ICD-FEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin pro flex/ext cont","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5859","description":"Knee-shin pro flex/ext cont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Msh6 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81299","description":"Msh6 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk fork strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5684","description":"Bk fork strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB231","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCA1","description":"ICD-CFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace socket hip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5702","description":"Replace socket hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8C","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIE1","description":"ICD-BFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mopath procedure level 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81407","description":"Mopath procedure level 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFME1","description":"ICD-NFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHD0","description":"ICD-IEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQE1","description":"ICD-CHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTF1","description":"ICD-ABTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85461","description":"Hemoglobin fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient achieves refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9391","description":"Patient achieves refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost urine pch w b/bltin conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4430","description":"Ost urine pch w b/bltin conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIB0","description":"ICD-EBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24365","description":"Reconstruct head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIE1","description":"ICD-EIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCA0","description":"ICD-KBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB235","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXC0","description":"ICD-OCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documented reason for not screening or recommending a follow-up for high blood pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1288","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTD0","description":"ICD-OHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3471","description":"Surgical repair of root resorption - anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC06","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vaccine toxoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90749","description":"Vaccine toxoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients using hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9688","description":"Patients using hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nikaidoh proc w/ostia implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33783","description":"Nikaidoh proc w/ostia implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDC0","description":"ICD-NIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transparent film <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6257","description":"Transparent film <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTA1","description":"ICD-GFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNA0","description":"ICD-NFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Growth hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80428","description":"Growth hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWC0","description":"ICD-DEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDD1","description":"ICD-GFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie_ ELISA)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0085U","description":"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie_ ELISA)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQE0","description":"ICD-HGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSE0","description":"ICD-LHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tildrakizumab_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3245","description":"Injection_ tildrakizumab_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove tendon sheath lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26160","description":"Remove tendon sheath lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tensix_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4146","description":"Tensix_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFB0","description":"ICD-NIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93248","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFF0","description":"ICD-GCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2D","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67120","description":"Remove eye implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2173","description":"Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIB1","description":"ICD-MJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2B","description":"High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monit store cryo embryo 30 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4040","description":"Monit store cryo embryo 30 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYF0","description":"ICD-LBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTB1","description":"ICD-CHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vagotomy & pylorus repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43641","description":"Vagotomy & pylorus repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq device breast 1st imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19281","description":"Perq device breast 1st imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWF1","description":"ICD-PCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAE0","description":"ICD-FCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES355","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHC0","description":"ICD-BDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4030","description":"Pulmonology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCD1","description":"ICD-IBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iv tubing extension set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1015","description":"Iv tubing extension set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth bladder tumor surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91251","description":"Anesth bladder tumor surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal foreign body jawbone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41806","description":"Removal foreign body jawbone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor intestine/artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44721","description":"Prep donor intestine/artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pcp prophylax rxd 3mon low %","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4280F","description":"Pcp prophylax rxd 3mon low %","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKE0","description":"ICD-BBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt notrcvng1st antitnf txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6150F","description":"Pt notrcvng1st antitnf txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crotalidae poly immune fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0840","description":"Crotalidae poly immune fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryptococcus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86641","description":"Cryptococcus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNA1","description":"ICD-OGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNE0","description":"ICD-OGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harvest stem cell concentrte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38215","description":"Harvest stem cell concentrte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELE1","description":"ICD-IELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subtemporal decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61340","description":"Subtemporal decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXA1","description":"ICD-JIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laminotomy addl cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63043","description":"Laminotomy addl cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75982","description":"Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTB0","description":"ICD-KBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4371","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","description":"HCPCS-Q4371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEF0","description":"ICD-EIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALE1","description":"ICD-MALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11B","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22D","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14C","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESE0","description":"ICD-CESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc forearm les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25071","description":"Exc forearm les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xenograft implantation into the articular surface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0737T","description":"Xenograft implantation into the articular surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDC1","description":"ICD-MFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOB1","description":"ICD-KHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPB0","description":"ICD-NIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKD0","description":"ICD-NFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc medrsn no compl antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9300","description":"Doc medrsn no compl antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ilr device eval progr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93285","description":"Ilr device eval progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXA0","description":"ICD-CAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlorothiazide sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1205","description":"Chlorothiazide sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair anti-tipping devi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0971","description":"Wheelchair anti-tipping devi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBE0","description":"ICD-FHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFB1","description":"ICD-FFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15B","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand/chin ctrl spec joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2373","description":"Hand/chin ctrl spec joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFD1","description":"ICD-OIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elev bp plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0513F","description":"Elev bp plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC31","description":"ICD-3DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contracept iud","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4989","description":"Contracept iud","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWE1","description":"ICD-OKWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8I","description":"Very High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEE1","description":"ICD-OGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPE1","description":"ICD-OLPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise & drain bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51040","description":"Incise & drain bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMA1","description":"ICD-OCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAA0","description":"ICD-AGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0899","description":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth blepharoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10351","description":"Anesth blepharoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise hand/foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64704","description":"Revise hand/foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFD1","description":"ICD-FCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25446","description":"Wrist replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUF0","description":"ICD-MCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood_ l/r_ cmv-neg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9051","description":"Blood_ l/r_ cmv-neg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAF0","description":"ICD-OLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES136","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sympathectomy cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64802","description":"Sympathectomy cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTE0","description":"ICD-IBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEF1","description":"ICD-OGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply intrcav radiat interm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77762","description":"Apply intrcav radiat interm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABD1","description":"ICD-AABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ any specimen source","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2023","description":"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ any specimen source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (congenital neutropenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Congenital Neutropenia Panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0271U","description":"Hematology (congenital neutropenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Congenital Neutropenia Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQA1","description":"ICD-OCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial hosp prog service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0129","description":"Partial hosp prog service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcervical ablation of uterine fibroid(s)_ including intraoperative ultrasound guidance and monitoring_ radiofrequency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58580","description":"Transcervical ablation of uterine fibroid(s)_ including intraoperative ultrasound guidance and monitoring_ radiofrequency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUD0","description":"ICD-MLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIF1","description":"ICD-IEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0343U","description":"Oncology (prostate)_ exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBB0","description":"ICD-JGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0304","description":"HCPCS-C0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUB0","description":"ICD-OJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antibody_ severe acute respiratory system coronavirus 2 (SARS CoV-2) (Coronavirus disease [COVID-19])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86769","description":"Antibody_ severe acute respiratory system coronavirus 2 (SARS CoV-2) (Coronavirus disease [COVID-19])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABB0","description":"ICD-BABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBID0","description":"ICD-OBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46750","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLE1","description":"ICD-MJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHF1","description":"ICD-BDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acesso dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4293","description":"Acesso dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMA1","description":"ICD-EGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optokinetic nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92534","description":"Optokinetic nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of arm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24201","description":"Removal of arm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Current cig smoker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9642","description":"Current cig smoker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Msh2 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81295","description":"Msh2 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELD1","description":"ICD-MELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIE1","description":"ICD-ABIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mediskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4135","description":"Mediskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0401","description":"HCPCS-A0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQB0","description":"ICD-HEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81285","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUD0","description":"ICD-EGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18H","description":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA RESPIRATORY SYNCTIAL VIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87420","description":"IAAD IA RESPIRATORY SYNCTIAL VIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tear duct system surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68899","description":"Tear duct system surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9801","description":"Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAA1","description":"ICD-KGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct neck spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72125","description":"Ct neck spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOD1","description":"ICD-KDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBA0","description":"ICD-FIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70486","description":"Ct maxillofacial w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUB0","description":"ICD-GBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74280","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of phenytoin free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80186","description":"Assay of phenytoin free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct soft tissue neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70491","description":"Ct soft tissue neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMB0","description":"ICD-JGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGA0","description":"ICD-OCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1069T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1069T","description":"CPT-1069T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABE1","description":"ICD-AABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHE0","description":"ICD-MDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERD0","description":"ICD-OERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec osteogen stim spinal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0748","description":"Elec osteogen stim spinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body fluid cell count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89051","description":"Body fluid cell count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of abdominal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27100","description":"Transfer of abdominal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAE1","description":"ICD-AGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Daclizumab_ parenteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7513","description":"Daclizumab_ parenteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fem/popl revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37226","description":"Fem/popl revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTB1","description":"ICD-BFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHB1","description":"ICD-CAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSC1","description":"ICD-GBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWA1","description":"ICD-PBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELE0","description":"ICD-FELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUF1","description":"ICD-JCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald telephone amplifier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5268","description":"Ald telephone amplifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic appliance full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0665","description":"Pneumatic appliance full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hair analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2031","description":"Hair analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYA1","description":"ICD-PBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLF1","description":"ICD-NJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERB1","description":"ICD-KERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Receiving >5 Mg Daily Prednisone (Or Equivalent) For Longer Than 6 Months_ And Improvement Or No Change In Disease Activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2113","description":"Patient Receiving >5 Mg Daily Prednisone (Or Equivalent) For Longer Than 6 Months_ And Improvement Or No Change In Disease Activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOC0","description":"ICD-CFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIC1","description":"ICD-KGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPA1","description":"ICD-OJPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTE1","description":"ICD-JCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQB1","description":"ICD-HGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1015","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYC0","description":"ICD-CFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVD0","description":"ICD-CAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQA1","description":"ICD-DDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCF1","description":"ICD-OCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGF1","description":"ICD-CFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDB0","description":"ICD-OJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject epidural patch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62273","description":"Inject epidural patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVD0","description":"ICD-NEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSB0","description":"ICD-OJSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBME0","description":"ICD-NBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOF1","description":"ICD-PDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMF0","description":"ICD-BGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDC0","description":"ICD-FEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incontinence garment anytype","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4520","description":"Incontinence garment anytype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx pancreatic unresectab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9107","description":"Onc dx pancreatic unresectab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fosaprepitant (teva)_ not therapeutically equivalent to j1453_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1456","description":"Injection_ fosaprepitant (teva)_ not therapeutically equivalent to j1453_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEE1","description":"ICD-OKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEA0","description":"ICD-FEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermabind sl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4284","description":"Dermabind sl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18E","description":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCD1","description":"ICD-KHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIB0","description":"ICD-EDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHD0","description":"ICD-CGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRF0","description":"ICD-LGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBF0","description":"ICD-NFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBB1","description":"ICD-GDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27826","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGF0","description":"ICD-CFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBB0","description":"ICD-BFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asp presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9435","description":"Asp presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBC1","description":"ICD-MGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEA0","description":"ICD-EBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWE0","description":"ICD-LGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65220","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCD0","description":"ICD-CFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQE1","description":"ICD-OCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatases","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84080","description":"Assay alkaline phosphatases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRE1","description":"ICD-CHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTC1","description":"ICD-GCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multi-axial ankle/ft prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5979","description":"Multi-axial ankle/ft prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUC0","description":"ICD-BBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0102","description":"HCPCS-A0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUD1","description":"ICD-ODUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLE1","description":"ICD-JFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDD0","description":"ICD-GFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuromuscular stim for scoli","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0744","description":"Neuromuscular stim for scoli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA21","description":"ICD-2AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt rsk death w/in 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1150F","description":"Doc pt rsk death w/in 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27187","description":"Reinforce hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC234","description":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90964","description":"Esrd home pt serv p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29355","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tdap vaccine 7 yrs/> im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90715","description":"Tdap vaccine 7 yrs/> im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEC0","description":"ICD-AEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXA1","description":"ICD-BFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot insert plastazote or eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3002","description":"Foot insert plastazote or eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIE1","description":"ICD-FAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGD1","description":"ICD-CAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special med equip_ noswaiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2029","description":"Special med equip_ noswaiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUF0","description":"ICD-KCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18F","description":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIF0","description":"ICD-MGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interferon alfa-2a inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9213","description":"Interferon alfa-2a inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coombs test indirect qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86885","description":"Coombs test indirect qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDD0","description":"ICD-BCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNC1","description":"ICD-JDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"C-1 esterase_ cinryze","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0598","description":"C-1 esterase_ cinryze","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUF1","description":"ICD-KGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art pancreas ext receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1037","description":"Art pancreas ext receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSE1","description":"ICD-DDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove tonsils and adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42820","description":"Remove tonsils and adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9592","description":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYF0","description":"ICD-DEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wedging of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29740","description":"Wedging of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj aripiprazole ext rel 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0401","description":"Inj aripiprazole ext rel 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTD0","description":"ICD-KDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTC0","description":"ICD-CCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice in lt/non-skilled nf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5003","description":"Hospice in lt/non-skilled nf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAE0","description":"ICD-JBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC02","description":"High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIA0","description":"ICD-CCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNA1","description":"ICD-CCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHB0","description":"ICD-AGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOF1","description":"ICD-GDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXB1","description":"ICD-NJXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8A","description":"High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBE0","description":"ICD-EIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg >16<=48 w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6235","description":"Hydrocolld drg >16<=48 w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Poliovirus ipv sc/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90713","description":"Poliovirus ipv sc/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74775","description":"X-ray exam of perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDC1","description":"ICD-MGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETE1","description":"ICD-CETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPB1","description":"ICD-GBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQA0","description":"ICD-PEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB260","description":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair no. 2 footplates","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0970","description":"Wheelchair no. 2 footplates","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECC1","description":"ICD-MECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Growth stimulation gene 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83006","description":"Growth stimulation gene 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with therapeutic injection(s) (eg_ chemodenervation agent or corticosteroid_ injected percutaneous_ transoral_ or via endoscope channel)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31573","description":"Laryngoscopy_ flexible; with therapeutic injection(s) (eg_ chemodenervation agent or corticosteroid_ injected percutaneous_ transoral_ or via endoscope channel)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAD0","description":"ICD-OKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUF0","description":"ICD-ECUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDD0","description":"ICD-IIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESF1","description":"ICD-LESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGC1","description":"ICD-GEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOB0","description":"ICD-HCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOE1","description":"ICD-OLOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFA1","description":"ICD-FDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental inlay metalic 1 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2510","description":"Dental inlay metalic 1 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDE0","description":"ICD-OJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMF0","description":"ICD-GEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDB0","description":"ICD-IHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFD1","description":"ICD-KFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lacosamide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9254","description":"Injection_ lacosamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Estradiol valerate 10 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1380","description":"Estradiol valerate 10 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEB0","description":"ICD-KBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDC1","description":"ICD-JHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBB1","description":"ICD-IDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of chromium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82495","description":"Assay of chromium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHC1","description":"ICD-GBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray exam of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74210","description":"Contrst x-ray exam of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUA0","description":"ICD-AIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prenatal flow sheet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0501F","description":"Prenatal flow sheet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PLCG2 (phospholipase C gamma 2) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ R665W_ S707F_ L845F)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81320","description":"PLCG2 (phospholipase C gamma 2) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ R665W_ S707F_ L845F)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQE0","description":"ICD-GGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJA1","description":"ICD-FGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEA0","description":"ICD-KEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDC1","description":"ICD-GEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt=d(rh)+ or sensitized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3291F","description":"Pt=d(rh)+ or sensitized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCF0","description":"ICD-MFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKC0","description":"ICD-NFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSA0","description":"ICD-DCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMB0","description":"ICD-FFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAF1","description":"ICD-JHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9145","description":"Injection_ daratumumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80402","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99204","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBF1","description":"ICD-FIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQD1","description":"ICD-LHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAA0","description":"ICD-CBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAD1","description":"ICD-MEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAA0","description":"ICD-IBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUC1","description":"ICD-MFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGE1","description":"ICD-NAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYF1","description":"ICD-KIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXA1","description":"ICD-FBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLB1","description":"ICD-CCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01992","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","description":"CPT-01992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","description":"HCPCS-J9028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRD0","description":"ICD-LGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of homocystine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83090","description":"Assay of homocystine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJC1","description":"ICD-CIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4A","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSF0","description":"ICD-DBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 3 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34843","description":"Endovasc visc aorta 3 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Under The Care Of The Same Practitioner Or Group Partner As Of The Last Hemodialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1027","description":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Under The Care Of The Same Practitioner Or Group Partner As Of The Last Hemodialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSD1","description":"ICD-CHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prim art m-thrmbc 1st vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37184","description":"Prim art m-thrmbc 1st vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation tray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4320","description":"Irrigation tray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98976","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHME1","description":"ICD-MHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1301","description":"HCPCS-B1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITA0","description":"ICD-IITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYF0","description":"ICD-PDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00918","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","description":"CPT-00918","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAC1","description":"ICD-KFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Test Appropriate_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1006","description":"Clinical Decision Support Mechanism Test Appropriate_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWA0","description":"ICD-OHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB20","description":"High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC260","description":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC230","description":"Special Care High _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBF0","description":"ICD-NCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abut support retainer titani","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6194","description":"Abut support retainer titani","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGD1","description":"ICD-OGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enterovirus probe&revrs trns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87498","description":"Enterovirus probe&revrs trns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSC0","description":"ICD-ODSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGB1","description":"ICD-GHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUC1","description":"ICD-GIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening barbiturates","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80345","description":"Drug screening barbiturates","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ apolipoprotein A4 (ApoA4)_ CD5 antigen-like (CD5L)_ and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0385U","description":"Nephrology (chronic kidney disease)_ apolipoprotein A4 (ApoA4)_ CD5 antigen-like (CD5L)_ and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44345","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC250","description":"Special Care Low _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen quant zonisamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80203","description":"Drug screen quant zonisamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILF1","description":"ICD-BILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine screen for bacteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81007","description":"Urine screen for bacteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBA0","description":"ICD-BHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echocardiography_ transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg_TAVR_ transcatheter pulmonary valve repl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93355","description":"Echocardiography_ transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg_TAVR_ transcatheter pulmonary valve repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBF1","description":"ICD-CEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHF1","description":"ICD-EGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUD0","description":"ICD-FBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Garamycin gentamicin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1580","description":"Garamycin gentamicin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHA1","description":"ICD-EHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILC0","description":"ICD-AILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAD0","description":"ICD-MHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0605U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","description":"CPT-0605U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLF0","description":"ICD-IFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (brixadi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0576","description":"Injection_ buprenorphine extended-release (brixadi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATC1","description":"ICD-FATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDE1","description":"ICD-EFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBB1","description":"ICD-EBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB211","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFB0","description":"ICD-CGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2045","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","description":"HCPCS-A2045","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient died prior to the end of the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1060","description":"Patient died prior to the end of the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5253","description":"Hearing aid_ prog_ bin_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVD0","description":"ICD-CIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pleurodesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32650","description":"Thoracoscopy w/pleurodesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRD0","description":"ICD-HCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01840","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","description":"CPT-01840","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10B","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWE1","description":"ICD-HDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVB1","description":"ICD-KEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0578U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","description":"CPT-0578U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L8720","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8720","description":"HCPCS-L8720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tacrolimus injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7525","description":"Tacrolimus injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQB1","description":"ICD-CEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSC1","description":"ICD-KDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSA1","description":"ICD-OCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAB0","description":"ICD-BAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAA0","description":"ICD-KBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEB1","description":"ICD-FHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1460","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","description":"HCPCS-M1460","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95718","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHA0","description":"ICD-KAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHD0","description":"ICD-ABHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5654","description":"Socket insert symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy islet cell trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0342","description":"Laparoscopy islet cell trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUE0","description":"ICD-BEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRB0","description":"ICD-PDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical Physics Dose Evaluation For Radiation Exposure That Exceeds Institutional Review Threshold_ Including Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76145","description":"Medical Physics Dose Evaluation For Radiation Exposure That Exceeds Institutional Review Threshold_ Including Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLC0","description":"ICD-OLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient was not admitted to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9856","description":"Patient was not admitted to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spec collection for sev acute resp synd coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ from an ind in a SNF or by a lab on behalf of an HH agcy any spec srce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2024","description":"Spec collection for sev acute resp synd coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ from an ind in a SNF or by a lab on behalf of an HH agcy any spec srce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYC1","description":"ICD-OFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSF1","description":"ICD-DFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNE1","description":"ICD-OHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILF0","description":"ICD-IILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9169","description":"HCPCS-C9169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCA0","description":"ICD-IFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bed pan standard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0275","description":"Bed pan standard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11624","description":"Exc s/n/h/f/g mal+mrg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13B","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCF0","description":"ICD-CHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of androstenedione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82157","description":"Assay of androstenedione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE260","description":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cogenex Flowable Amnion_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4230","description":"Cogenex Flowable Amnion_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHC1","description":"ICD-MLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEB0","description":"ICD-CDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECA1","description":"ICD-BECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADA1","description":"ICD-JADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACB1","description":"ICD-NACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"JR GNOTYP ABCG2 EXONS 2-26","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0193U","description":"JR GNOTYP ABCG2 EXONS 2-26","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43118","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJA1","description":"ICD-OEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscop w/vc inj + scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31571","description":"Laryngoscop w/vc inj + scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMA0","description":"ICD-FGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIA1","description":"ICD-OLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 1 vst p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90959","description":"Esrd serv 1 vst p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASB0","description":"ICD-KASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert cath pleura w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32556","description":"Insert cath pleura w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES110","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vaginal hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58260","description":"Vaginal hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77600","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB45","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infratemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61590","description":"Infratemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVF0","description":"ICD-NCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMD1","description":"ICD-OHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA11","description":"ICD-2DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIF1","description":"ICD-AAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conditioning play audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92582","description":"Conditioning play audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc comm risk calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9317","description":"No doc comm risk calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93532","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"U1nonsealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2364","description":"U1nonsealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJA1","description":"ICD-JHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOE1","description":"ICD-CIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22C","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67340","description":"Revise eye muscle add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3D","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19081","description":"Bx breast 1st lesion strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECA1","description":"ICD-NECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; single view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71045","description":"Radiologic examination_ chest; single view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA126","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lenticular lens_ single","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2121","description":"Lenticular lens_ single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYC0","description":"ICD-CAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEF0","description":"ICD-CBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1004T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","description":"CPT-1004T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Col chromotography qual/quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82542","description":"Col chromotography qual/quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWD0","description":"ICD-CIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1803","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1803","description":"CDT-D1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVE0","description":"ICD-GCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93931","description":"Upper extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDB1","description":"ICD-OLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBC0","description":"ICD-NHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ givosiran_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9056","description":"Injection_ givosiran_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Brolucizumab-Dbll_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0179","description":"Injection_ Brolucizumab-Dbll_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3271F","description":"Low risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUB0","description":"ICD-JAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ microRNA profiling by RT-PCR of 10 microRNA sequences_ utilizing fine needle aspirate_ algorithm reported as a positive or negative result for moderate to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0018U","description":"Oncology (thyroid)_ microRNA profiling by RT-PCR of 10 microRNA sequences_ utilizing fine needle aspirate_ algorithm reported as a positive or negative result for moderate to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCD1","description":"ICD-KGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMA1","description":"ICD-MGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytp urine 3-5 probes cmptr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88121","description":"Cytp urine 3-5 probes cmptr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal smear for eosinophils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89190","description":"Nasal smear for eosinophils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55040","description":"Removal of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWB1","description":"ICD-OKWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKB1","description":"ICD-NJKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMD0","description":"ICD-FFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAE1","description":"ICD-FAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERA0","description":"ICD-GERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASD0","description":"ICD-HASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOB0","description":"ICD-LFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Had Prior Pneumococcal Vaccine Adverse Reaction Any Time During Or Before The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2158","description":"Patient Had Prior Pneumococcal Vaccine Adverse Reaction Any Time During Or Before The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQB0","description":"ICD-CIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse esophagus & stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43320","description":"Fuse esophagus & stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vis item/svc in other code","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2797","description":"Vis item/svc in other code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIF1","description":"ICD-KGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mirror coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2761","description":"Mirror coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal placement of biodegradable material_ peri-prostatic_ single or multiple injection(s)_ including image guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55874","description":"Transperineal placement of biodegradable material_ peri-prostatic_ single or multiple injection(s)_ including image guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8E","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMC0","description":"ICD-GIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthesis_ breast_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1789","description":"Prosthesis_ breast_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJF0","description":"ICD-GAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHC1","description":"ICD-FDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9763","description":"Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRB1","description":"ICD-GFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDD1","description":"ICD-AHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICD1","description":"ICD-GICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1604","description":"HCPCS-C1604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1100T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1100T","description":"CPT-1100T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSD0","description":"ICD-LGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1029T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1029T","description":"CPT-1029T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in wheelch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9721","description":"Patient not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in wheelch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66850","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSD0","description":"ICD-PCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inherited bone marrow failure syndromes (IBMFS) (eg_ Fanconi anemia_ dyskeratosis congenita_ Diamond-Blackfan anemia_ Shwachman-Diamond syndrome_ GATA2 deficiency syndrome_ co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81441","description":"Inherited bone marrow failure syndromes (IBMFS) (eg_ Fanconi anemia_ dyskeratosis congenita_ Diamond-Blackfan anemia_ Shwachman-Diamond syndrome_ GATA2 deficiency syndrome_ co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNC1","description":"ICD-KCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0428","description":"Bls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronch ebus ivntj perph les","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31654","description":"Bronch ebus ivntj perph les","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Soft protect helmet prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8000","description":"Soft protect helmet prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAD1","description":"ICD-CBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBF0","description":"ICD-CBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mrs discogenic pain i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0612T","description":"Mrs discogenic pain i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso r post pnl sj-t9 pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0630","description":"Lso r post pnl sj-t9 pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std seat elevate s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0830","description":"Pwc gp2 std seat elevate s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"P32 chromic phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9564","description":"P32 chromic phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diag tst detect mucos abnorm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0431","description":"Diag tst detect mucos abnorm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB121","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove uro sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53446","description":"Remove uro sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDF1","description":"ICD-KEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Circumcision neonate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54160","description":"Circumcision neonate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoglobulin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86023","description":"Immunoglobulin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vascular surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37799","description":"Vascular surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychia interven order","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4525F","description":"Neuropsychia interven order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8G","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYB0","description":"ICD-LFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92851","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMD0","description":"ICD-KEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban_ 1 mg (for non-ESRD use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0883","description":"Injection_ argatroban_ 1 mg (for non-ESRD use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67908","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRE0","description":"ICD-HCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11643","description":"Exc f/e/e/n/l mal+mrg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Memory d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9170","description":"Memory d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-60661","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","description":"CPT-60661","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of urinary leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53085","description":"Drainage of urinary leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUF1","description":"ICD-JGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect phalanx of toe tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28175","description":"Resect phalanx of toe tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPB0","description":"ICD-CEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECE0","description":"ICD-BECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWE1","description":"ICD-LGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGC0","description":"ICD-CGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25C","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBC1","description":"ICD-ABBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLC0","description":"ICD-KBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUA0","description":"ICD-MCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVA1","description":"ICD-BGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD101","description":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-invasive vagus nerve stimulator (GammaCore-S)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1020","description":"Non-invasive vagus nerve stimulator (GammaCore-S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLE0","description":"ICD-MKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEF1","description":"ICD-GIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWB1","description":"ICD-PJWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVC1","description":"ICD-JDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lefamulin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0691","description":"Injection_ lefamulin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagus n eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64570","description":"Remove vagus n eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99344","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHB1","description":"ICD-BBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYD0","description":"ICD-KEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24575","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQC1","description":"ICD-OFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATC1","description":"ICD-NATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scap thorac prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6570","description":"Scap thorac prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAA1","description":"ICD-JEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVC0","description":"ICD-JEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUF0","description":"ICD-JBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy premal lesions 15/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17004","description":"Destroy premal lesions 15/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILE0","description":"ICD-JILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat forearm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25035","description":"Treat forearm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0B","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUC0","description":"ICD-IGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHF0","description":"ICD-GEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat combo w/shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1007","description":"Pwr seat combo w/shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2206","description":"Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 2 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34842","description":"Endovasc visc aorta 2 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWE0","description":"ICD-PFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77401","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lumasiran_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0224","description":"Injection_ lumasiran_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Access thoracic lymph duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38794","description":"Access thoracic lymph duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted reprod med lab proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89398","description":"Unlisted reprod med lab proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALE1","description":"ICD-FALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap es sph augment dev place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0392T","description":"Lap es sph augment dev place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML31","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis via catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4054F","description":"Hemodialysis via catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRC1","description":"ICD-LFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8F","description":"Very High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJA0","description":"ICD-BDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX11","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDE1","description":"ICD-MGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76529","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVA0","description":"ICD-NCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTD1","description":"ICD-NDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXE1","description":"ICD-BBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Root canal therapy 3 canals","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3330","description":"Root canal therapy 3 canals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUA0","description":"ICD-NHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEF0","description":"ICD-NFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDE0","description":"ICD-GCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAB0","description":"ICD-CDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQE0","description":"ICD-KCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Variable concentration mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4620","description":"Variable concentration mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLE0","description":"ICD-MHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29902","description":"Mcp joint arthroscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXD1","description":"ICD-GGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD150","description":"Special Care Low _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Olanzapine long-acting inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2358","description":"Olanzapine long-acting inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEE0","description":"ICD-MFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38571","description":"Laparoscopy lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMA1","description":"ICD-MCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBD0","description":"ICD-EFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a patient navigator; 60 m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0023","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a patient navigator; 60 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYD1","description":"ICD-HCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical nutrition group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97804","description":"Medical nutrition group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDB1","description":"ICD-OEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHE0","description":"ICD-MJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCE0","description":"ICD-BGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEF1","description":"ICD-JGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHME0","description":"ICD-KHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVE0","description":"ICD-OHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXC0","description":"ICD-FDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA45","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAA0","description":"ICD-IHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of adrenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86651","description":"Anesth removal of adrenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0302","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0302","description":"CDT-D0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIA0","description":"ICD-IEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQE0","description":"ICD-LBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA114","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair brain fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62100","description":"Repair brain fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHC1","description":"ICD-BCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0641T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA36","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ intraoperative thoracic aorta (eg_ epiaortic)_ diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76984","description":"Ultrasound_ intraoperative thoracic aorta (eg_ epiaortic)_ diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJE0","description":"ICD-NIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDD1","description":"ICD-NDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTD0","description":"ICD-EFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE231","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAID1","description":"ICD-FAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEA1","description":"ICD-MLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINF0","description":"ICD-NINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/svc oxygen equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0740","description":"Repair/svc oxygen equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOA0","description":"ICD-HIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB31","description":"ICD-4AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Create tear duct drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68745","description":"Create tear duct drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHC0","description":"ICD-IGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suction lipectomy trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15877","description":"Suction lipectomy trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0016","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat odontoid fx w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22318","description":"Treat odontoid fx w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFF1","description":"ICD-CEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients age 75 or older on their initiation of dialysis date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1264","description":"Patients age 75 or older on their initiation of dialysis date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAF0","description":"ICD-OFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNA1","description":"ICD-GGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Delivery/set up/dispensing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9901","description":"Delivery/set up/dispensing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUB0","description":"ICD-MAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99234","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSE0","description":"ICD-LBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10A","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special service/proc/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99199","description":"Special service/proc/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQA1","description":"ICD-OFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx contour defects 1.1-5.0cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11951","description":"Tx contour defects 1.1-5.0cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOF1","description":"ICD-KDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPD0","description":"ICD-BFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interferon alfacon-1 inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9212","description":"Interferon alfacon-1 inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45100","description":"Biopsy of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28B","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEF1","description":"ICD-KBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAB0","description":"ICD-AAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXA1","description":"ICD-CBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAC0","description":"ICD-MJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQB1","description":"ICD-HDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esano ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4274","description":"Esano ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18B","description":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation caregiver is trained and certified in dementia care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2185","description":"Documentation caregiver is trained and certified in dementia care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVD0","description":"ICD-BFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anaphylaxis due to the vaccine on or before the date of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1311","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: high complexity_ requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the pla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97163","description":"Physical therapy evaluation: high complexity_ requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the pla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB21","description":"ICD-3IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTF1","description":"ICD-GBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M.pneumon dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87581","description":"M.pneumon dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGF0","description":"ICD-FCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4C","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42960","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Posterior vertebral joint replacement_ including bilateral facetectomy_ laminectomy_ and radical discectomy_ including imaging guidance_ lumbar spine_ single segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0719T","description":"Posterior vertebral joint replacement_ including bilateral facetectomy_ laminectomy_ and radical discectomy_ including imaging guidance_ lumbar spine_ single segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Convert nephrostomy catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50434","description":"Convert nephrostomy catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64859","description":"Nerve surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTB0","description":"ICD-FBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had documentation of use of anticoagulant medications overlapping the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9724","description":"Patients who had documentation of use of anticoagulant medications overlapping the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic appliance half arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0655","description":"Pneumatic appliance half arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mesna injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9209","description":"Mesna injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lower Esophageal Myotomy_ Transoral (Ie_ Peroral Endoscopic Myotomy [Poem])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43497","description":"Lower Esophageal Myotomy_ Transoral (Ie_ Peroral Endoscopic Myotomy [Poem])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77333","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOA1","description":"ICD-DGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (atypical hemolytic uremic syndrome [aHUS])_ genomic sequence analysis of 15 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ aHUS Genetic Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0268U","description":"Hematology (atypical hemolytic uremic syndrome [aHUS])_ genomic sequence analysis of 15 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ aHUS Genetic Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOA1","description":"ICD-CAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSE1","description":"ICD-HFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDB1","description":"ICD-JEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGF1","description":"ICD-JIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal_ entire osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid and involving a bony defect greater t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69728","description":"Removal_ entire osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid and involving a bony defect greater t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICB1","description":"ICD-JICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAA0","description":"ICD-IDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAD1","description":"ICD-BHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFE0","description":"ICD-BHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tissue for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20926","description":"Removal of tissue for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are breastfeeding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9779","description":"Patients who are breastfeeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGME0","description":"ICD-EGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHD1","description":"ICD-AFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5877","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5877","description":"CDT-D5877","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel dsg<=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6231","description":"Hydrogel dsg<=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFA1","description":"ICD-CAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11C","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"LU GNOTYP BCAM EXON 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0196U","description":"LU GNOTYP BCAM EXON 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFD1","description":"ICD-NJFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUD1","description":"ICD-KEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shrinker upper limb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8465","description":"Shrinker upper limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHB0","description":"ICD-FFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSF0","description":"ICD-PHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQF0","description":"ICD-LGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26125","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each multiplex antibody stain procedure (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0762T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each multiplex antibody stain procedure (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMB1","description":"ICD-JFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63003","description":"Remove spine lamina 1/2 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metacarp fx orthosis pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3918","description":"Metacarp fx orthosis pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLB1","description":"ICD-OGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp<5 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99148","description":"Mod sed diff phys/qhp<5 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTE1","description":"ICD-AFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVB0","description":"ICD-CHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumizyme injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0221","description":"Lumizyme injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fr frz plasma donor retested","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9060","description":"Fr frz plasma donor retested","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWC0","description":"ICD-HAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVF0","description":"ICD-CBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBC0","description":"ICD-BEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB21","description":"ICD-3AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0716","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0716","description":"HCPCS-E0716","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB211","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPA0","description":"ICD-NLPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Locm 100-199mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9965","description":"Locm 100-199mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infratemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61591","description":"Infratemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJD0","description":"ICD-FHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srs spinal lesion addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63621","description":"Srs spinal lesion addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKF0","description":"ICD-OEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBF0","description":"ICD-FBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extra heavy duty wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0007","description":"Extra heavy duty wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTD0","description":"ICD-OLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIC0","description":"ICD-MGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55707","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","description":"CPT-55707","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLF0","description":"ICD-NBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual wc hand rim w project","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0967","description":"Manual wc hand rim w project","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9956","description":"Patient received combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOF1","description":"ICD-PHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUD1","description":"ICD-GGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pontic-indirect resin based","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6205","description":"Pontic-indirect resin based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBC1","description":"ICD-FEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vision svcs frames purchases","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2020","description":"Vision svcs frames purchases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37278","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","description":"CPT-37278","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSB0","description":"ICD-LGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTD0","description":"ICD-FFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMB0","description":"ICD-MBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUB1","description":"ICD-BAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Straight knee joint heavy du","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2385","description":"Straight knee joint heavy du","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medrsn >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9353","description":"Medrsn >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerv collar supp adj cerv ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0190","description":"Cerv collar supp adj cerv ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93621","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC16","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28D","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMB0","description":"ICD-NKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision Or Replacement Of Hypoglossal Nerve Neurostimulator Array And Distal Respiratory Sensor Electrode Or Electrode Array_ Including Connection To Existing Pulse Generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64583","description":"Revision Or Replacement Of Hypoglossal Nerve Neurostimulator Array And Distal Respiratory Sensor Electrode Or Electrode Array_ Including Connection To Existing Pulse Generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00548","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","description":"CPT-00548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAC0","description":"ICD-EBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHA0","description":"ICD-KIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 2","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1782","description":"vaccine administration-human papillomavirus - Dose 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng ace/arb b-blockertx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4480F","description":"Pt rcvng ace/arb b-blockertx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert subq exten to ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49435","description":"Insert subq exten to ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIB1","description":"ICD-FBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEB0","description":"ICD-KEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dias bp > or = 90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8755","description":"Dias bp > or = 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Counsel prov driving risks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6110F","description":"Counsel prov driving risks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRE0","description":"ICD-DCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair extra toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28344","description":"Repair extra toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQB1","description":"ICD-KAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHE0","description":"ICD-FGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETC1","description":"ICD-FETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXB1","description":"ICD-BBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDB1","description":"ICD-CEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert electrd/pm cath sngl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33210","description":"Insert electrd/pm cath sngl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNC0","description":"ICD-CGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy nail unit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11755","description":"Biopsy nail unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syph scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3512F","description":"Syph scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXC1","description":"ICD-NFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARC0","description":"ICD-HARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHF1","description":"ICD-EIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthr0 w/debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29862","description":"Hip arthr0 w/debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16020","description":"Dress/debrid p-thick burn s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelet antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86022","description":"Platelet antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exoskel hip ultra-light mate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5795","description":"Exoskel hip ultra-light mate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngotomy (thyrotomy_ laryngofissure)_ with removal of tumor or laryngocele_ cordectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31300","description":"Laryngotomy (thyrotomy_ laryngofissure)_ with removal of tumor or laryngocele_ cordectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQB1","description":"ICD-HCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES251","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSC0","description":"ICD-OJSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cranial electrotherapy stimulation (CES) system supplies and accessories_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4596","description":"Cranial electrotherapy stimulation (CES) system supplies and accessories_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFB0","description":"ICD-NKFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHF1","description":"ICD-EAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81336","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA23","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKF0","description":"ICD-NHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27096","description":"Inject sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFA0","description":"ICD-NHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLF1","description":"ICD-FHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27788","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDB1","description":"ICD-CFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVE0","description":"ICD-KFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPA1","description":"ICD-FAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMB0","description":"ICD-EAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of a modality to 1 or more areas; low-level laser therapy (ie_ nonthermal and non-ablative) for post-operative pain reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97037","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie_ nonthermal and non-ablative) for post-operative pain reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXC0","description":"ICD-FFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIF1","description":"ICD-EGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conformity evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5020","description":"Conformity evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJE0","description":"ICD-GGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIE1","description":"ICD-AEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLA1","description":"ICD-AFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine reagent strips/tablets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4250","description":"Urine reagent strips/tablets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHF0","description":"ICD-CBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE110","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFE1","description":"ICD-KBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway pressure filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7038","description":"Pos airway pressure filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKD0","description":"ICD-KGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLB1","description":"ICD-AFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAF0","description":"ICD-MEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINE1","description":"ICD-OINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI ct scan ord rvwd rqstd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3324F","description":"MRI ct scan ord rvwd rqstd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rigid ped w/c tilt-in-space","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1231","description":"Rigid ped w/c tilt-in-space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2C","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28208","description":"Repair of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENB1","description":"ICD-FENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diag laparo separate proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49320","description":"Diag laparo separate proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocortisone sodium succ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1720","description":"Hydrocortisone sodium succ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHA1","description":"ICD-CCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFE0","description":"ICD-NKFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCE1","description":"ICD-NKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB05","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARE1","description":"ICD-HARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28H","description":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay carbamazepine free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80157","description":"Assay carbamazepine free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy dose plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77300","description":"Radiation therapy dose plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB226","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Circum 28 days or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54161","description":"Circum 28 days or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPB1","description":"ICD-NKPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening mammography_ bilateral (2-view study of each breast)_ including computer-aided detection (CAD) when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77067","description":"Screening mammography_ bilateral (2-view study of each breast)_ including computer-aided detection (CAD) when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFD1","description":"ICD-CCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of gastrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82941","description":"Assay of gastrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPB0","description":"ICD-KBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPB1","description":"ICD-BBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETF0","description":"ICD-CETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No pt care icu/vent in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4169F","description":"No pt care icu/vent in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted px small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44799","description":"Unlisted px small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD224","description":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFF0","description":"ICD-KHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEB1","description":"ICD-ECEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00800","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","description":"CPT-00800","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43865","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVC0","description":"ICD-OLVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYC0","description":"ICD-LDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQF1","description":"ICD-OKQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0491U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","description":"CPT-0491U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHD1","description":"ICD-NIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No low pecarn ped head traum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9597","description":"No low pecarn ped head traum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWF0","description":"ICD-GDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGF1","description":"ICD-FAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29840","description":"Wrist arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1298","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB126","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWC0","description":"ICD-OCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX51","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Patient Education/Training And Device Calibration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99473","description":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Patient Education/Training And Device Calibration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34707","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Th/wght bear quad-lat brim m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2510","description":"Th/wght bear quad-lat brim m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conform band s w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6446","description":"Conform band s w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0188T","description":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlh uterus over 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58572","description":"Tlh uterus over 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECD0","description":"ICD-GECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place needles h&n for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41019","description":"Place needles h&n for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAME0","description":"ICD-GAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMF1","description":"ICD-CGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asthma education","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9441","description":"Asthma education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHF0","description":"ICD-JFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of protein serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84155","description":"Assay of protein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip disart sach laminat mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5600","description":"Hip disart sach laminat mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluphenazine decanoate 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2680","description":"Fluphenazine decanoate 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user_ reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9624","description":"Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user_ reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11471","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIED1","description":"ICD-JIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA50","description":"High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Most recent hemoglobin a1c level > 9.0%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1211","description":"Most recent hemoglobin a1c level > 9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68135","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLF1","description":"ICD-JCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unplnd ret to surg w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9308","description":"Unplnd ret to surg w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMD1","description":"ICD-FAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINC1","description":"ICD-KINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft subclav-axilary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35516","description":"Art byp grft subclav-axilary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOA0","description":"ICD-PFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ high complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes review of medical and/or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97167","description":"Occupational therapy evaluation_ high complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes review of medical and/or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX05","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAA0","description":"ICD-NDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65900","description":"Remove eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1435","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","description":"HCPCS-M1435","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA40","description":"Low Rehab_ ADL Index 0-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASB1","description":"ICD-OASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQB0","description":"ICD-LCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCC1","description":"ICD-NHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures maxill part resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5211","description":"Dentures maxill part resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOC1","description":"ICD-PBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTE0","description":"ICD-ECTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA11","description":"ICD-1JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKB1","description":"ICD-OEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNC1","description":"ICD-FGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC124","description":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv vacc pandemic adjuvt im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90667","description":"Iiv vacc pandemic adjuvt im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31201","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revis reconst shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23473","description":"Revis reconst shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQD1","description":"ICD-OCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSB0","description":"ICD-LFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUA0","description":"ICD-MEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMD0","description":"ICD-KGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9312","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9312","description":"HCPCS-C9312","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4343","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","description":"HCPCS-Q4343","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ drainage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1729","description":"Cath_ drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefiderocol_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0699","description":"Injection_ cefiderocol_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDD0","description":"ICD-OGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alert device_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9280","description":"Alert device_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTD0","description":"ICD-NHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy flex remove fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43215","description":"Esophagoscopy flex remove fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft femur head/neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27170","description":"Repair/graft femur head/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGB1","description":"ICD-FGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed semi-electr w/o mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0261","description":"Hosp bed semi-electr w/o mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBF1","description":"ICD-JDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA40","description":"High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBE0","description":"ICD-GHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLF0","description":"ICD-KBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ JAK2 mutation_ DNA_ PCR amplification of exons 12-14 and sequence analysis_ blood or bone marrow_ report of JAK2 mutation not detected or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0017U","description":"Oncology (hematolymphoid neoplasia)_ JAK2 mutation_ DNA_ PCR amplification of exons 12-14 and sequence analysis_ blood or bone marrow_ report of JAK2 mutation not detected or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTC0","description":"ICD-ODTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asparaginase_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9020","description":"Asparaginase_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brst cncr stage > t1n0m0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8881","description":"Brst cncr stage > t1n0m0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rep dev_ urinary_ w/o sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2631","description":"Rep dev_ urinary_ w/o sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18A","description":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKD1","description":"ICD-GHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMF1","description":"ICD-GDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMF1","description":"ICD-FAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATE0","description":"ICD-KATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No elig ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8857","description":"No elig ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8807","description":"Doc reas no us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUD1","description":"ICD-BBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBC0","description":"ICD-IIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWD1","description":"ICD-KBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19380","description":"Revise breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61605","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEB0","description":"ICD-NCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFF0","description":"ICD-KCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Belt/harness extremity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0945","description":"Belt/harness extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAE0","description":"ICD-FEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB43","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFED0","description":"ICD-KFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAA1","description":"ICD-IAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cst noble mtl inlay >=3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6607","description":"Cst noble mtl inlay >=3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26685","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEE1","description":"ICD-BIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRE1","description":"ICD-DCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAD0","description":"ICD-ACAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exchange nephrostomy catheter_ percutaneous_ with ureteral stricture balloon dilation_ including diagnostic nephrostogram and/or ureterogram when performed_ imaging guidance (","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7548","description":"Exchange nephrostomy catheter_ percutaneous_ with ureteral stricture balloon dilation_ including diagnostic nephrostogram and/or ureterogram when performed_ imaging guidance (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD230","description":"Clinically Complex _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRB1","description":"ICD-CBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGD1","description":"ICD-OCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cebpa gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81218","description":"Cebpa gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAD1","description":"ICD-MDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEF1","description":"ICD-FIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid met uptake","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78020","description":"Thyroid met uptake","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCE1","description":"ICD-CHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXE0","description":"ICD-FEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Cardiac Catheterization Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0622","description":"Hospital Special Treatment Room Support Component (Hstrsc) Cardiac Catheterization Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEC1","description":"ICD-GHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUD1","description":"ICD-IGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0018","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTD0","description":"ICD-FDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services for patient received any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9723","description":"Hospice services for patient received any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gadobutrol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9585","description":"Gadobutrol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl exhalation port for pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7045","description":"Repl exhalation port for pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCF0","description":"ICD-ABCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBE0","description":"ICD-FDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)_ including placement of a new ele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0520T","description":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)_ including placement of a new ele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD234","description":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGF1","description":"ICD-CCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide cardiocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76930","description":"Echo guide cardiocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2A","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAB0","description":"ICD-NLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGE1","description":"ICD-KCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEB1","description":"ICD-IDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUA1","description":"ICD-OKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES131","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBD1","description":"ICD-MHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUD1","description":"ICD-OKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEB0","description":"ICD-OAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Floxuridine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9200","description":"Floxuridine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBA0","description":"ICD-MCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no rh-immuno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8810","description":"Doc reas no rh-immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01933","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","description":"CPT-01933","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 hd mult pow s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0886","description":"Pwc gp4 hd mult pow s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBF1","description":"ICD-GCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCC0","description":"ICD-MJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMD0","description":"ICD-IIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEC1","description":"ICD-FAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTF1","description":"ICD-EFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27176","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHB0","description":"ICD-BFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compl zift case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4014","description":"Compl zift case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYE1","description":"ICD-CAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Device handling phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99002","description":"Device handling phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC31","description":"Very High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXD1","description":"ICD-NEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKE0","description":"ICD-OKKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine nrv >2 segmnts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63190","description":"Incise spine nrv >2 segmnts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen prsmptv 1 class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80302","description":"Drug screen prsmptv 1 class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAF1","description":"ICD-EDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHID0","description":"ICD-OHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIC1","description":"ICD-KCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMC0","description":"ICD-EIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of knee ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27409","description":"Repair of knee ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAD0","description":"ICD-KCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTF1","description":"ICD-KGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGF1","description":"ICD-GEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVD0","description":"ICD-KFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mod compres band w>=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6451","description":"Mod compres band w>=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPC1","description":"ICD-GDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNB0","description":"ICD-FBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj reshaping components","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7865","description":"Tmj reshaping components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKC0","description":"ICD-FGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLF1","description":"ICD-MKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diaphragm surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39599","description":"Diaphragm surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ONC THYR MRNA XPRSN ALYS 593","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0204U","description":"ONC THYR MRNA XPRSN ALYS 593","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tap block bi by infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64489","description":"Tap block bi by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch drain for barrier fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4425","description":"Ost pch drain for barrier fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Locm 200-299mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9966","description":"Locm 200-299mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAA0","description":"ICD-OCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLC1","description":"ICD-OJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30903","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEF0","description":"ICD-FAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVB0","description":"ICD-CGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUC1","description":"ICD-JGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69310","description":"Rebuild outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region cancer at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1037","description":"Patients with a diagnosis of lumbar spine region cancer at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ corticotropin (ANI)_ up to 40 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0802","description":"Injection_ corticotropin (ANI)_ up to 40 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPA0","description":"ICD-NKPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELF0","description":"ICD-OELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIF1","description":"ICD-AFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of thyroglobulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84432","description":"Assay of thyroglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pegademase bovine_ 25 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2504","description":"Pegademase bovine_ 25 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA234","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDE0","description":"ICD-FBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUA1","description":"ICD-GDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rheumatology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4032","description":"Rheumatology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYF0","description":"ICD-GDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraut copper contraceptive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7300","description":"Intraut copper contraceptive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGA0","description":"ICD-JDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWA1","description":"ICD-CEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADF0","description":"ICD-FADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIA0","description":"ICD-FIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test socket symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5618","description":"Test socket symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14A","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIB0","description":"ICD-CBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAB0","description":"ICD-KEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9033","description":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total hip arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27130","description":"Total hip arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPC0","description":"ICD-KEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temsirolimus injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9330","description":"Temsirolimus injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98986","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","description":"CPT-98986","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML11","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABE0","description":"ICD-NABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ceruloplasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82390","description":"Assay of ceruloplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXB0","description":"ICD-FFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLD1","description":"ICD-NLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUD0","description":"ICD-IAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFB0","description":"ICD-CHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score hip >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8651","description":"Fun stat score hip >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWA1","description":"ICD-GFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFE0","description":"ICD-OFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC260","description":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of 17-hydroxypregneno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84143","description":"Assay of 17-hydroxypregneno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTB0","description":"ICD-BFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PrecisionBlood™_ San Diego Blood Bank","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0246U","description":"PrecisionBlood™_ San Diego Blood Bank","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg <4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64892","description":"Nerve graft arm/leg <4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECME1","description":"ICD-ECME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of gonadotropin (fsh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83001","description":"Assay of gonadotropin (fsh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dopamine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1265","description":"Dopamine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGE0","description":"ICD-BHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWF1","description":"ICD-CDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Panitumumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9303","description":"Panitumumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQF0","description":"ICD-LIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCA1","description":"ICD-MHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUD0","description":"ICD-CGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEA1","description":"ICD-MIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9250","description":"Methotrexate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4341","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","description":"HCPCS-Q4341","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB254","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal Tract Imaging_ Intraluminal (Eg_ Capsule Endoscopy)_ Colon_ With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91113","description":"Gastrointestinal Tract Imaging_ Intraluminal (Eg_ Capsule Endoscopy)_ Colon_ With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPB1","description":"ICD-JAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-imaging heart function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78414","description":"Non-imaging heart function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKD1","description":"ICD-GEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITF1","description":"ICD-GITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pelvic structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51597","description":"Removal of pelvic structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERA0","description":"ICD-HERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDD0","description":"ICD-OHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAD1","description":"ICD-NJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVA0","description":"ICD-KAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absolute Quantitation Of Myocardial Blood Flow (Aqmbf)_ Positron Emission Tomography (Pet)_ Rest And Pharmacologic Stress (List Separately In Addition To Code For Primary Proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78434","description":"Absolute Quantitation Of Myocardial Blood Flow (Aqmbf)_ Positron Emission Tomography (Pet)_ Rest And Pharmacologic Stress (List Separately In Addition To Code For Primary Proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEA1","description":"ICD-BCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aortobi-iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35638","description":"Art byp aortobi-iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng anti-rheum thxpy ra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4195F","description":"Pt rcvng anti-rheum thxpy ra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRD0","description":"ICD-HIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLA1","description":"ICD-NFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor xiii fibrin scrn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85291","description":"Clot factor xiii fibrin scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermal filler injection(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0429","description":"Dermal filler injection(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITE0","description":"ICD-CITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9459","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUE1","description":"ICD-JEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC02","description":"Very High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXC1","description":"ICD-JAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCD0","description":"ICD-EHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSB0","description":"ICD-PFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEC1","description":"ICD-BEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30999","description":"Nasal surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Latex suspension sleeve each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6632","description":"Latex suspension sleeve each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYB0","description":"ICD-LGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLC0","description":"ICD-AGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAF1","description":"ICD-AEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80439","description":"Trh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Topical prep rx aoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4130F","description":"Topical prep rx aoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald blu tooth fm/dm receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5286","description":"Ald blu tooth fm/dm receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert pulse gen sngl lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33212","description":"Insert pulse gen sngl lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIB0","description":"ICD-KCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGC1","description":"ICD-BEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Isavuconazonium Sulfate_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9456","description":"Injection_ Isavuconazonium Sulfate_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of procainamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80190","description":"Assay of procainamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFE1","description":"ICD-KGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE126","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTB1","description":"ICD-NFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBF0","description":"ICD-JIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMD0","description":"ICD-EAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKE1","description":"ICD-BIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of intranasal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30118","description":"Removal of intranasal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB06","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDE1","description":"ICD-JDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDC0","description":"ICD-MHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero & or pyeloscope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52351","description":"Cystouretero & or pyeloscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHC0","description":"ICD-MKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYC1","description":"ICD-KEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUE1","description":"ICD-IDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLB0","description":"ICD-GBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSB1","description":"ICD-OCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDB1","description":"ICD-JHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFF0","description":"ICD-CAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCB1","description":"ICD-ADCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self care d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8989","description":"Self care d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB31","description":"ICD-1LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOE1","description":"ICD-HGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQF1","description":"ICD-KCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBE0","description":"ICD-IBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSA1","description":"ICD-PGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative visual axis identification using patient fixation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0514T","description":"Intraoperative visual axis identification using patient fixation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9191","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9191","description":"HCPCS-J9191","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOF0","description":"ICD-PJOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crutch underarm pair no wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0114","description":"Crutch underarm pair no wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMB1","description":"ICD-EHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0902","description":"HCPCS-A0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lingual frenectomy (frenulectomy)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7962","description":"Lingual frenectomy (frenulectomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPA0","description":"ICD-BCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate (Xatmep)_ oral_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8612","description":"Methotrexate (Xatmep)_ oral_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTE1","description":"ICD-JGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of quinidine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80194","description":"Assay of quinidine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic Analysis With Simple Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse Wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0589T","description":"Electronic Analysis With Simple Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse Wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPF1","description":"ICD-NEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVC0","description":"ICD-JGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No antipla/p2y12 ord_ rs nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9611","description":"No antipla/p2y12 ord_ rs nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28298","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHE1","description":"ICD-JIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise thigh tendon & fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27305","description":"Incise thigh tendon & fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIA0","description":"ICD-MKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee ext/flex w act res ctrl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1812","description":"Knee ext/flex w act res ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFC0","description":"ICD-OGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18C","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDC1","description":"ICD-JDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELD1","description":"ICD-GELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0592","description":"Hospital Special Treatment Room Support Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95170","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITB1","description":"ICD-GITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDB1","description":"ICD-MHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIA0","description":"ICD-CDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37180","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOA1","description":"ICD-OBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBA0","description":"ICD-FGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL07","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWF1","description":"ICD-LDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1827","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","description":"HCPCS-E1827","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMF1","description":"ICD-OBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65750","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64605","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulm function test by gas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94727","description":"Pulm function test by gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILA0","description":"ICD-CILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALA0","description":"ICD-BALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bioimpedance cv analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93701","description":"Bioimpedance cv analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYF0","description":"ICD-HCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMB0","description":"ICD-CEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath ren art 1st bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36252","description":"Ins cath ren art 1st bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34401","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIB0","description":"ICD-IFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLA0","description":"ICD-FGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNB1","description":"ICD-CCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6070","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert idrl body crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63304","description":"Remove vert idrl body crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTF0","description":"ICD-ABTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPE1","description":"ICD-CAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJE0","description":"ICD-NDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBB0","description":"ICD-CIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTC1","description":"ICD-GHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53601","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOF1","description":"ICD-KGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEB1","description":"ICD-EFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology Cardiac Specialist Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4002","description":"Electrophysiology Cardiac Specialist Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq device breast ea imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19282","description":"Perq device breast ea imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit2.6-7.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12042","description":"Intmd rpr n-hf/genit2.6-7.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTD1","description":"ICD-FFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Control unit bowel system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0350","description":"Control unit bowel system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKB1","description":"ICD-KEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2215","description":"Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLE1","description":"ICD-FFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHB0","description":"ICD-CHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIE0","description":"ICD-EFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIF0","description":"ICD-CBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCME0","description":"ICD-GCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intranasal biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30100","description":"Intranasal biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apc gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81201","description":"Apc gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87183","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","description":"CPT-87183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0175","description":"Commode chair foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9913","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9913","description":"CDT-D9913","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFA0","description":"ICD-FEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37140","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and transluminal s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9767","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and transluminal s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear antigen antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86235","description":"Nuclear antigen antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCB0","description":"ICD-KGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","description":"HCPCS-J7174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC34","description":"Medium Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMA0","description":"ICD-NGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACB1","description":"ICD-EACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microbe suscept macrobroth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87188","description":"Microbe suscept macrobroth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Addition to lower extremity prostheses_ osseointegrated external prosthetic connector","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5991","description":"Addition to lower extremity prostheses_ osseointegrated external prosthetic connector","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAA1","description":"ICD-NDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization admin each add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90472","description":"Immunization admin each add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical foods for inborn err","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9435","description":"Medical foods for inborn err","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA34","description":"High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMB0","description":"ICD-EHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMB0","description":"ICD-FEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMD1","description":"ICD-NIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27566","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relieve cranial pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61345","description":"Relieve cranial pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOB1","description":"ICD-GDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sinus aug w bone/bone sup","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7951","description":"Sinus aug w bone/bone sup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cftr gene intron poly t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81224","description":"Cftr gene intron poly t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQE0","description":"ICD-KBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOB1","description":"ICD-CIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMC1","description":"ICD-CFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKC1","description":"ICD-NJKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1902","description":"HCPCS-A1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose/normal saline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7042","description":"5% dextrose/normal saline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLE0","description":"ICD-OHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual reticulocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85044","description":"Manual reticulocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIE1","description":"ICD-CCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81188","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACE1","description":"ICD-KACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65426","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECD0","description":"ICD-EECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC12","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast milk proc/store/dist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2101","description":"Breast milk proc/store/dist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAC1","description":"ICD-BIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (pemrydi rtu)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9324","description":"Injection_ pemetrexed (pemrydi rtu)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMF1","description":"ICD-ECMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levetiracetam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1953","description":"Levetiracetam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVE0","description":"ICD-CFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDF1","description":"ICD-EFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1B","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHD0","description":"ICD-NEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27808","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peg interferon alfa-2b/10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0148","description":"Peg interferon alfa-2b/10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0894T","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emr pwr source elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0490","description":"Emr pwr source elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare donor heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33944","description":"Prepare donor heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLF1","description":"ICD-IBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINF0","description":"ICD-JINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMF0","description":"ICD-ICMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who have a diagnosis of pregnancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9778","description":"Patients who have a diagnosis of pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMC1","description":"ICD-BHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAF1","description":"ICD-NHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ cryoablation nasal tissue(s) and/or nerve(s)_ unilateral or bilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9771","description":"Nasal/sinus endoscopy_ cryoablation nasal tissue(s) and/or nerve(s)_ unilateral or bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI lower extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73718","description":"MRI lower extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQD0","description":"ICD-PBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAA0","description":"ICD-OBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1126","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10A","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGD1","description":"ICD-BIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nafcillin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0032","description":"Injection_ nafcillin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine proces distract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171T","description":"Lumbar spine proces distract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCD0","description":"ICD-ODCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nb resuscitation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99465","description":"Nb resuscitation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWD1","description":"ICD-CCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSE1","description":"ICD-HDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIC1","description":"ICD-CGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Detach adjust armrest base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0017","description":"Detach adjust armrest base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICF0","description":"ICD-FICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWE1","description":"ICD-KEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1044T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1044T","description":"CPT-1044T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCE1","description":"ICD-BBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA expression profiling by real-time quantitative PCR of MDK_ HOXA13_ CDC2_ IGFBP5_ and CXCR2 in combination with droplet digital PCR (ddPCR) analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0420U","description":"Oncology (urothelial)_ mRNA expression profiling by real-time quantitative PCR of MDK_ HOXA13_ CDC2_ IGFBP5_ and CXCR2 in combination with droplet digital PCR (ddPCR) analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVB1","description":"ICD-JCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAF0","description":"ICD-KIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDA1","description":"ICD-ACDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES334","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAC0","description":"ICD-CDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Homemaker service nos /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5131","description":"Homemaker service nos /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Paramedicintercep nonhospals","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0207","description":"Paramedicintercep nonhospals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCC1","description":"ICD-OJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAF0","description":"ICD-MDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMC0","description":"ICD-BEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Provide inr test mater/equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0249","description":"Provide inr test mater/equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ash fibrosure (tm)_ labcorp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002M","description":"Ash fibrosure (tm)_ labcorp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerv col supp adj bar & thor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0200","description":"Cerv col supp adj bar & thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPA1","description":"ICD-OCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYA0","description":"ICD-PDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBD0","description":"ICD-MIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEC0","description":"ICD-IIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDE0","description":"ICD-NBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gngvl flap w rootplan 1-3 th","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4241","description":"Gngvl flap w rootplan 1-3 th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert i-aort percut device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33967","description":"Insert i-aort percut device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSA0","description":"ICD-HDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSF0","description":"ICD-GDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWE0","description":"ICD-CIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMB1","description":"ICD-EAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIC0","description":"ICD-GDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mechlorethamine hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9230","description":"Mechlorethamine hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJE1","description":"ICD-OGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt ref doc oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8559","description":"Pt ref doc oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVE0","description":"ICD-KBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGA0","description":"ICD-JIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12004","description":"Rpr s/n/ax/gen/trk7.6-12.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMC0","description":"ICD-CEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGD1","description":"ICD-BBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVA1","description":"ICD-CAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA146","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAA1","description":"ICD-NFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In111 oxyquinoline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9547","description":"In111 oxyquinoline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEB0","description":"ICD-BGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid check one ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92592","description":"Hearing aid check one ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscope_ single-use (i.e. disposable)_ upper GI_ imaging/illumination device (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1748","description":"Endoscope_ single-use (i.e. disposable)_ upper GI_ imaging/illumination device (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive thyroid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60254","description":"Extensive thyroid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26370","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIF1","description":"ICD-JHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ mRNA_ microarray gene expression profiling of 209 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as molecular subtype (lumina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0016M","description":"Oncology (bladder)_ mRNA_ microarray gene expression profiling of 209 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as molecular subtype (lumina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compression stocking bk30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6531","description":"Compression stocking bk30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90471","description":"Immunization admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDF0","description":"ICD-ABDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLC0","description":"ICD-CGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDF1","description":"ICD-JBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhc ot assistant ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0158","description":"Hhc ot assistant ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNF0","description":"ICD-NLNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcysteine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7604","description":"Acetylcysteine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXF0","description":"ICD-NFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHF0","description":"ICD-IEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEE1","description":"ICD-EGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal abdomen lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38564","description":"Removal abdomen lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epstein-barr antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86663","description":"Epstein-barr antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prenatal vitamins 30 day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0197","description":"Prenatal vitamins 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0537","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","description":"HCPCS-G0537","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYC0","description":"ICD-GCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42335","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNF1","description":"ICD-KGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQD0","description":"ICD-PGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC21","description":"ICD-4LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKA1","description":"ICD-KBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home vent invasive interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0465","description":"Home vent invasive interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g._ porcine small intestine submocosa[SIS])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9796","description":"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g._ porcine small intestine submocosa[SIS])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Streptokinase antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86590","description":"Streptokinase antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital outpt clinic visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0463","description":"Hospital outpt clinic visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBF0","description":"ICD-EDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVE1","description":"ICD-KHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 5MCG/0.5ML AS03","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91310","description":"SARSCOV2 VAC 5MCG/0.5ML AS03","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYE1","description":"ICD-LFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide for artery repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76936","description":"Echo guide for artery repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic propulsion tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2211","description":"Pneumatic propulsion tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJF1","description":"ICD-FDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us guide vascular access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76937","description":"Us guide vascular access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28I","description":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEE0","description":"ICD-JDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4545","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","description":"HCPCS-A4545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOF1","description":"ICD-KHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB24","description":"High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYD1","description":"ICD-KDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDB0","description":"ICD-FFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLA0","description":"ICD-MGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHF0","description":"ICD-BFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0823","description":"Pwc gp 2 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACID1","description":"ICD-ACID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOB1","description":"ICD-LHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUA1","description":"ICD-BEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUB0","description":"ICD-OEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYA1","description":"ICD-HEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult companioncare per 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5135","description":"Adult companioncare per 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC44","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid caster integrated whl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2222","description":"Solid caster integrated whl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMC0","description":"ICD-NDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Devlopment test interpt&rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0451","description":"Devlopment test interpt&rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harvest eye tissue alograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68371","description":"Harvest eye tissue alograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFC1","description":"ICD-FIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDD1","description":"ICD-KCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients Who Receive Palliative Care Services Any Time During The Intake Period Through The End Of The Measurement Year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0048","description":"Patients Who Receive Palliative Care Services Any Time During The Intake Period Through The End Of The Measurement Year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHA0","description":"ICD-ADHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27840","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp periodontal evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0180","description":"Comp periodontal evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40652","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCD1","description":"ICD-CFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ diagnostic with cell washing(s) when performed_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7509","description":"Bronchoscopy_ rigid or flexible_ diagnostic with cell washing(s) when performed_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hpv low-risk types","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87623","description":"Hpv low-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIB1","description":"ICD-NHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vit d 1 25-dihydroxy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82652","description":"Vit d 1 25-dihydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEE0","description":"ICD-BFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXE0","description":"ICD-KHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOA1","description":"ICD-GEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTA0","description":"ICD-GDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCA1","description":"ICD-NGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCF1","description":"ICD-FHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise kneecap with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27438","description":"Revise kneecap with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAID0","description":"ICD-FAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0920T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","description":"CPT-0920T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQA0","description":"ICD-KFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rsa upper extr exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0349T","description":"Rsa upper extr exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tens two lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0720","description":"Tens two lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1496","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","description":"HCPCS-M1496","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skel musc relaxant 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80370","description":"Skel musc relaxant 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBD0","description":"ICD-ABBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDC0","description":"ICD-NJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX51","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc no fall in asc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8911","description":"Pt doc no fall in asc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICC1","description":"ICD-OICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Not disch home by day #2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8838","description":"Not disch home by day #2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exoskeletal ak ultra-light m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5790","description":"Exoskeletal ak ultra-light m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20A","description":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; first 30 minutes of patient face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0368T","description":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; first 30 minutes of patient face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEB1","description":"ICD-AIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTD0","description":"ICD-GGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"YT GNOTYP ACHE EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0201U","description":"YT GNOTYP ACHE EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETA0","description":"ICD-FETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0553","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","description":"HCPCS-G0553","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB03","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat shoulder blade fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23570","description":"Treat shoulder blade fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye Imaging Validated To Match Diagnosis From Seven Standard Field Stereoscopic Photos Results Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2104","description":"Eye Imaging Validated To Match Diagnosis From Seven Standard Field Stereoscopic Photos Results Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQC1","description":"ICD-HBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERB1","description":"ICD-LERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc serum pretx id dilution","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86976","description":"Rbc serum pretx id dilution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50695","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0102","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0102","description":"CDT-D0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [ha]_ procollagen iii amino terminal peptide [piiinp]_ tissue inhibitor of metalloproteinase 1 [timp-1])_ using immuno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014M","description":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [ha]_ procollagen iii amino terminal peptide [piiinp]_ tissue inhibitor of metalloproteinase 1 [timp-1])_ using immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQD1","description":"ICD-GGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDB1","description":"ICD-FCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIB0","description":"ICD-GEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9300","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9300","description":"HCPCS-C9300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKC1","description":"ICD-NCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Procuren or other growth fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9055","description":"Procuren or other growth fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTF0","description":"ICD-IBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair & adjust spectacles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92371","description":"Repair & adjust spectacles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOF0","description":"ICD-OBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert heart pm ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33207","description":"Insert heart pm ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hygienic item or device_ disposable or non-disposable_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9286","description":"Hygienic item or device_ disposable or non-disposable_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj test 9-10 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95911","description":"Nrv cndj test 9-10 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEB1","description":"ICD-MEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote 30 day ecg tech supp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93229","description":"Remote 30 day ecg tech supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAD0","description":"ICD-NIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEB1","description":"ICD-MJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24940","description":"Revision of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak/knee disartic pelvic band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5697","description":"Ak/knee disartic pelvic band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAC1","description":"ICD-OIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std mult pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0842","description":"Pwc gp2 std mult pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVF1","description":"ICD-NFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1957","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1957","description":"HCPCS-J1957","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFD1","description":"ICD-NAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTF1","description":"ICD-CCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHE1","description":"ICD-CCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","description":"CPT-76016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBA1","description":"ICD-IDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPD0","description":"ICD-CCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mepolizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2182","description":"Injection_ mepolizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diphtheria antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90296","description":"Diphtheria antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKE0","description":"ICD-JIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA33","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy shower protect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7523","description":"Tracheostomy shower protect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAA0","description":"ICD-IIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair fixed retainers","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8694","description":"Repair fixed retainers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHED0","description":"ICD-AHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUB0","description":"ICD-FDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPD1","description":"ICD-NJPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSA1","description":"ICD-CGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFA1","description":"ICD-NBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0558U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","description":"CPT-0558U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28F","description":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRF0","description":"ICD-CFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11426","description":"Exc h-f-nk-sp b9+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq card revasc chronic addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92944","description":"Prq card revasc chronic addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKE1","description":"ICD-CIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFE0","description":"ICD-ODFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA06","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mibm but no dx of breast ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8946","description":"Mibm but no dx of breast ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0637U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0637U","description":"CPT-0637U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood glucose test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4772","description":"Blood glucose test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEE0","description":"ICD-OEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGC1","description":"ICD-JIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enteral supp not otherwise c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9998","description":"Enteral supp not otherwise c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24C","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWF1","description":"ICD-OAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC105","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMB0","description":"ICD-ECMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB26","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31090","description":"Exploration of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECD0","description":"ICD-KECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUF1","description":"ICD-ABUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rigid wheeled walker adj/fix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0141","description":"Rigid wheeled walker adj/fix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vit for membrane dissect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67043","description":"Vit for membrane dissect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA205","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVF1","description":"ICD-GFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDC0","description":"ICD-JIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stationary o2 contents_ liq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0442","description":"Stationary o2 contents_ liq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete sl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4270","description":"Complete sl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risperidone (uzedy)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2799","description":"Injection_ risperidone (uzedy)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61705","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5D","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12C","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIF0","description":"ICD-OIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBE1","description":"ICD-GGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis c probe&rvrs trnsc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87521","description":"Hepatitis c probe&rvrs trnsc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx px nfrosgrm &/urtrgrm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50430","description":"Njx px nfrosgrm &/urtrgrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHD1","description":"ICD-GCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKB0","description":"ICD-GIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKE0","description":"ICD-CIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ esmolol hydrochloride_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1805","description":"Injection_ esmolol hydrochloride_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDE0","description":"ICD-CFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIF1","description":"ICD-GEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLA0","description":"ICD-MJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUE1","description":"ICD-OHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAF0","description":"ICD-IGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0305","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0305","description":"CDT-D0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ spherical_ photochromic additive_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2524","description":"Contact lens_ hydrophilic_ spherical_ photochromic additive_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCF1","description":"ICD-AHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITE0","description":"ICD-JITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary stress test/simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94620","description":"Pulmonary stress test/simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOD1","description":"ICD-GFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental case management - addressing appointment compliance barriers","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9991","description":"Dental case management - addressing appointment compliance barriers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thyroidectomy_ total or complete with parathyroid autotransplantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7555","description":"Thyroidectomy_ total or complete with parathyroid autotransplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPE1","description":"ICD-GFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTB0","description":"ICD-OLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41110","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHB0","description":"ICD-JIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv)_ includes: hiv risk assessment (initial or continued","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0013","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv)_ includes: hiv risk assessment (initial or continued","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23B","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUE0","description":"ICD-FHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12C","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADF1","description":"ICD-NADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5916","description":"Ocular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHC1","description":"ICD-BGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB144","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative assay drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80299","description":"Quantitative assay drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMD1","description":"ICD-BBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGE0","description":"ICD-ODGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBA0","description":"ICD-GHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1011T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","description":"CPT-1011T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITF0","description":"ICD-IITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUC1","description":"ICD-IDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psych disorders assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3700F","description":"Psych disorders assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIF1","description":"ICD-MKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQB1","description":"ICD-KEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Highly Complex Clinical Problem_ With Comprehensive Review Of Patient_S History And Medical Records And High Level Of Medical Decision M","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80505","description":"Pathology Clinical Consultation; For A Highly Complex Clinical Problem_ With Comprehensive Review Of Patient_S History And Medical Records And High Level Of Medical Decision M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOD1","description":"ICD-OGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADA0","description":"ICD-KADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSE1","description":"ICD-PLSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDB0","description":"ICD-EDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54060","description":"Excision of penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFA1","description":"ICD-NEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counselin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1289","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counselin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEC1","description":"ICD-NJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo partial nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50543","description":"Laparo partial nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFB1","description":"ICD-NCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKE0","description":"ICD-OIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJF0","description":"ICD-OGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove lung artery emboli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33910","description":"Remove lung artery emboli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGE0","description":"ICD-OCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj pudendal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64430","description":"N block inj pudendal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSA1","description":"ICD-KBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of extremity artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37618","description":"Ligation of extremity artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy/needle bx each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31629","description":"Bronchoscopy/needle bx each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBE0","description":"ICD-JBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHE0","description":"ICD-CBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMC1","description":"ICD-AHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Delay flap eye/nos/ear/lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15630","description":"Delay flap eye/nos/ear/lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBD1","description":"ICD-GHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWA1","description":"ICD-PEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOC1","description":"ICD-PIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAC1","description":"ICD-OLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tetracyclin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0120","description":"Tetracyclin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1470","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","description":"HCPCS-M1470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Loop heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0951","description":"Loop heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUB0","description":"ICD-NGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leptospira antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86720","description":"Leptospira antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPE1","description":"ICD-ODPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIB0","description":"ICD-OKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQA0","description":"ICD-DHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conform band n/s w>=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6443","description":"Conform band n/s w>=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71550","description":"MRI chest w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBD1","description":"ICD-NBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUC1","description":"ICD-KCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHC0","description":"ICD-MLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo iv infus each addl seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96417","description":"Chemo iv infus each addl seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25275","description":"Repair forearm tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRD1","description":"ICD-LIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEC0","description":"ICD-CBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDC1","description":"ICD-OIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apnea monitor w recorder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0619","description":"Apnea monitor w recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRB1","description":"ICD-CDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLB0","description":"ICD-ACLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB112","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGF1","description":"ICD-CHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKF1","description":"ICD-FEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBB0","description":"ICD-OKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC31","description":"ICD-3GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTB0","description":"ICD-FHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITA1","description":"ICD-BITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOD0","description":"ICD-PGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTF1","description":"ICD-ACTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjv hrmnl thxpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4164F","description":"Adjv hrmnl thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYA0","description":"ICD-GGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNA0","description":"ICD-KHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETD1","description":"ICD-CETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIB1","description":"ICD-NIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74020","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hip prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27090","description":"Removal of hip prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51555","description":"Partial removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAC1","description":"ICD-KAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGA0","description":"ICD-NLGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOB1","description":"ICD-OKOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Free assay (ft-3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84481","description":"Free assay (ft-3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBE1","description":"ICD-NDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB101","description":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lidocaine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2001","description":"Lidocaine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Financial management_ self-directed_ waiver; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2050","description":"Financial management_ self-directed_ waiver; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noonan spectrum disorders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81442","description":"Noonan spectrum disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJD0","description":"ICD-JBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ oliceridine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9101","description":"Injection_ oliceridine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ talimogene laherparepvec_ 1 million plaque forming units (PFU) (Imlygic)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9472","description":"Injection_ talimogene laherparepvec_ 1 million plaque forming units (PFU) (Imlygic)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0619U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","description":"CPT-0619U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4C","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe lifts elevation heel /i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3334","description":"Shoe lifts elevation heel /i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icm/ilr remote tech serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93299","description":"Icm/ilr remote tech serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18G","description":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46200","description":"Removal of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asthma mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8646","description":"Asthma mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sys bp > or = 140","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8753","description":"Sys bp > or = 140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sprvsd xrcz back pn >12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4242F","description":"Sprvsd xrcz back pn >12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESE0","description":"ICD-LESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAB0","description":"ICD-OEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetics 10-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88273","description":"Cytogenetics 10-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVE0","description":"ICD-GBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKE0","description":"ICD-JGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ cell-free DNA (cfDNA)_ methylation-based quantitative PCR assay (SEPTIN9_ IKZF1_ BCAT1_ Septin9-2_ VAV3_ BCAN)_ plasma_ reported as presence or a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0453U","description":"Oncology (colorectal cancer)_ cell-free DNA (cfDNA)_ methylation-based quantitative PCR assay (SEPTIN9_ IKZF1_ BCAT1_ Septin9-2_ VAV3_ BCAN)_ plasma_ reported as presence or a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4337","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","description":"HCPCS-Q4337","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of complications","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9930","description":"Treatment of complications","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWA0","description":"ICD-PDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIB1","description":"ICD-AIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNB1","description":"ICD-OHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1201","description":"HCPCS-A1201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aqueous shunt eye w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66180","description":"Aqueous shunt eye w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay metl 4/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2544","description":"Dental onlay metl 4/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing care_ in the home; b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9124","description":"Nursing care_ in the home; b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0425","description":"Inpt/ed teleconsult30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Potent antivir thxpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4276F","description":"Potent antivir thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPD0","description":"ICD-ODPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 10 MCG TRS-SUCR (pediatric vaccine)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91307","description":"SARSCOV2 VAC 10 MCG TRS-SUCR (pediatric vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEE1","description":"ICD-OAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITE1","description":"ICD-KITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemi-wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1085","description":"Hemi-wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPD1","description":"ICD-BCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AI IBD MRNA XPRSN PRFL 17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0203U","description":"AI IBD MRNA XPRSN PRFL 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKC0","description":"ICD-GBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHE0","description":"ICD-ACHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICC1","description":"ICD-CICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx vert fx w/o manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22310","description":"Closed tx vert fx w/o manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIA1","description":"ICD-KEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNB0","description":"ICD-KCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNC0","description":"ICD-CHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair nonunion carpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25431","description":"Repair nonunion carpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0697T","description":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genetic testing als","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3800","description":"Genetic testing als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61210","description":"Pierce skull implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEA0","description":"ICD-EEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2005","description":"HCPCS-A2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups_ utilizing whole blood_ common RBC alleles reported","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001U","description":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups_ utilizing whole blood_ common RBC alleles reported","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pentamidine comp unit dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7676","description":"Pentamidine comp unit dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJD0","description":"ICD-OHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0904T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","description":"CPT-0904T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathologists/dermatopathologists providing a second opinion on a biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9784","description":"Pathologists/dermatopathologists providing a second opinion on a biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMF0","description":"ICD-MBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRB0","description":"ICD-OFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parathyrd planar w/wo subtrj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78071","description":"Parathyrd planar w/wo subtrj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTC1","description":"ICD-NKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKF0","description":"ICD-NFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDA1","description":"ICD-FCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ luspatercept-aamt_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0896","description":"Injection_ luspatercept-aamt_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKF1","description":"ICD-BGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ full leg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6586","description":"Gradient pressure wrap with adjustable straps_ full leg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVB0","description":"ICD-BHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA31","description":"ICD-4EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWF0","description":"ICD-GHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78499","description":"Cardiovascular nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear medicine therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79999","description":"Nuclear medicine therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXC1","description":"ICD-OAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYB1","description":"ICD-KCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace skull plate/flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62143","description":"Replace skull plate/flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOB0","description":"ICD-KIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microbe susceptible diffuse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87181","description":"Microbe susceptible diffuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBD1","description":"ICD-GDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10B","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITD0","description":"ICD-EITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj heparin sodium per 10 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1642","description":"Inj heparin sodium per 10 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44364","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjustable angle footplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0040","description":"Adjustable angle footplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ leuprolide acetate for depot suspension (lutrate)_ 7.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1954","description":"Injection_ leuprolide acetate for depot suspension (lutrate)_ 7.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRC1","description":"ICD-HIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTC1","description":"ICD-OFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQB0","description":"ICD-LDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide (ingenus)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9073","description":"Injection_ cyclophosphamide (ingenus)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28600","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoskel knee-shin mnl lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5810","description":"Endoskel knee-shin mnl lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81239","description":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney imaging morphol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78700","description":"Kidney imaging morphol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLC1","description":"ICD-NFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB17","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAC0","description":"ICD-ICAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor xiii fibrin stab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85290","description":"Clot factor xiii fibrin stab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECC0","description":"ICD-BECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML16","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmi is documented as being outside of normal parameters_ follow-up plan is not completed for documented medical reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1286","description":"Bmi is documented as being outside of normal parameters_ follow-up plan is not completed for documented medical reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wbc alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85540","description":"Wbc alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC21","description":"ICD-4FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0663","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","description":"HCPCS-G0663","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC21","description":"ICD-3BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML43","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiotherapy dose plan imrt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77301","description":"Radiotherapy dose plan imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enverse_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4258","description":"Enverse_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test socket below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5620","description":"Test socket below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABC1","description":"ICD-IABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL50","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA40","description":"Very High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWC1","description":"ICD-HHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Installation_ ciprofloxacin otic suspension_ 6mg (Otiprio)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9479","description":"Installation_ ciprofloxacin otic suspension_ 6mg (Otiprio)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDB1","description":"ICD-NEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQA0","description":"ICD-GBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo tib fx semi-rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2114","description":"Afo tib fx semi-rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA110","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVF1","description":"ICD-JGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spirmtry w/brnchdil inf-2 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94012","description":"Spirmtry w/brnchdil inf-2 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand-held pefr meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4614","description":"Hand-held pefr meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYC1","description":"ICD-KDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUB0","description":"ICD-GCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHD1","description":"ICD-CCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRB0","description":"ICD-KIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUB0","description":"ICD-AEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKE1","description":"ICD-FFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Perdominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6121","description":"Implant Supported Retainer For Metal Fpd - Perdominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meningococcal recombinant protein and outer membrane vesicle vaccine_ serogroup B (MenB-4C)_ 2 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90620","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine_ serogroup B (MenB-4C)_ 2 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRD1","description":"ICD-DHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBF0","description":"ICD-NHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLE1","description":"ICD-IBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNF1","description":"ICD-CHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQD0","description":"ICD-OAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACD1","description":"ICD-KACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth lens surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14251","description":"Anesth lens surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERD1","description":"ICD-GERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVF0","description":"ICD-JIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLB1","description":"ICD-CHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC105","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVB1","description":"ICD-JIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBB1","description":"ICD-IBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIA0","description":"ICD-AFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq card angio/athrect 1 art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92924","description":"Prq card angio/athrect 1 art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11A","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA31","description":"ICD-2EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBC1","description":"ICD-JFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLE0","description":"ICD-FCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILA1","description":"ICD-MILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJE0","description":"ICD-JAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were deceased when the hu survey reached them","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1254","description":"Patients who were deceased when the hu survey reached them","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKF0","description":"ICD-GEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMC0","description":"ICD-IFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFA1","description":"ICD-FFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSD0","description":"ICD-PDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCF0","description":"ICD-AGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOC0","description":"ICD-CGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antibody_ Treponema pallidum_ total and rapid plasma reagin (RPR)_ immunoassay_ qualitativ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0064U","description":"Antibody_ Treponema pallidum_ total and rapid plasma reagin (RPR)_ immunoassay_ qualitativ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVA0","description":"ICD-NAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy irrigation bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4398","description":"Ostomy irrigation bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSE1","description":"ICD-ODSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIC1","description":"ICD-CAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33976","description":"Implant ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGF0","description":"ICD-KHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of gentamicin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80170","description":"Assay of gentamicin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84590","description":"Assay of vitamin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHF0","description":"ICD-KBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA06","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62200","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ eravacycline_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0122","description":"Injection_ eravacycline_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVE1","description":"ICD-NEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37279","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","description":"CPT-37279","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSE1","description":"ICD-OGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0477U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","description":"CPT-0477U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAF0","description":"ICD-MIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKF0","description":"ICD-BGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISC1","description":"ICD-DISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEA1","description":"ICD-MAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRD1","description":"ICD-HGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; device(s) supply with daily recording(s) or program","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99454","description":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; device(s) supply with daily recording(s) or program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enzyme cell activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82657","description":"Enzyme cell activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33277","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1C","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHE1","description":"ICD-FEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilated macul exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2019F","description":"Dilated macul exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ionm remote/>1 pt or per hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95941","description":"Ionm remote/>1 pt or per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMC1","description":"ICD-GCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo <2yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90963","description":"Esrd home pt serv p mo <2yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay free hydroxyproline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83500","description":"Assay free hydroxyproline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 xhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0840","description":"Pwc gp2 xhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of left heart vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33989","description":"Removal of left heart vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28160","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; anomalous or persistent superior vena cava when it ex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93584","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; anomalous or persistent superior vena cava when it ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64600","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX50","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75820","description":"Vein x-ray arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQF0","description":"ICD-DGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11B","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBND0","description":"ICD-FBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGA0","description":"ICD-JAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAB1","description":"ICD-JEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQD0","description":"ICD-OHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLF1","description":"ICD-OJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visual evoked potential (VEP) checkerboard or flash testing_ central nervous system except glaucoma_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95930","description":"Visual evoked potential (VEP) checkerboard or flash testing_ central nervous system except glaucoma_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of heel bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28118","description":"Removal of heel bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28306","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACC1","description":"ICD-AACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQE0","description":"ICD-ODQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB255","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMF1","description":"ICD-AEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA246","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYE0","description":"ICD-PGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAC1","description":"ICD-BGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXD1","description":"ICD-JGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ladies shoes hightop depth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3217","description":"Ladies shoes hightop depth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIB0","description":"ICD-GHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCC0","description":"ICD-AGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUA1","description":"ICD-EEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKC0","description":"ICD-BBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyqvia 100mg immuneglobulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1575","description":"Hyqvia 100mg immuneglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open/perq place stent 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37236","description":"Open/perq place stent 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28G","description":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat dental ridge fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21445","description":"Treat dental ridge fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj arthroscopy discectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7876","description":"Tmj arthroscopy discectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIC0","description":"ICD-JDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gingival irrigation per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4921","description":"Gingival irrigation per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIC1","description":"ICD-IHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ikbkap gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81260","description":"Ikbkap gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAB1","description":"ICD-MFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc shoulder les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23075","description":"Exc shoulder les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWD1","description":"ICD-OEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAB1","description":"ICD-NKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCC0","description":"ICD-CGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACED1","description":"ICD-ACED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAD1","description":"ICD-BAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTC0","description":"ICD-IHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSC0","description":"ICD-GDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJC0","description":"ICD-BFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAA0","description":"ICD-JEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWF1","description":"ICD-HDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXC0","description":"ICD-FIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver imaging with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78202","description":"Liver imaging with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALE0","description":"ICD-KALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCA0","description":"ICD-FCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIE1","description":"ICD-BIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWD0","description":"ICD-PBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin test candida","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86485","description":"Skin test candida","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDE1","description":"ICD-IGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress spinal cord thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63055","description":"Decompress spinal cord thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0243","description":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIC0","description":"ICD-FGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKID1","description":"ICD-MKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPA1","description":"ICD-FCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMA1","description":"ICD-CFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Msh2 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81296","description":"Msh2 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDA0","description":"ICD-AGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESE0","description":"ICD-PESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYB0","description":"ICD-LEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDD1","description":"ICD-GGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0963T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","description":"CPT-0963T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28I","description":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24C","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive mastoid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69530","description":"Extensive mastoid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj prohance multipack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9576","description":"Inj prohance multipack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRF1","description":"ICD-CFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAE1","description":"ICD-FHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCA1","description":"ICD-GFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening fentanyl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80354","description":"Drug screening fentanyl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXB1","description":"ICD-GEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1060T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1060T","description":"CPT-1060T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA35","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKD1","description":"ICD-KDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral administration ki","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4224","description":"Parenteral administration ki","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resolve Matrix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2024","description":"Resolve Matrix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrical stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97032","description":"Electrical stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Novafix dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4254","description":"Novafix dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDC1","description":"ICD-BHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osseous surgery per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4260","description":"Osseous surgery per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50900","description":"Repair of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBD0","description":"ICD-KBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECC1","description":"ICD-OECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUC0","description":"ICD-AAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFE0","description":"ICD-FAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMD1","description":"ICD-MEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iadna-dna/rna probe tq 12-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87507","description":"Iadna-dna/rna probe tq 12-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0934T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","description":"CPT-0934T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKA1","description":"ICD-KIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth head nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22251","description":"Anesth head nerve surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVD0","description":"ICD-CCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMA0","description":"ICD-KBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Audiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0062","description":"Audiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med serv eve/wkend/holiday","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99051","description":"Med serv eve/wkend/holiday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cabg w/o pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56651","description":"Anesth cabg w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLE0","description":"ICD-MLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1B","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDA1","description":"ICD-CEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); laparoscopic or robotic_ from living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0666T","description":"Donor hysterectomy (including cold preservation); laparoscopic or robotic_ from living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision malig les complicat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7415","description":"Excision malig les complicat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUD1","description":"ICD-MLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEND1","description":"ICD-KEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22A","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vasopressin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84588","description":"Assay of vasopressin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNF1","description":"ICD-CFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENC1","description":"ICD-JENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBE0","description":"ICD-AFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBA0","description":"ICD-OHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCF0","description":"ICD-BBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLF1","description":"ICD-NBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pancreatic duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48148","description":"Removal of pancreatic duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYE0","description":"ICD-HGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCB1","description":"ICD-FHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQB1","description":"ICD-CAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Applied Pathways_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1000","description":"Clinical Decision Support Mechanism Applied Pathways_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA07","description":"Very High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACC0","description":"ICD-CACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIB0","description":"ICD-NKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHD1","description":"ICD-IIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunofluor antb addl stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88350","description":"Immunofluor antb addl stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis B screening in non-pregnant_ high risk individual includes hepatitis B surface antigen (HBSAG) followed by a neutralizing confirmatory test for initially reactive re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0499","description":"Hepatitis B screening in non-pregnant_ high risk individual includes hepatitis B surface antigen (HBSAG) followed by a neutralizing confirmatory test for initially reactive re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert lens prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66985","description":"Insert lens prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc renal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50549","description":"Laparoscope proc renal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69642","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft finger lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26215","description":"Remove/graft finger lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medicaid certified community behavioral health clinic services_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1041","description":"Medicaid certified community behavioral health clinic services_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd w/thrml txmnt gerd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43257","description":"Egd w/thrml txmnt gerd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEA0","description":"ICD-BAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKF1","description":"ICD-KEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOA1","description":"ICD-OAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJB1","description":"ICD-NEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90966","description":"Esrd home pt serv p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDB1","description":"ICD-AGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSD0","description":"ICD-OHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOD1","description":"ICD-DEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQB1","description":"ICD-LIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDB0","description":"ICD-IBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECE1","description":"ICD-JECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10A","description":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brief (20 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2006","description":"Brief (20 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blinded procedure for New York Heart Association (NYHA) Class II or III heart failure_ or Canadian Cardiovascular Society (CCS) Class III or IV chronic refractory angina; tran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9782","description":"Blinded procedure for New York Heart Association (NYHA) Class II or III heart failure_ or Canadian Cardiovascular Society (CCS) Class III or IV chronic refractory angina; tran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation supply sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4397","description":"Irrigation supply sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTF0","description":"ICD-KDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETE1","description":"ICD-FETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYB0","description":"ICD-CIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUF0","description":"ICD-AIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Av dialysis shunt imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75791","description":"Av dialysis shunt imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHD1","description":"ICD-IHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEC1","description":"ICD-JBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduce testis torsion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54600","description":"Reduce testis torsion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29843","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blm gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81209","description":"Blm gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCF0","description":"ICD-FDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD125","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC236","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mechanical traction therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97012","description":"Mechanical traction therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLF1","description":"ICD-OFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSC1","description":"ICD-PDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFME0","description":"ICD-AFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum_ low energy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0864T","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum_ low energy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28D","description":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Co57/58","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9546","description":"Co57/58","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4370","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","description":"HCPCS-Q4370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4035","description":"Thoracic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFB0","description":"ICD-ODFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLD1","description":"ICD-NCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins tun ip cath for dial opn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49421","description":"Ins tun ip cath for dial opn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHB1","description":"ICD-CFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fee covid-19 vac 3 booster","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0023A","description":"Fee covid-19 vac 3 booster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tonsil tags","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42860","description":"Excision of tonsil tags","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA35","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECE0","description":"ICD-EECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBED1","description":"ICD-NBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recording without 24 hour attended mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0498T","description":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recording without 24 hour attended mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1090","description":"Lumbar sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPA0","description":"ICD-JEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUF1","description":"ICD-CEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFA1","description":"ICD-OJFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise/graft midfoot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28305","description":"Incise/graft midfoot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELF0","description":"ICD-JELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc deglycerolized","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9039","description":"Rbc deglycerolized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perphenazine 4mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0175","description":"Perphenazine 4mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCF1","description":"ICD-OHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection abdominal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49427","description":"Injection abdominal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","description":"CPT-01470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTB1","description":"ICD-OCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28090","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATE1","description":"ICD-GATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMB0","description":"ICD-MHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flu vacc iiv4 no preserv id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90630","description":"Flu vacc iiv4 no preserv id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmt harv/transpl 28d pkg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2150","description":"Bmt harv/transpl 28d pkg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCD1","description":"ICD-GBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvas vasc dx study proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93998","description":"Noninvas vasc dx study proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWE0","description":"ICD-PAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELA0","description":"ICD-CELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB15","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXD0","description":"ICD-KDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD120","description":"Special Care Low _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHD0","description":"ICD-KAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBF0","description":"ICD-CHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33234","description":"Removal of pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMD1","description":"ICD-IGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCF0","description":"ICD-BHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUF0","description":"ICD-OEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBE1","description":"ICD-KBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKC1","description":"ICD-OJKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHE0","description":"ICD-CEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 11-20 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99422","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 11-20 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMC0","description":"ICD-OKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGB1","description":"ICD-OBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJC0","description":"ICD-FAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNE1","description":"ICD-JCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HIV-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87391","description":"IAAD IA HIV-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUD0","description":"ICD-EFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAF0","description":"ICD-IEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23B","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium_ not otherwise specified_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0650","description":"Injection_ levothyroxine sodium_ not otherwise specified_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subs episode for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1128F","description":"Subs episode for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGD0","description":"ICD-BIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair elbow w/deb open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24358","description":"Repair elbow w/deb open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGA1","description":"ICD-GAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWB0","description":"ICD-GIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVA0","description":"ICD-BDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHE1","description":"ICD-NAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRB1","description":"ICD-PGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilated Retinal Eye Exam With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2102","description":"Dilated Retinal Eye Exam With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFD0","description":"ICD-KGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18X","description":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMB1","description":"ICD-NDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIF1","description":"ICD-GCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0C","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSB0","description":"ICD-GHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKF1","description":"ICD-FIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smoker/exposed 2nd hnd smoke","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1032F","description":"Smoker/exposed 2nd hnd smoke","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPB0","description":"ICD-GHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tibper revasc w/ather add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37233","description":"Tibper revasc w/ather add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (ccIIV4)_ derived from cell cultures_ subunit_ preservative and antibiotic free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90674","description":"Influenza virus vaccine_ quadrivalent (ccIIV4)_ derived from cell cultures_ subunit_ preservative and antibiotic free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGB1","description":"ICD-OKGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKD1","description":"ICD-KAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXD0","description":"ICD-KBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60271","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDB1","description":"ICD-BBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lambswool sheepskin pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0189","description":"Lambswool sheepskin pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVB0","description":"ICD-BDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFF0","description":"ICD-OKFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93978","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress spine cord add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63057","description":"Decompress spine cord add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ob us detailed addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76812","description":"Ob us detailed addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20B","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXC0","description":"ICD-JAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyalomatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4117","description":"Hyalomatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJD0","description":"ICD-KEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHD0","description":"ICD-ADHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66630","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28B","description":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJD0","description":"ICD-NAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIF0","description":"ICD-JFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDA1","description":"ICD-OCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX14","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIC0","description":"ICD-MBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1072","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","description":"HCPCS-J1072","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA STREPTOCOCCUS GROUP A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87430","description":"IAAD IA STREPTOCOCCUS GROUP A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco use assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1000F","description":"Tobacco use assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60520","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67914","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBB0","description":"ICD-CGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18D","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJD0","description":"ICD-CCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult day care per half day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5101","description":"Adult day care per half day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psych svcs provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4060F","description":"Psych svcs provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Expose behav assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0362T","description":"Expose behav assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIC1","description":"ICD-FCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDA1","description":"ICD-CFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFB1","description":"ICD-OFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBD0","description":"ICD-EIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trapezius sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1070","description":"Trapezius sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBB1","description":"ICD-BFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Of Anterior Segment Aqueous Drainage Device Into The Trabecular Meshwork_ Without External Reservoir_ And Without Concomitant Cataract Removal_ One Or More","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0671T","description":"Insertion Of Anterior Segment Aqueous Drainage Device Into The Trabecular Meshwork_ Without External Reservoir_ And Without Concomitant Cataract Removal_ One Or More","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNB0","description":"ICD-NKNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human papillomavirus (HPV)_ oropharyngeal swab_ 14 high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ and 68)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0429U","description":"Human papillomavirus (HPV)_ oropharyngeal swab_ 14 high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ and 68)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms) gene analysis_ full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81236","description":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms) gene analysis_ full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOD0","description":"ICD-DHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imported lipodox inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2049","description":"Imported lipodox inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA12","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEF0","description":"ICD-IEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIED0","description":"ICD-EIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTD1","description":"ICD-NHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage board postural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0606","description":"Drainage board postural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARB1","description":"ICD-GARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip flex inner socket ext fr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5643","description":"Hip flex inner socket ext fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose/water","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7060","description":"5% dextrose/water","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9183","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","description":"HCPCS-J9183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21243","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calc bmi blw low param f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8418","description":"Calc bmi blw low param f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFC0","description":"ICD-JHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWE1","description":"ICD-KGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVB1","description":"ICD-FEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of low back nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64862","description":"Repair of low back nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQC1","description":"ICD-OLQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","description":"HCPCS-Q4428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEF0","description":"ICD-GFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plasma_ cryoprecipitate reduced_ pathogen reduced_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9025","description":"Plasma_ cryoprecipitate reduced_ pathogen reduced_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFD0","description":"ICD-JDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRF1","description":"ICD-OGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUC0","description":"ICD-KAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAB0","description":"ICD-FEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect thigh/knee tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27329","description":"Resect thigh/knee tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso flex no ri stays pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0628","description":"Lso flex no ri stays pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXD1","description":"ICD-OKXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26560","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAC0","description":"ICD-GHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVB0","description":"ICD-KEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGD0","description":"ICD-FEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQB1","description":"ICD-PJQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIB1","description":"ICD-OJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGD1","description":"ICD-CDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exsufflation belt_ includes all supplies and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4468","description":"Exsufflation belt_ includes all supplies and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise lesion testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54512","description":"Excise lesion testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vivaglobin_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1562","description":"Vivaglobin_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJD1","description":"ICD-NKJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyoscyamine sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1980","description":"Hyoscyamine sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVA0","description":"ICD-OHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68761","description":"Close tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPE1","description":"ICD-FAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10120","description":"Remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABF1","description":"ICD-IABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHB1","description":"ICD-MLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open brachial artery exposure for delivery of endovascular prosthesis_ unilateral (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34834","description":"Open brachial artery exposure for delivery of endovascular prosthesis_ unilateral (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPD0","description":"ICD-KAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPA0","description":"ICD-KIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEC1","description":"ICD-BFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJC0","description":"ICD-CCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAC1","description":"ICD-NFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73630","description":"X-ray exam of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFA0","description":"ICD-OJFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCB1","description":"ICD-NLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECE0","description":"ICD-IECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBA1","description":"ICD-MBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy retro balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43213","description":"Esophagoscopy retro balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ABO GNOTYP ABO 7 EXONS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0180U","description":"ABO GNOTYP ABO 7 EXONS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHF0","description":"ICD-ECHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venous mech thrombectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37187","description":"Venous mech thrombectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefoperazone sod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0021","description":"Injection_ cefoperazone sod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDB1","description":"ICD-EFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8A","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGF1","description":"ICD-GAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mycobacteria dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87550","description":"Mycobacteria dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel-skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44640","description":"Repair bowel-skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair iris & ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66682","description":"Repair iris & ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser tx skin >500 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96922","description":"Laser tx skin >500 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap resect s/intestine addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44203","description":"Lap resect s/intestine addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDD0","description":"ICD-AGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDD0","description":"ICD-EGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVF0","description":"ICD-CFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carry d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8986","description":"Carry d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Segesterone acetate and ethinyl estradiol 0.15 mg_ 0.013 mgper 24 hours; yearly vaginal system_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7294","description":"Segesterone acetate and ethinyl estradiol 0.15 mg_ 0.013 mgper 24 hours; yearly vaginal system_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermabrasion total face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15780","description":"Dermabrasion total face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE121","description":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI joint upr extrem w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73222","description":"MRI joint upr extrem w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCD1","description":"ICD-GGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9786","description":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anal/urinary muscle study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51784","description":"Anal/urinary muscle study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBA0","description":"ICD-KCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFME0","description":"ICD-MFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSA1","description":"ICD-CHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v auto redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88152","description":"Cytopath c/v auto redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","description":"HCPCS-J2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cur funct asses; no care pln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8543","description":"Cur funct asses; no care pln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0552","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","description":"HCPCS-G0552","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68040","description":"Treatment of eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1304","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1304","description":"CDT-D1304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJF0","description":"ICD-OEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOF1","description":"ICD-PFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEF1","description":"ICD-BIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVF1","description":"ICD-FCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNF0","description":"ICD-BDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low rsk thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3550F","description":"Low rsk thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYE1","description":"ICD-HFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93152","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oprelvekin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2355","description":"Oprelvekin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIC0","description":"ICD-FAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1398","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","description":"HCPCS-M1398","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvef less than/equal to 35%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3055F","description":"Lvef less than/equal to 35%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVD0","description":"ICD-FIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQF1","description":"ICD-HHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHF1","description":"ICD-CCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis_ interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95251","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis_ interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13151","description":"Cmplx rpr e/n/e/l 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNE1","description":"ICD-KBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aortofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35647","description":"Art byp aortofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTC1","description":"ICD-MGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1075T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1075T","description":"CPT-1075T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGD1","description":"ICD-CGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30124","description":"Removal of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXC0","description":"ICD-OIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHD1","description":"ICD-JBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAE1","description":"ICD-KDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHA1","description":"ICD-BHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWB1","description":"ICD-OGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVA1","description":"ICD-CDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAA1","description":"ICD-GDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval amniotic fluid protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84112","description":"Eval amniotic fluid protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPE0","description":"ICD-KDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAB0","description":"ICD-MBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1749","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","description":"HCPCS-J1749","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHC0","description":"ICD-KBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pain neg no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8731","description":"Pain neg no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ FISH analysis of 4 genes (ASAP1_ HDAC9_ CHD1 and PTEN)_ needle biopsy specimen_ algorithm reported as probability of higher tumor grade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053U","description":"Oncology (prostate cancer)_ FISH analysis of 4 genes (ASAP1_ HDAC9_ CHD1 and PTEN)_ needle biopsy specimen_ algorithm reported as probability of higher tumor grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEF1","description":"ICD-EAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKB1","description":"ICD-GAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62140","description":"Repair of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA21","description":"ICD-1GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I131 max 100uci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9531","description":"I131 max 100uci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Promethazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2550","description":"Promethazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tandem cuff","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53444","description":"Insert tandem cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No unplnd hosp readm in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9309","description":"No unplnd hosp readm in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81213","description":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exercise Test For Bronchospasm_ Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94619","description":"Exercise Test For Bronchospasm_ Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXA1","description":"ICD-KDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracostomy w/flap drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32036","description":"Thoracostomy w/flap drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKA0","description":"ICD-JDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_ copy number variants_ microsatellite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81459","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_ copy number variants_ microsatellite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFD0","description":"ICD-JFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIE1","description":"ICD-IEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAF1","description":"ICD-MLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant ureter in bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50800","description":"Implant ureter in bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJD1","description":"ICD-FFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth chest procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52051","description":"Anesth chest procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHE1","description":"ICD-OEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ATXN3 (ataxin 3) (eg_ spinocerebellar ataxia_ Machado-Joseph disease) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81180","description":"ATXN3 (ataxin 3) (eg_ spinocerebellar ataxia_ Machado-Joseph disease) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1806","description":"HCPCS-B1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home ventilator_ multi-function respiratory device_ also performs any or all of the additional functions of oxygen concentratio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0467","description":"Home ventilator_ multi-function respiratory device_ also performs any or all of the additional functions of oxygen concentratio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWF0","description":"ICD-HFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCF1","description":"ICD-GGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of triglycerides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84478","description":"Assay of triglycerides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trabectedin_ 0.1mg (Yondelis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9480","description":"Injection_ trabectedin_ 0.1mg (Yondelis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE220","description":"Special Care High _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiographic procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76499","description":"Radiographic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKD1","description":"ICD-NHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13C","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including ultrasound guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10005","description":"Fine needle aspiration biopsy_ including ultrasound guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lifestyle mod 1st stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0340","description":"Lifestyle mod 1st stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCE1","description":"ICD-KDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSE1","description":"ICD-DBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; interpretation and report only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76989","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; interpretation and report only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g._ salvage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9895","description":"Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g._ salvage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPB0","description":"ICD-KDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVD0","description":"ICD-GGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXD0","description":"ICD-BAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt not on statin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9508","description":"Doc pt not on statin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSF1","description":"ICD-PKSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elb mold sock flex hinge pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6100","description":"Elb mold sock flex hinge pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Open_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33267","description":"Exclusion Of Left Atrial Appendage_ Open_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVF0","description":"ICD-JGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCC0","description":"ICD-CCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIC1","description":"ICD-MBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release foot/toe nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64726","description":"Release foot/toe nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temporary external pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92953","description":"Temporary external pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOA1","description":"ICD-GGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCA0","description":"ICD-EFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFB0","description":"ICD-FFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQD1","description":"ICD-DFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ear and throat examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92502","description":"Ear and throat examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMF0","description":"ICD-JEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGA0","description":"ICD-BGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCE0","description":"ICD-KGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWE1","description":"ICD-PBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXB1","description":"ICD-KBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVB0","description":"ICD-CEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCB0","description":"ICD-IGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEND1","description":"ICD-NEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icut allergy test-delayed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95028","description":"Icut allergy test-delayed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99190","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLA1","description":"ICD-OHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHND1","description":"ICD-NHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYD0","description":"ICD-KDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEF1","description":"ICD-NHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA11","description":"ICD-1GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80331","description":"Analgesics non-opioid 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQD1","description":"ICD-DIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBE0","description":"ICD-KFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged service inpatient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99356","description":"Prolonged service inpatient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hallus-valgus nt dyn pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3100","description":"Hallus-valgus nt dyn pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICF1","description":"ICD-JICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36573","description":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB52","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMB0","description":"ICD-NLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cine/video x-rays add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76125","description":"Cine/video x-rays add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99401","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ gene expression profiling by real-time RT-PCR of 7 gene pathways (ER_ AR_ PI3K_ MAPK_ HH_ TGFB_ Notch)_ formalin-fixed paraffin-embedded (FFPE)_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0262U","description":"Oncology (solid tumor)_ gene expression profiling by real-time RT-PCR of 7 gene pathways (ER_ AR_ PI3K_ MAPK_ HH_ TGFB_ Notch)_ formalin-fixed paraffin-embedded (FFPE)_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBB1","description":"ICD-NCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove nail bed/tip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11752","description":"Remove nail bed/tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCE1","description":"ICD-OJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLC1","description":"ICD-EFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1099","description":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99308","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fluocinolone acetonide_ intravitreal implant (Yutiq)_ 0.01 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7314","description":"Injection_ fluocinolone acetonide_ intravitreal implant (Yutiq)_ 0.01 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGED1","description":"ICD-BGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKC1","description":"ICD-KEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPF1","description":"ICD-GHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVC1","description":"ICD-CDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture interm part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5821","description":"Denture interm part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACD1","description":"ICD-MACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Salivary surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42699","description":"Salivary surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATA1","description":"ICD-IATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE213","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKE1","description":"ICD-JCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLE0","description":"ICD-ACLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82077","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXA1","description":"ICD-CIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin pneum/hydra pneum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5780","description":"Knee-shin pneum/hydra pneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amniply_ for topical use only_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4249","description":"Amniply_ for topical use only_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXA1","description":"ICD-OEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUE0","description":"ICD-CGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15A","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0A","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFF1","description":"ICD-NBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Twelve volt battery utah/equ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7364","description":"Twelve volt battery utah/equ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKID0","description":"ICD-NKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mattress foam rubber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0272","description":"Mattress foam rubber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISE0","description":"ICD-OISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKA1","description":"ICD-JCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mon anesth care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9654","description":"Mon anesth care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA31","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISC1","description":"ICD-CISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis b dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87516","description":"Hepatitis b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAA0","description":"ICD-GCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLE1","description":"ICD-ICLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixation of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27570","description":"Fixation of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens pmma spherical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2500","description":"Contact lens pmma spherical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOD1","description":"ICD-CAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43621","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVF1","description":"ICD-GIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAD1","description":"ICD-AAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74250","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOD1","description":"ICD-LIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38505","description":"Needle biopsy lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70200","description":"X-ray exam of eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lift assist for elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6635","description":"Lift assist for elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAE0","description":"ICD-KDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWB0","description":"ICD-KFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1245","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of lower jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21244","description":"Reconstruction of lower jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAE1","description":"ICD-OEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPF0","description":"ICD-CHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug/substance nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80376","description":"Drug/substance nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bamlanivimab_ 700 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0239","description":"Bamlanivimab_ 700 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVB1","description":"ICD-KFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE114","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIB1","description":"ICD-MGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","description":"HCPCS-J3389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKC1","description":"ICD-OHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGE1","description":"ICD-GEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWB0","description":"ICD-GBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMD1","description":"ICD-NBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2117","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rib and nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21616","description":"Removal of rib and nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc stroke after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9257","description":"Doc stroke after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRA1","description":"ICD-HFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0780T","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tisagenlecleucel_ up to 600 million car-positive viable t-cells_ including leukopheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2042","description":"Tisagenlecleucel_ up to 600 million car-positive viable t-cells_ including leukopheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compres burngarment facehood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6503","description":"Compres burngarment facehood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMC1","description":"ICD-IBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBC1","description":"ICD-KBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIE0","description":"ICD-OIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sumatriptan succinate / 6 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3030","description":"Sumatriptan succinate / 6 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIE0","description":"ICD-KFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair windpipe opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31613","description":"Repair windpipe opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIA1","description":"ICD-JFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJF1","description":"ICD-GDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXC1","description":"ICD-BGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMD1","description":"ICD-NLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla typing dr/dq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86817","description":"Hla typing dr/dq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBD0","description":"ICD-MGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGE1","description":"ICD-BDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Janssen (Johnson & Johnson) COVID-19 vaccine administration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1707","description":"Janssen (Johnson & Johnson) COVID-19 vaccine administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWE1","description":"ICD-PEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAE0","description":"ICD-GGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC21","description":"ICD-4AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHF0","description":"ICD-EIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPA1","description":"ICD-OEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXB1","description":"ICD-BFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYC1","description":"ICD-OHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTE1","description":"ICD-OGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fna w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10021","description":"Fna w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLA0","description":"ICD-OBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28296","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUA0","description":"ICD-MLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA31","description":"ICD-4KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGD0","description":"ICD-OCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit periton dialysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9339","description":"Hit periton dialysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28293","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD204","description":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCB1","description":"ICD-KBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHB1","description":"ICD-MEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDE0","description":"ICD-KFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5259","description":"Hearing aid_ digit_ bin_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trluml perip athrc visceral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0235T","description":"Trluml perip athrc visceral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periph field stimul revise","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0284T","description":"Periph field stimul revise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-Invasive Calculation And Analysis Of Central Arterial Pressure Waveforms With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0311T","description":"Non-Invasive Calculation And Analysis Of Central Arterial Pressure Waveforms With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADE0","description":"ICD-GADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD230","description":"Special Care High _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCA1","description":"ICD-GGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5099","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","description":"HCPCS-Q5099","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHD0","description":"ICD-IDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALB1","description":"ICD-OALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1481","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","description":"HCPCS-M1481","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost a/e ultlite mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7401","description":"Add ue prost a/e ultlite mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUB0","description":"ICD-ECUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hammertoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28286","description":"Repair of hammertoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOC1","description":"ICD-CEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNB1","description":"ICD-JFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise bile duct sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47460","description":"Incise bile duct sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQD1","description":"ICD-PDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAF0","description":"ICD-ABAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Path consult intraop 1 bloc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88331","description":"Path consult intraop 1 bloc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEF0","description":"ICD-IIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBD0","description":"ICD-NBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPC1","description":"ICD-NDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYF0","description":"ICD-KEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiology port images(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77417","description":"Radiology port images(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Facility/Er/Emergency Room","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"450U5","description":"Facility/Er/Emergency Room","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCE1","description":"ICD-IDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17274","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTD0","description":"ICD-MCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGE0","description":"ICD-CFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj theophylline per 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2810","description":"Inj theophylline per 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKF1","description":"ICD-BCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect fibula tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27646","description":"Resect fibula tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLB1","description":"ICD-GDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55650","description":"Remove sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIE0","description":"ICD-GHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGB0","description":"ICD-OKGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEB1","description":"ICD-IEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1302","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1302","description":"CDT-D1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl water chamber_ pap dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7046","description":"Repl water chamber_ pap dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2177","description":"Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUE1","description":"ICD-AAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLB1","description":"ICD-OLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of chin nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64736","description":"Incision of chin nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc mechanical fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85547","description":"Rbc mechanical fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHB0","description":"ICD-KDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc foot/toe tum sc < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28043","description":"Exc foot/toe tum sc < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of foot contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28270","description":"Release of foot contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL46","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEC0","description":"ICD-GIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDF0","description":"ICD-FFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELD1","description":"ICD-BELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDE1","description":"ICD-MHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mitomycin pyelocalyceal instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9281","description":"Mitomycin pyelocalyceal instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTC1","description":"ICD-CBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGND1","description":"ICD-CGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing antigen system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86911","description":"Blood typing antigen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWD0","description":"ICD-CBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1602","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1602","description":"CDT-D1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJC1","description":"ICD-JGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vitreoretinal surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14551","description":"Anesth vitreoretinal surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8009","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8009","description":"HCPCS-C8009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOD0","description":"ICD-KEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coll-e-Derm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4193","description":"Coll-e-Derm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQB1","description":"ICD-PCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANA1","description":"ICD-NANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0244T","description":"Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNB0","description":"ICD-KBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKA0","description":"ICD-KCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWF0","description":"ICD-PLWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_  tibial/peroneal artery(ies); with intravascular lithotripsy_ and transluminal stent placement(s)_ includes angioplasty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9773","description":"Revascularization_ endovascular_ open or percutaneous_  tibial/peroneal artery(ies); with intravascular lithotripsy_ and transluminal stent placement(s)_ includes angioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHC0","description":"ICD-BCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX41","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acupunct w/stimul addl 15m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97814","description":"Acupunct w/stimul addl 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQC1","description":"ICD-HAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPA0","description":"ICD-CDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNA0","description":"ICD-FBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA45","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cymetra injectable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4112","description":"Cymetra injectable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKE0","description":"ICD-NJKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIB1","description":"ICD-CDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ reslizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2786","description":"Injection_ reslizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Construct thumb replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26550","description":"Construct thumb replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDD0","description":"ICD-MFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physician Direct Care - Must be provided by a hospice physician and must be related to the patient_s terminal illness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0607","description":"Physician Direct Care - Must be provided by a hospice physician and must be related to the patient_s terminal illness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLF1","description":"ICD-OGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chimerism anal no cell selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81267","description":"Chimerism anal no cell selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25C","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFD0","description":"ICD-OLFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLF1","description":"ICD-CCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJF0","description":"ICD-JIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Donor lobectomy (lung)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2061","description":"Donor lobectomy (lung)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rectal marker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46030","description":"Removal of rectal marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLF0","description":"ICD-IDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0951T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","description":"CPT-0951T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect femur/knee tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27365","description":"Resect femur/knee tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45500","description":"Repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optimal care for patients with episodic neurological conditions mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0003","description":"Optimal care for patients with episodic neurological conditions mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31576","description":"Laryngoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELD1","description":"ICD-AELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antipsychotics nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80343","description":"Antipsychotics nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC11","description":"ICD-1GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOC0","description":"ICD-OEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUB0","description":"ICD-FAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8004","description":"HCPCS-C8004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92082","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alveolus open reduction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7671","description":"Alveolus open reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"(Rapivab) Injection_ Peramivir_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9451","description":"(Rapivab) Injection_ Peramivir_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETB0","description":"ICD-NETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No vis inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9630","description":"No vis inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0663U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0663U","description":"CPT-0663U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrde addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61868","description":"Implant neuroelectrde addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXD0","description":"ICD-KIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emr pwr cbl elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0492","description":"Emr pwr cbl elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA31","description":"ICD-2JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0933T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","description":"CPT-0933T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trimethobenzamide hcl 250mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0173","description":"Trimethobenzamide hcl 250mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESB1","description":"ICD-GESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch urine w barrier/tapv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4431","description":"Ost pch urine w barrier/tapv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKE0","description":"ICD-OFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSB1","description":"ICD-OKSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms and identification of 16 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0321U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms and identification of 16 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteoarthritis composite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0005F","description":"Osteoarthritis composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagomyotomy abdominal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43330","description":"Esophagomyotomy abdominal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNE1","description":"ICD-BGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVF0","description":"ICD-OHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKE1","description":"ICD-GAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC01","description":"High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ brexanolone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1632","description":"Injection_ brexanolone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc ext unknwn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9070","description":"Onc dx sclc/nsclc ext unknwn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGD1","description":"ICD-JEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Salivary gland imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78230","description":"Salivary gland imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort iii w/o lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21154","description":"Lefort iii w/o lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGC1","description":"ICD-OIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOA0","description":"ICD-CGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESD1","description":"ICD-LESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47780","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61710","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXF0","description":"ICD-BGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12C","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL41","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone replce graft each add","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4264","description":"Bone replce graft each add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Streptozocin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9320","description":"Streptozocin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Csf shunt evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78645","description":"Csf shunt evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVE0","description":"ICD-CIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELA0","description":"ICD-OELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Placement of intraocular radiation source applicator (List separately in addition to primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0190T","description":"Placement of intraocular radiation source applicator (List separately in addition to primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB124","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelets_ irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9032","description":"Platelets_ irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy rem totl cortex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32652","description":"Thoracoscopy rem totl cortex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTC0","description":"ICD-GFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJD1","description":"ICD-GGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOC1","description":"ICD-DGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXC0","description":"ICD-KEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24D","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microprcsr cu elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0481","description":"Microprcsr cu elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXF1","description":"ICD-JDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Head surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21499","description":"Head surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ infliximab-abda_ biosimilar_ (Renflexis)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5104","description":"Injection_ infliximab-abda_ biosimilar_ (Renflexis)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUC0","description":"ICD-MBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine shunt to intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50815","description":"Urine shunt to intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB201","description":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alerting device_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5269","description":"Alerting device_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUE0","description":"ICD-GCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cad cxr remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0175T","description":"Cad cxr remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of ureters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50760","description":"Fusion of ureters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDF0","description":"ICD-NHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81005","description":"Urinalysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCF1","description":"ICD-BDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESF0","description":"ICD-DESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69320","description":"Rebuild outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBF0","description":"ICD-ACBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-CDC SARS-CoV-2/2019-nCoV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0002","description":"Non-CDC SARS-CoV-2/2019-nCoV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYA1","description":"ICD-PHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec size w foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1221","description":"Wheelchair spec size w foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSA0","description":"ICD-LCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; electrode only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0531T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; electrode only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTD1","description":"ICD-CCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"repair resin partial denture base_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5612","description":"repair resin partial denture base_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc abd tum 5 cm or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49203","description":"Exc abd tum 5 cm or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast add lesion mr imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19086","description":"Bx breast add lesion mr imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIC0","description":"ICD-MLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srn clin dep doc no f/u pln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8940","description":"Srn clin dep doc no f/u pln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEE1","description":"ICD-MFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N-et; stretcher van","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2005","description":"N-et; stretcher van","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA31","description":"ICD-4JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUC1","description":"ICD-OEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHB1","description":"ICD-MHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOA1","description":"ICD-PHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHE1","description":"ICD-ADHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUD1","description":"ICD-AAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPC0","description":"ICD-CBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99221","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0802","description":"HCPCS-A0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPC1","description":"ICD-JBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic vein harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33508","description":"Endoscopic vein harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE244","description":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIC0","description":"ICD-EDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA11","description":"ICD-4BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIC0","description":"ICD-NFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metabolic panel total ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80048","description":"Metabolic panel total ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEC1","description":"ICD-CIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMF0","description":"ICD-MKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Basic life support mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0380","description":"Basic life support mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tigecycline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3243","description":"Tigecycline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEC1","description":"ICD-BHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD130","description":"Special Care Low _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95979","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTA1","description":"ICD-MHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQA0","description":"ICD-GHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic resorbable wound dressing_ sterile_ pad size 16 sq in or less_ without adhesive border_ each dressing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6460","description":"Synthetic resorbable wound dressing_ sterile_ pad size 16 sq in or less_ without adhesive border_ each dressing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL43","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHB1","description":"ICD-OLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temperature gradient studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93740","description":"Temperature gradient studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVC0","description":"ICD-KEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67917","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Filters elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0500","description":"Filters elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opioids & opiate analogs 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80362","description":"Opioids & opiate analogs 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphere bifocal 4.12-7.0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2201","description":"Lens sphere bifocal 4.12-7.0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop dress & 1 cast chg bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5400","description":"Postop dress & 1 cast chg bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJC1","description":"ICD-JIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0502","description":"HCPCS-A0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFD1","description":"ICD-KHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levonorgestrel-releasing intrauterine contraceptive system_ (Kyleena)_ 19.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7296","description":"Levonorgestrel-releasing intrauterine contraceptive system_ (Kyleena)_ 19.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39010","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1097T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1097T","description":"CPT-1097T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gene expression profiling panel for use in the management of breast cancer treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3854","description":"Gene expression profiling panel for use in the management of breast cancer treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear canal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69140","description":"Remove ear canal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEC0","description":"ICD-FHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHE1","description":"ICD-MFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUB1","description":"ICD-BCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRF0","description":"ICD-PCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTF0","description":"ICD-AGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXB0","description":"ICD-JIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXA0","description":"ICD-KFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLD1","description":"ICD-IFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below knee leather socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5638","description":"Below knee leather socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 16 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0347U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 16 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2041","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","description":"HCPCS-A2041","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEF0","description":"ICD-KAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiofq trsmtr for implt neu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8683","description":"Radiofq trsmtr for implt neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas biopsy not review","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8884","description":"Doc reas biopsy not review","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRD1","description":"ICD-OBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1503","description":"HCPCS-B1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBED1","description":"ICD-JBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB251","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8A","description":"Medium Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFC1","description":"ICD-OAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meg spontaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95965","description":"Meg spontaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQC0","description":"ICD-OEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSC0","description":"ICD-CBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacotherapy for OUD initiated after June 30th of performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1033","description":"Pharmacotherapy for OUD initiated after June 30th of performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVA0","description":"ICD-NBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOB0","description":"ICD-PBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDB1","description":"ICD-EDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISB1","description":"ICD-GISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMC1","description":"ICD-JEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUB0","description":"ICD-GAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ melphalan (Evomela)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9246","description":"Injection_ melphalan (Evomela)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hypnotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90880","description":"Hypnotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPE1","description":"ICD-KBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEC0","description":"ICD-ACEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELD0","description":"ICD-FELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKE0","description":"ICD-OGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excellagen_ 0.1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4149","description":"Excellagen_ 0.1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJF0","description":"ICD-BDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28X","description":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision or replacement of chest wall respiratory sensor electrode or electrode array_ including connection to existing pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0467T","description":"Revision or replacement of chest wall respiratory sensor electrode or electrode array_ including connection to existing pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUD0","description":"ICD-OHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKC1","description":"ICD-KDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDC1","description":"ICD-MHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services for patient provided any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9718","description":"Hospice services for patient provided any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBB1","description":"ICD-CBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxford w/ supinator/pronator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3203","description":"Oxford w/ supinator/pronator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDF1","description":"ICD-KHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens_ 1.54-1.65 p/1.60-1.79g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2782","description":"Lens_ 1.54-1.65 p/1.60-1.79g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXA0","description":"ICD-NKXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUB0","description":"ICD-AFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38720","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped crit care transport","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99466","description":"Ped crit care transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITF0","description":"ICD-MITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery blockage each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75964","description":"Repair artery blockage each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHA0","description":"ICD-IGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCC0","description":"ICD-JCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETA1","description":"ICD-IETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt recvd no inhal anesthic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4555F","description":"Pt recvd no inhal anesthic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of neck cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42815","description":"Excision of neck cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBME0","description":"ICD-MBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct perfusion w/contrast cbf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042T","description":"Ct perfusion w/contrast cbf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr umbil hern reduc < 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49580","description":"Rpr umbil hern reduc < 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELB0","description":"ICD-KELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCA0","description":"ICD-NJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE115","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gen use back cush wdth>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2612","description":"Gen use back cush wdth>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Androstanediol glucuronide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82154","description":"Androstanediol glucuronide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEC1","description":"ICD-OEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYA0","description":"ICD-DBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJF0","description":"ICD-BHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAD1","description":"ICD-ACAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ velmanase alfa-tycv_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0217","description":"Injection_ velmanase alfa-tycv_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIME0","description":"ICD-AIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKB1","description":"ICD-NBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRD1","description":"ICD-KGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEID1","description":"ICD-FEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYD1","description":"ICD-LBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXE1","description":"ICD-OBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj manipulation under anest","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7830","description":"Tmj manipulation under anest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14C","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pi volunteer ambulance co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0432","description":"Pi volunteer ambulance co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolytic antiplasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85410","description":"Fibrinolytic antiplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48153","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; 6 Years And Older Without Congenita","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33017","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; 6 Years And Older Without Congenita","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTC1","description":"ICD-EBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 21_ 18_ and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff_ algorithm reported as a risk score for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0168U","description":"Fetal aneuploidy (trisomy 21_ 18_ and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff_ algorithm reported as a risk score for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22B","description":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using posttransplant peripheral blood_ algorithm reported as a risk score for acute cellular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0320U","description":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using posttransplant peripheral blood_ algorithm reported as a risk score for acute cellular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIE0","description":"ICD-CIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg_ colorectal cancer) promoter methylation analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0229U","description":"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg_ colorectal cancer) promoter methylation analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUD1","description":"ICD-GBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTD1","description":"ICD-BGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA35","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23C","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ hydroxocobalamin_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3425","description":"Injection_ hydroxocobalamin_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14B","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBE0","description":"ICD-EGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPF0","description":"ICD-FAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC250","description":"Clinically Complex _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38520","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive Care Management For A Single High-Risk Disease Services_ E.G. Principal Care Management_ At Least 30 Minutes Of Clinical Staff Time Directed By A Physician Or Ot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2065","description":"Comprehensive Care Management For A Single High-Risk Disease Services_ E.G. Principal Care Management_ At Least 30 Minutes Of Clinical Staff Time Directed By A Physician Or Ot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Unilateral Space Maintainer - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1553","description":"Re-Cement Or Re-Bond Unilateral Space Maintainer - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46607","description":"Diagnostic anoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPC1","description":"ICD-OJPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEA0","description":"ICD-KFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJC1","description":"ICD-BIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESB1","description":"ICD-HESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment x10sv retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67228","description":"Treatment x10sv retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"marsupialization of odontogenic cyst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7509","description":"marsupialization of odontogenic cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin reuse pen 3 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5561","description":"Insulin reuse pen 3 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEC0","description":"ICD-EAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUE0","description":"ICD-FBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sinus tarsi implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0510T","description":"Removal of sinus tarsi implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on eye; iridectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0121U","description":"Anesthesia for procedures on eye; iridectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC10","description":"High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAE1","description":"ICD-FIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLF0","description":"ICD-AGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc biliary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47579","description":"Laparoscope proc biliary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXC0","description":"ICD-JCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVA1","description":"ICD-GIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLA1","description":"ICD-ICLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9308","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9308","description":"HCPCS-C9308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUB1","description":"ICD-OJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63103","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penicillin g benzathine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0561","description":"Penicillin g benzathine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCD1","description":"ICD-ICCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/tr/ext 7.6-12.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12034","description":"Intmd rpr s/tr/ext 7.6-12.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHE1","description":"ICD-ODHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC111","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBE1","description":"ICD-KGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGA1","description":"ICD-FEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIA1","description":"ICD-FFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFD1","description":"ICD-ODFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFID0","description":"ICD-BFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24920","description":"Amputation of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cadmium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82300","description":"Assay of cadmium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWE1","description":"ICD-OJWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGD1","description":"ICD-JFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ziconotide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2278","description":"Ziconotide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pancreas removal/transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48160","description":"Pancreas removal/transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place cath carotid/inom art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36223","description":"Place cath carotid/inom art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; first 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92622","description":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; first 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLD0","description":"ICD-JHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0887T","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAME1","description":"ICD-JAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9899","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRA0","description":"ICD-PGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFB1","description":"ICD-JCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBD0","description":"ICD-CBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manipulation of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27275","description":"Manipulation of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI compatible system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0859","description":"MRI compatible system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIC1","description":"ICD-ABIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAF0","description":"ICD-AAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18C","description":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26775","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGA1","description":"ICD-JHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCID0","description":"ICD-BCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Topographic brain mapping","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8040","description":"Topographic brain mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCC0","description":"ICD-OBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECE0","description":"ICD-MECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMA0","description":"ICD-BEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSA0","description":"ICD-DGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEC1","description":"ICD-EAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cerliponase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9014","description":"Injection_ cerliponase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0008","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Car-car bp grft/endovas taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33891","description":"Car-car bp grft/endovas taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0587U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","description":"CPT-0587U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBF0","description":"ICD-FFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3B","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8007","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8007","description":"HCPCS-C8007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Storage/year oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89346","description":"Storage/year oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABD1","description":"ICD-OABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMF0","description":"ICD-NLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDB0","description":"ICD-MGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE117","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCD1","description":"ICD-EGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBID1","description":"ICD-OBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hfe gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81256","description":"Hfe gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 5.1-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12053","description":"Intmd rpr face/mm 5.1-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNB1","description":"ICD-NGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVA1","description":"ICD-NKVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQB1","description":"ICD-DBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28737","description":"Revision of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped critical care subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99472","description":"Ped critical care subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aud rehab postling hear loss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92633","description":"Aud rehab postling hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contraceptive vaginal ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7303","description":"Contraceptive vaginal ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99348","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQC1","description":"ICD-GEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable Collection And Storage Bag For Breast Milk_ Any Size_ Any Type_ Each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1005","description":"Disposable Collection And Storage Bag For Breast Milk_ Any Size_ Any Type_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXD1","description":"ICD-BIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMB0","description":"ICD-OLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lsh w/t/o ut 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58542","description":"Lsh w/t/o ut 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc brst cncr stage 0 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3370F","description":"Ajcc brst cncr stage 0 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tongue suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41512","description":"Tongue suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC230","description":"Special Care Low _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBA1","description":"ICD-AIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC35","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom glove for term device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6895","description":"Custom glove for term device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUA1","description":"ICD-AFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone 80 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1040","description":"Methylprednisolone 80 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDB0","description":"ICD-CIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQE1","description":"ICD-OFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD115","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBE0","description":"ICD-IHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWC0","description":"ICD-PCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESA0","description":"ICD-LESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEB0","description":"ICD-AGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTD1","description":"ICD-OLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGA0","description":"ICD-BAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0701","description":"HCPCS-C0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photorefractive keratectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0810","description":"Photorefractive keratectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINB0","description":"ICD-KINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICB0","description":"ICD-IICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEF0","description":"ICD-MAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALC1","description":"ICD-AALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLC0","description":"ICD-AFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDB1","description":"ICD-FFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34201","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKA1","description":"ICD-GBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETB1","description":"ICD-FETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPF1","description":"ICD-NKPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27590","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBND0","description":"ICD-OBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCB0","description":"ICD-JHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 4 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0871","description":"Pwc gp 4 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1202","description":"HCPCS-B1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDF1","description":"ICD-JFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADD1","description":"ICD-BADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumocystis carinii ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87281","description":"Pneumocystis carinii ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPD1","description":"ICD-GDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5C","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of amylase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82150","description":"Assay of amylase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neck spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22595","description":"Neck spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electron microscopy diagnost","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0481","description":"Electron microscopy diagnost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery translocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33506","description":"Repair artery translocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKB0","description":"ICD-FHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"100 insulin syringes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8490","description":"100 insulin syringes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQA0","description":"ICD-CDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRB1","description":"ICD-KCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXC1","description":"ICD-JFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRA0","description":"ICD-LDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt tobacco screen rcvd tlk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4004F","description":"Pt tobacco screen rcvd tlk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0503","description":"HCPCS-B0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86409","description":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cessj therapy cath removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37214","description":"Cessj therapy cath removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL33","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACA1","description":"ICD-CACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOB0","description":"ICD-DIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDF0","description":"ICD-MKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIF1","description":"ICD-KDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBC1","description":"ICD-IGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQA0","description":"ICD-HEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76979","description":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVF0","description":"ICD-CGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt asked/cnsld aed effects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6070F","description":"Pt asked/cnsld aed effects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ dom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0077","description":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ dom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHA1","description":"ICD-IGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGD1","description":"ICD-KHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES201","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWC1","description":"ICD-OBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA07","description":"Low Rehab_ ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALB0","description":"ICD-JALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ initial artery_ open or pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7532","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ initial artery_ open or pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caloric vestibular test_ each irrigation (binaural_ bithermalstimulation constitutes four tests)_ with recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92543","description":"Caloric vestibular test_ each irrigation (binaural_ bithermalstimulation constitutes four tests)_ with recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAC0","description":"ICD-FDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVE1","description":"ICD-BHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFE0","description":"ICD-OHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQA1","description":"ICD-PLQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other immunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86325","description":"Other immunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJF0","description":"ICD-JBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRC1","description":"ICD-HHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobramycin non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7682","description":"Tobramycin non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct scan for localization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77011","description":"Ct scan for localization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRE1","description":"ICD-PJRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNC0","description":"ICD-CBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOF1","description":"ICD-KCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2132","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0909T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","description":"CPT-0909T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUD0","description":"ICD-GCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41827","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPD0","description":"ICD-OIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBA0","description":"ICD-GFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral counseling for diabetes prevention_ in-person_ group_ 60 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9886","description":"Behavioral counseling for diabetes prevention_ in-person_ group_ 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMF1","description":"ICD-IGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJB0","description":"ICD-JBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRF0","description":"ICD-HCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open reduc compd alveolus fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7770","description":"Open reduc compd alveolus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1025T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","description":"CPT-1025T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUD0","description":"ICD-JBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVA1","description":"ICD-KFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBB0","description":"ICD-OJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66635","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis training complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90989","description":"Dialysis training complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy pouch solid deodorant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4395","description":"Ostomy pouch solid deodorant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAF0","description":"ICD-BCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11621","description":"Exc s/n/h/f/g mal+mrg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABB0","description":"ICD-CABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0927T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","description":"CPT-0927T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imm admin by intramusc injection of  (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 1st dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0021A","description":"Imm admin by intramusc injection of  (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 1st dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak/knee disartic silesian ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5698","description":"Ak/knee disartic silesian ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen concentrator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1390","description":"Oxygen concentrator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELC0","description":"ICD-BELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mycophenolate mofetil_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7519","description":"Injection_ mycophenolate mofetil_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81405","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophageal sphincter augmentation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43285","description":"Removal of esophageal sphincter augmentation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin stability screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83068","description":"Hemoglobin stability screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35271","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suture bile duct injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47900","description":"Suture bile duct injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDB0","description":"ICD-IFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGC0","description":"ICD-NDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNA0","description":"ICD-OLNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMC0","description":"ICD-NBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12D","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTB1","description":"ICD-GCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE214","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of major vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37660","description":"Revision of major vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enlarge breast with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19325","description":"Enlarge breast with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEA1","description":"ICD-NBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemical peel face epiderm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15788","description":"Chemical peel face epiderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Topotecan oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8705","description":"Topotecan oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8X","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHC1","description":"ICD-NAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX60","description":"Very High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9369","description":"Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQE1","description":"ICD-LCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clsd red simp malar/zygom fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7660","description":"Clsd red simp malar/zygom fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ankle bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28130","description":"Removal of ankle bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemolysins/agglutinins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86941","description":"Hemolysins/agglutinins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTF1","description":"ICD-IHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTB1","description":"ICD-JDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Norsn no foot exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9225","description":"Norsn no foot exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputate hand at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25920","description":"Amputate hand at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGD1","description":"ICD-GDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95707","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYC0","description":"ICD-GGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC41","description":"High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phleb veins - extrem 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37766","description":"Phleb veins - extrem 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECB0","description":"ICD-CECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antiviral ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9245","description":"Antiviral ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37272","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","description":"CPT-37272","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom shape cover bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5704","description":"Custom shape cover bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ant fusion 4-7 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22810","description":"Ant fusion 4-7 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBD0","description":"ICD-KFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFD0","description":"ICD-GEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5172","description":"HCPCS-Q5172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ige","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82785","description":"Assay of ige","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBE1","description":"ICD-ABBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tun ip cath perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49418","description":"Insert tun ip cath perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHE1","description":"ICD-ICHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Haloperidol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1630","description":"Haloperidol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABE1","description":"ICD-JABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","description":"HCPCS-L6028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Most recent assess vol mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8955","description":"Most recent assess vol mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0B","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27253","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMC0","description":"ICD-AEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rxt breast appl place/remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9726","description":"Rxt breast appl place/remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPD1","description":"ICD-NIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block other peripheral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64450","description":"N block other peripheral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Duration of monitored anesthesia care(mac)or peripheral nerve block(pnb)without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9363","description":"Duration of monitored anesthesia care(mac)or peripheral nerve block(pnb)without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amitriptyline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1320","description":"Amitriptyline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diast bp >/= 90 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3080F","description":"Diast bp >/= 90 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/transpose nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64856","description":"Repair/transpose nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Procenta_ per 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4310","description":"Procenta_ per 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy tubal block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58671","description":"Laparoscopy tubal block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung transplant with bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32854","description":"Lung transplant with bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9289","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","description":"HCPCS-J9289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic mens shoes dpth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3221","description":"Orthopedic mens shoes dpth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUF0","description":"ICD-FFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insitu hybridization manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88368","description":"Insitu hybridization manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCC0","description":"ICD-NBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43499","description":"Esophagus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCE1","description":"ICD-KHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13D","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLE1","description":"ICD-KHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDE0","description":"ICD-JFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spinal disk surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63035","description":"Spinal disk surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB40","description":"Low Rehab_ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHA0","description":"ICD-ODHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIED1","description":"ICD-NIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDA1","description":"ICD-KIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAE0","description":"ICD-OAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22548","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise two eye muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67316","description":"Revise two eye muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic shoe add rub insl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3510","description":"Orthopedic shoe add rub insl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHD1","description":"ICD-EGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed var ht w/o rail w/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0293","description":"Hosp bed var ht w/o rail w/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFE0","description":"ICD-CFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRF0","description":"ICD-PDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVD0","description":"ICD-JIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery for urethra pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53240","description":"Surgery for urethra pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIF0","description":"ICD-OFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0850","description":"Pwc gp 3 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydralazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0360","description":"Hydralazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frozen plasma_ pooled_ sd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9023","description":"Frozen plasma_ pooled_ sd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUF1","description":"ICD-NHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYF0","description":"ICD-KCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98007","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","description":"CPT-98007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHA0","description":"ICD-MEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTD0","description":"ICD-IGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEE0","description":"ICD-NKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aldesleukin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9015","description":"Aldesleukin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSA1","description":"ICD-HDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1441","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","description":"HCPCS-M1441","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No reop req bld grft oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8578","description":"No reop req bld grft oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2B","description":"Low Rehab_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision hyperplastic tissue","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7970","description":"Excision hyperplastic tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hd low limb pros vacuum pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5782","description":"Hd low limb pros vacuum pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44378","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove blood clot from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65930","description":"Remove blood clot from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDE1","description":"ICD-MEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA110","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","description":"HCPCS-J0164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removable Unilateral Partial Denture - One Piece Flexible Base - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5284","description":"Removable Unilateral Partial Denture - One Piece Flexible Base - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein byp pop-tibl peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35587","description":"Vein byp pop-tibl peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary rehabilitation pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9473","description":"Pulmonary rehabilitation pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMF0","description":"ICD-JBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTF1","description":"ICD-MDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth chest wall repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47251","description":"Anesth chest wall repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0630U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","description":"CPT-0630U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suction lipectomy lwr extrem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15879","description":"Suction lipectomy lwr extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATB1","description":"ICD-BATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult companioncare per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5136","description":"Adult companioncare per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFID1","description":"ICD-GFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXD1","description":"ICD-BAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFE0","description":"ICD-KIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX20","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33367","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSB0","description":"ICD-PBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRC1","description":"ICD-GCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 4 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0870","description":"Pwc gp 4 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med trng & support per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0034","description":"Med trng & support per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lysis of labial lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56441","description":"Lysis of labial lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone biopsy excisional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20240","description":"Bone biopsy excisional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4435","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","description":"HCPCS-Q4435","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVD0","description":"ICD-CHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBC1","description":"ICD-IDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of spinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63172","description":"Drainage of spinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVF1","description":"ICD-KEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC201","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx cml blast phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9125","description":"Onc dx cml blast phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glasses binaural hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5150","description":"Glasses binaural hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2208","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAC1","description":"ICD-EHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18E","description":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMF1","description":"ICD-MBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFE0","description":"ICD-NBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22558","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 0.5 cm<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11400","description":"Exc tr-ext b9+marg 0.5 cm<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC140","description":"Special Care Low _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIB1","description":"ICD-IFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALD1","description":"ICD-CALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0165","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","description":"HCPCS-J0165","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5258","description":"Hearing aid_ digit_ bin_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAC0","description":"ICD-NFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB51","description":"High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMC0","description":"ICD-OHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ldct for lung ca screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0297","description":"Ldct for lung ca screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6023","description":"Sigmoidoscopy_ flexible; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVA1","description":"ICD-OEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNE1","description":"ICD-OFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDA1","description":"ICD-NBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34710","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDA1","description":"ICD-CGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYA0","description":"ICD-DHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJD0","description":"ICD-CAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tezepelumab-ekko_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2356","description":"Injection_ tezepelumab-ekko_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hgh risk for thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3552F","description":"Hgh risk for thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg_ anchor_ screw_ tack) and all associated radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34712","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg_ anchor_ screw_ tack) and all associated radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTB0","description":"ICD-NJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTC0","description":"ICD-NCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2711","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","description":"HCPCS-J2711","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CT/MRI chest/neck follup rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9554","description":"CT/MRI chest/neck follup rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDE0","description":"ICD-BIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUA0","description":"ICD-FDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46040","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ctlso axilla sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1010","description":"Ctlso axilla sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEC1","description":"ICD-OBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJB0","description":"ICD-KGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATD1","description":"ICD-OATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB230","description":"Reduced Physical Function _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xcell amnio matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4280","description":"Xcell amnio matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Probe nl duct w/balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68816","description":"Probe nl duct w/balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainable rubber pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4378","description":"Drainable rubber pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUB1","description":"ICD-NFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDE0","description":"ICD-CBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic pancreatoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43273","description":"Endoscopic pancreatoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAB0","description":"ICD-IDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00730","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","description":"CPT-00730","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMD0","description":"ICD-KBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPB1","description":"ICD-CHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLB1","description":"ICD-ODLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEF0","description":"ICD-MGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATF1","description":"ICD-AATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNA0","description":"ICD-JGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIF0","description":"ICD-ICIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak flex inner socket ext fra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5651","description":"Ak flex inner socket ext fra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETC0","description":"ICD-FETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj iv push","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96374","description":"Ther/proph/diag inj iv push","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNE1","description":"ICD-JFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADB1","description":"ICD-EADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lyse chest fibrin subq day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32562","description":"Lyse chest fibrin subq day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 1 visit p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90962","description":"Esrd serv 1 visit p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJA1","description":"ICD-FAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILC1","description":"ICD-EILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic decompression of spinal cord_ nerve root(s)_ including laminotomy_ partial facetectomy_ foraminotomy_ discectomy and/or excision of herniated intervertebral disc_ 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62380","description":"Endoscopic decompression of spinal cord_ nerve root(s)_ including laminotomy_ partial facetectomy_ foraminotomy_ discectomy and/or excision of herniated intervertebral disc_ 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt queried prkns complic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4324F","description":"Pt queried prkns complic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx bipol_ death_ nhres_ hosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9394","description":"Dx bipol_ death_ nhres_ hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKC0","description":"ICD-GFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESC0","description":"ICD-HESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMB0","description":"ICD-BCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auditory osseointegrated device_ transducer/actuator_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8694","description":"Auditory osseointegrated device_ transducer/actuator_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSE0","description":"ICD-DBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECF0","description":"ICD-KECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYB1","description":"ICD-DCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERA1","description":"ICD-CERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood mucoprotein","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2038","description":"Blood mucoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bypass graft/av fist patency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35686","description":"Bypass graft/av fist patency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPD1","description":"ICD-NHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRF0","description":"ICD-PLRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCID0","description":"ICD-OCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0512U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","description":"CPT-0512U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFE1","description":"ICD-OIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Talk re uv light pt/crgvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4176F","description":"Talk re uv light pt/crgvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCA1","description":"ICD-AFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54380","description":"Repair penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31288","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient use of hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9693","description":"Patient use of hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMD0","description":"ICD-OIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMA1","description":"ICD-CDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21B","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAD1","description":"ICD-EBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDB0","description":"ICD-KEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACE1","description":"ICD-AACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep a vac injxn admin/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4148F","description":"Hep a vac injxn admin/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETF0","description":"ICD-OETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8566","description":"Pt inelig ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath w/drainage 3-way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4316","description":"Cath w/drainage 3-way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUB0","description":"ICD-IEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11750","description":"Removal of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINB0","description":"ICD-OINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDA0","description":"ICD-IHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","description":"HCPCS-Q4403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy resect bullae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32655","description":"Thoracoscopy resect bullae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA11","description":"ICD-2FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHB1","description":"ICD-GAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE111","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart flow reserve measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93572","description":"Heart flow reserve measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23525","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15950","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivitive_ genvisc 850_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7320","description":"Hyaluronan or derivitive_ genvisc 850_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2004","description":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGC0","description":"ICD-FEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRA1","description":"ICD-DDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMC0","description":"ICD-NHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWC0","description":"ICD-OFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood methemoglobin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83050","description":"Blood methemoglobin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLD1","description":"ICD-OBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatology (nonalcoholic steatohepatitis [NASH])_ miR-34a-5p_ alpha 2-macroglobulin_ YKL40_ HbA1c_ serum and whole blood_ algorithm reported as a single score for NASH activit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0468U","description":"Hepatology (nonalcoholic steatohepatitis [NASH])_ miR-34a-5p_ alpha 2-macroglobulin_ YKL40_ HbA1c_ serum and whole blood_ algorithm reported as a single score for NASH activit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15D","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOE0","description":"ICD-DIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of scapula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23190","description":"Partial removal of scapula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXE1","description":"ICD-KBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICID0","description":"ICD-ICID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILC0","description":"ICD-OILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOC1","description":"ICD-DFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJE0","description":"ICD-FDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKE0","description":"ICD-BCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cataract surg w/iol 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66984","description":"Cataract surg w/iol 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther behav svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2019","description":"Ther behav svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKE0","description":"ICD-BGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHA0","description":"ICD-BEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVF0","description":"ICD-NDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA10","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYF1","description":"ICD-LEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICF0","description":"ICD-CICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRD0","description":"ICD-GHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD160","description":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTF1","description":"ICD-FFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELF0","description":"ICD-GELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJE0","description":"ICD-JDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIE1","description":"ICD-CIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable cycler set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4671","description":"Disposable cycler set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1602","description":"HCPCS-B1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCC1","description":"ICD-KBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDF0","description":"ICD-AFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQC1","description":"ICD-CDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electro connect btw control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2310","description":"Electro connect btw control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITB0","description":"ICD-GITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0548","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","description":"HCPCS-G0548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIE0","description":"ICD-MFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct lower extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73701","description":"Ct lower extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular prosthesis interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5923","description":"Ocular prosthesis interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAME0","description":"ICD-FAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scaling and debridement in the presence of inflammation or mucositis of a single implant_ including cleaning of the implant surfaces_ without flap entry and closure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6081","description":"Scaling and debridement in the presence of inflammation or mucositis of a single implant_ including cleaning of the implant surfaces_ without flap entry and closure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSC0","description":"ICD-CDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDA1","description":"ICD-NJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10A","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLE1","description":"ICD-CDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth chest surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54051","description":"Anesth chest surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMF1","description":"ICD-IEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95071","description":"Bronchial allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9246","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9246","description":"CDT-D9246","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLE0","description":"ICD-KGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33400","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28G","description":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology tum unknown origin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81540","description":"Oncology tum unknown origin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIID0","description":"ICD-JIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEF1","description":"ICD-AEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXE1","description":"ICD-JFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assist living waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2031","description":"Assist living waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDB0","description":"ICD-CBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDF1","description":"ICD-KCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBF1","description":"ICD-CIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15261","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBF0","description":"ICD-GGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESB0","description":"ICD-HESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA51","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMC1","description":"ICD-JFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB11","description":"ICD-1GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEE0","description":"ICD-BIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUD0","description":"ICD-JDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59150","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt cat and thck on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9294","description":"Pt cat and thck on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28312","description":"Revision of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUB1","description":"ICD-AIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88309","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antithymocyte globuln rabbit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7511","description":"Antithymocyte globuln rabbit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE260","description":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEC0","description":"ICD-JEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73070","description":"X-ray exam of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid skin barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4362","description":"Solid skin barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk removable medial brim sus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5672","description":"Bk removable medial brim sus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXE0","description":"ICD-BEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBF1","description":"ICD-OFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYA0","description":"ICD-OFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEC1","description":"ICD-KGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLE0","description":"ICD-CCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 5MCG/.5ML AS03B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0104A","description":"ADM SARSCOV2 5MCG/.5ML AS03B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCED0","description":"ICD-MCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microslide consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88321","description":"Microslide consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19316","description":"Suspension of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Splint - extra-coronal; natural teeth or prosthetic crowns","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4323","description":"Splint - extra-coronal; natural teeth or prosthetic crowns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDD1","description":"ICD-FDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microbe susceptible mic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87186","description":"Microbe susceptible mic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removable insert each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6691","description":"Removable insert each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJB0","description":"ICD-NKJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIME1","description":"ICD-CIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWE1","description":"ICD-LEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAE0","description":"ICD-JIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29875","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEA1","description":"ICD-GIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ docetaxel (ingenus) not therapeutically equivalent to j9171_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9172","description":"Injection_ docetaxel (ingenus) not therapeutically equivalent to j9171_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISD1","description":"ICD-OISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23800","description":"Fusion of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOA0","description":"ICD-HBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDF0","description":"ICD-CDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDE1","description":"ICD-IEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEF1","description":"ICD-EIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice home care in hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5010","description":"Hospice home care in hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMB1","description":"ICD-MLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLE1","description":"ICD-BBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ (AuroMedics)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9071","description":"Injection_ cyclophosphamide_ (AuroMedics)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0303U","description":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41822","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIC1","description":"ICD-JIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 15-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86300","description":"Immunoassay tumor ca 15-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or bo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1195","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or bo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absolute quantitation of myocardial blood flow (AQMBF)_ single-photon emission computed tomography (SPECT)_ with exercise or pharmacologic stress_ and at rest_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0742T","description":"Absolute quantitation of myocardial blood flow (AQMBF)_ single-photon emission computed tomography (SPECT)_ with exercise or pharmacologic stress_ and at rest_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBA1","description":"ICD-CBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect apical lung tum/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32504","description":"Resect apical lung tum/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debridement & contouring","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6102","description":"Debridement & contouring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTF0","description":"ICD-JDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLF1","description":"ICD-JBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATB0","description":"ICD-OATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJB1","description":"ICD-NJJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWE0","description":"ICD-HAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria w/bypass exten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33256","description":"Ablate atria w/bypass exten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASB1","description":"ICD-LASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise ulnar nerve at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64719","description":"Revise ulnar nerve at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIB0","description":"ICD-OIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo remove w/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50548","description":"Laparo remove w/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coch implant microphone repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8616","description":"Coch implant microphone repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDE1","description":"ICD-CCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulance 02 life sustaining","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0422","description":"Ambulance 02 life sustaining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ewho w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3764","description":"Ewho w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJD1","description":"ICD-OKJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGED1","description":"ICD-JGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYC1","description":"ICD-PLYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRA0","description":"ICD-LBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNC0","description":"ICD-OFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD256","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXD1","description":"ICD-OGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIE1","description":"ICD-MLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hdr rdncl skn surf brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77767","description":"Hdr rdncl skn surf brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNE1","description":"ICD-NLNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDA0","description":"ICD-CDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHE0","description":"ICD-KIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Routine Home Care - A flat per diem before area wage adjustment for intermittent services furnished.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0602","description":"Routine Home Care - A flat per diem before area wage adjustment for intermittent services furnished.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N-et; stretcher van_ mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2049","description":"N-et; stretcher van_ mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLF0","description":"ICD-MBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITD0","description":"ICD-AITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insrt heart pm atrial & vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33208","description":"Insrt heart pm atrial & vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPA1","description":"ICD-OIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPE0","description":"ICD-BHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB03","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMD0","description":"ICD-OHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63270","description":"Excise intrspinl lesion crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid fitting/checking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5011","description":"Hearing aid fitting/checking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKB1","description":"ICD-BAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rigid ped wc adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1235","description":"Rigid ped wc adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIB0","description":"ICD-JHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPC0","description":"ICD-BDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC50","description":"Very High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl oral cushion combo mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7028","description":"Repl oral cushion combo mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVD0","description":"ICD-KHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGC0","description":"ICD-NBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTE1","description":"ICD-IFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCF0","description":"ICD-MKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain aneurysm repr complx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61697","description":"Brain aneurysm repr complx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXC0","description":"ICD-CHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDA0","description":"ICD-MDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXD1","description":"ICD-KAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVD1","description":"ICD-OAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9311","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9311","description":"HCPCS-C9311","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Declot vascular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36593","description":"Declot vascular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWF1","description":"ICD-ODWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSC0","description":"ICD-LBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24C","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilat macular exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2021F","description":"Dilat macular exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKB1","description":"ICD-NLKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELC0","description":"ICD-AELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28H","description":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCA0","description":"ICD-EGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compres burn garment leotard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6510","description":"Compres burn garment leotard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99426","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4045","description":"Cast sup sht leg splnt plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0C","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ taliglucerase alfa_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3060","description":"Injection_ taliglucerase alfa_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUB1","description":"ICD-ACUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGC1","description":"ICD-BCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICA1","description":"ICD-NICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXC0","description":"ICD-FGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBE1","description":"ICD-MDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXC1","description":"ICD-NDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAB0","description":"ICD-JAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJD0","description":"ICD-NGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX56","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDB0","description":"ICD-MDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWE1","description":"ICD-OEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVB1","description":"ICD-NAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTD0","description":"ICD-IHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intrmed rsk thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3551F","description":"Intrmed rsk thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin pneum swg frc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5822","description":"Endo knee-shin pneum swg frc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-91125","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","description":"CPT-91125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 3-4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73522","description":"X-ray exam hips bi 3-4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy for aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31515","description":"Laryngoscopy for aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUC0","description":"ICD-CBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUE0","description":"ICD-CEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKF1","description":"ICD-JHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pafolacianine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9603","description":"Injection_ pafolacianine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0B","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1071","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gel pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0196","description":"Gel pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of end stage renal disease (esrd)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1187","description":"Patients with a diagnosis of end stage renal disease (esrd)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99220","description":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRC0","description":"ICD-PLRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig osteo screen measu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8401","description":"Pt inelig osteo screen measu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAE1","description":"ICD-FFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8E","description":"Very High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVC0","description":"ICD-GDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1612","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","description":"HCPCS-J1612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0702","description":"HCPCS-C0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1098T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1098T","description":"CPT-1098T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEC1","description":"ICD-CCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGA0","description":"ICD-GDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aprotonin_ 10_000 kiu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0365","description":"Aprotonin_ 10_000 kiu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPD0","description":"ICD-NLPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0878T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHF1","description":"ICD-GIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCME1","description":"ICD-BCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"L/s ratio fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83661","description":"L/s ratio fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Als routine disposble suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0398","description":"Als routine disposble suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC25","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assert comm tx pgm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0040","description":"Assert comm tx pgm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPC1","description":"ICD-GGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstr lwr jaw segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21198","description":"Reconstr lwr jaw segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBD1","description":"ICD-NKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43113","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRC1","description":"ICD-PBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECD1","description":"ICD-EECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24B","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISB0","description":"ICD-DISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0509U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509U","description":"CPT-0509U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAC1","description":"ICD-GHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXA1","description":"ICD-KCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit tpn 2 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9366","description":"Hit tpn 2 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Node neg inv brst cncr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8879","description":"Node neg inv brst cncr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46604","description":"Anoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of residual cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57550","description":"Removal of residual cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval npgs apnea 1 ses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0435T","description":"Prgrmg eval npgs apnea 1 ses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ofatumumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9302","description":"Ofatumumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"American amnion ac tri-layer_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4305","description":"American amnion ac tri-layer_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUA0","description":"ICD-FEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52283","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allergen specific IgE; quantitative or semiquantitative_ crude allergen extract_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86003","description":"Allergen specific IgE; quantitative or semiquantitative_ crude allergen extract_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKB0","description":"ICD-GDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal kidney open complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50225","description":"Removal kidney open complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVA1","description":"ICD-NFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAME0","description":"ICD-CAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brst prsths adhsv attchmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4280","description":"Brst prsths adhsv attchmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25441","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lat thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22532","description":"Lat thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB226","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCE0","description":"ICD-KCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvef assess planpost dschrge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3019F","description":"Lvef assess planpost dschrge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYD0","description":"ICD-PGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC201","description":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA53","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBC1","description":"ICD-CIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYA0","description":"ICD-DCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEB1","description":"ICD-EAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64581","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD155","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVC1","description":"ICD-GIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOE1","description":"ICD-CGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEB1","description":"ICD-KAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPF1","description":"ICD-JBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXF0","description":"ICD-ODXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFB1","description":"ICD-CCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surg proc w/in 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8627","description":"Surg proc w/in 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB21","description":"ICD-2FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSA0","description":"ICD-OBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIC1","description":"ICD-FAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGB0","description":"ICD-NAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heavy metal screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83015","description":"Heavy metal screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNB0","description":"ICD-OHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTC0","description":"ICD-BCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFB1","description":"ICD-GIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGF1","description":"ICD-NIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28G","description":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33280","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGB0","description":"ICD-OEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0658T","description":"Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with atherectomy_ includes angioplasty within the same vessel_ when performe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7534","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with atherectomy_ includes angioplasty within the same vessel_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIB0","description":"ICD-EHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBF0","description":"ICD-OGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNF0","description":"ICD-OFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01850","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","description":"CPT-01850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of foot infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28003","description":"Treatment of foot infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJB0","description":"ICD-BAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCB0","description":"ICD-EBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOB1","description":"ICD-OFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nipple exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19110","description":"Nipple exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUE0","description":"ICD-KIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPC1","description":"ICD-JDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC52","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNA1","description":"ICD-NLNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDC0","description":"ICD-IGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPA1","description":"ICD-JBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforced solid stirrup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2260","description":"Reinforced solid stirrup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOD1","description":"ICD-OJOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMF1","description":"ICD-ABMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1904","description":"HCPCS-B1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVD1","description":"ICD-NCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOF0","description":"ICD-HCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67922","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWB1","description":"ICD-OLWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIF0","description":"ICD-CDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC217","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVA1","description":"ICD-KCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHE1","description":"ICD-KCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryo embryo transf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4037","description":"Cryo embryo transf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDC0","description":"ICD-CCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct upper extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73201","description":"Ct upper extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10A","description":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXC1","description":"ICD-BDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRE1","description":"ICD-GGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCE0","description":"ICD-OHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMD1","description":"ICD-NFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAE0","description":"ICD-CCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDC1","description":"ICD-KHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIA0","description":"ICD-ABIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hip prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27091","description":"Removal of hip prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4368","description":"Ostomy filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcath closure of vsd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93581","description":"Transcath closure of vsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB216","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPF1","description":"ICD-KDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB260","description":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAA0","description":"ICD-MAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXB0","description":"ICD-BFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deep muscle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20205","description":"Deep muscle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No assess bone loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8863","description":"No assess bone loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQD1","description":"ICD-DBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35022","description":"Repair artery rupture chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstr w/lat flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19361","description":"Breast reconstr w/lat flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILC0","description":"ICD-GILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36578","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","description":"HCPCS-Q4376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIA0","description":"ICD-CAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision graft abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35907","description":"Excision graft abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES226","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27001","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPF1","description":"ICD-FIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKB1","description":"ICD-FIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1743","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1743","description":"HCPCS-C1743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINA1","description":"ICD-JINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMD0","description":"ICD-MEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAA0","description":"ICD-BCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGA1","description":"ICD-BCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88302","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Substernal Implantable Defibrillator Pulse Generator Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0580T","description":"Removal Of Substernal Implantable Defibrillator Pulse Generator Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethro cut ejacul duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52402","description":"Cystourethro cut ejacul duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJE0","description":"ICD-NCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIB0","description":"ICD-BFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ondansetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2405","description":"Ondansetron hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKF0","description":"ICD-OJKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reusable pull-on any size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4536","description":"Reusable pull-on any size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKE1","description":"ICD-GBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semen analysis w/huhner","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89300","description":"Semen analysis w/huhner","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4411","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","description":"HCPCS-Q4411","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMF0","description":"ICD-OGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23520","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOE1","description":"ICD-PGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQF0","description":"ICD-OAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVF1","description":"ICD-BIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Full Gene Sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81351","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Full Gene Sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBF1","description":"ICD-IEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0572U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","description":"CPT-0572U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLC1","description":"ICD-JBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21465","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAF0","description":"ICD-AIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBC0","description":"ICD-MLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53_ NY-ESO-1_ CAGE_ GBU4-5_ SOX2_ MAGE A4_ and HuD)_ plasma_ algorithm reported as a categoric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0360U","description":"Oncology (lung)_ enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53_ NY-ESO-1_ CAGE_ GBU4-5_ SOX2_ MAGE A4_ and HuD)_ plasma_ algorithm reported as a categoric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABB0","description":"ICD-NABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: head trauma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2187","description":"Patients with clinical indications for imaging of the head: head trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDB0","description":"ICD-EEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVB1","description":"ICD-KHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUD1","description":"ICD-NAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD112","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIA0","description":"ICD-FDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSA1","description":"ICD-GHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB235","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKA0","description":"ICD-KEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9054","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","description":"HCPCS-J9054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXE0","description":"ICD-OJXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96377","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCE0","description":"ICD-NKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93620","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECE0","description":"ICD-CECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair sciatic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64858","description":"Repair sciatic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOF1","description":"ICD-PLOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent prenatal care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0502F","description":"Subsequent prenatal care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFA0","description":"ICD-OKFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOF0","description":"ICD-PBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAA1","description":"ICD-OKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYA1","description":"ICD-CGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2127","description":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23020","description":"Release shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUD0","description":"ICD-NJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption study (eg_ Schilling test); without intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78270","description":"Vitamin B-12 absorption study (eg_ Schilling test); without intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24538","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj meniscectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7850","description":"Tmj meniscectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy pouch liq deodorant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4394","description":"Ostomy pouch liq deodorant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine eltrd plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63662","description":"Remove spine eltrd plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAE1","description":"ICD-GBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35341","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous rf vein add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36476","description":"Endovenous rf vein add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGID1","description":"ICD-EGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLA0","description":"ICD-JBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWE1","description":"ICD-OIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEA1","description":"ICD-NHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE210","description":"Special Care High _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVB0","description":"ICD-KCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7526","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7526","description":"HCPCS-J7526","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4A","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk joint covers pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5678","description":"Bk joint covers pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBND1","description":"ICD-GBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rad w backup invasive intrfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0472","description":"Rad w backup invasive intrfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCE1","description":"ICD-AGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incompl donor egg case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4023","description":"Incompl donor egg case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHD1","description":"ICD-FDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGB0","description":"ICD-NIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25D","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFC1","description":"ICD-FEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWF0","description":"ICD-KBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct bronchus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31775","description":"Reconstruct bronchus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHD0","description":"ICD-IFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIA1","description":"ICD-CGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSD0","description":"ICD-PJSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0533","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","description":"HCPCS-G0533","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTE1","description":"ICD-AGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAA0","description":"ICD-MLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEA0","description":"ICD-JDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leukacyte transfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86950","description":"Leukacyte transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA45","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1190","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cholera vaccine for injectable use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90725","description":"Cholera vaccine for injectable use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBF1","description":"ICD-CFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3D","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPD1","description":"ICD-CIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerv sr wire occ/man pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0160","description":"Cerv sr wire occ/man pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVF0","description":"ICD-OEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63075","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epidrm autogrft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15111","description":"Epidrm autogrft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59856","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mandibular denture prosth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5935","description":"Mandibular denture prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient was provided hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9710","description":"Patient was provided hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ meropenem_ vaborbactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2186","description":"Injection_ meropenem_ vaborbactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise urethra stage 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53400","description":"Revise urethra stage 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped home apnea rec compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94774","description":"Ped home apnea rec compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1106T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1106T","description":"CPT-1106T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPC1","description":"ICD-OGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest wall manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94668","description":"Chest wall manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKF0","description":"ICD-JEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pancreas)_ DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression_ pancreatic cyst fluid_ algorithm reported as a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0313U","description":"Oncology (pancreas)_ DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression_ pancreatic cyst fluid_ algorithm reported as a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTD0","description":"ICD-CDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB151","description":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYA0","description":"ICD-CEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTF1","description":"ICD-MJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIC0","description":"ICD-NHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair mouth laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40830","description":"Repair mouth laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIF0","description":"ICD-IIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBE1","description":"ICD-MBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGE0","description":"ICD-KGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1A","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ methylprednisolone sodium succinate_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2919","description":"Injection_ methylprednisolone sodium succinate_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSD1","description":"ICD-HBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spinal Puncture_ Therapeutic_ For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter); With Fluoroscopic Or Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62329","description":"Spinal Puncture_ Therapeutic_ For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter); With Fluoroscopic Or Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOB0","description":"ICD-CIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD144","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIE1","description":"ICD-MAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUE0","description":"ICD-KFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGC0","description":"ICD-OJGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1449","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","description":"HCPCS-M1449","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ emicizumab-kxwh_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9995","description":"Injection_ emicizumab-kxwh_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEF1","description":"ICD-KFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temproromandibular Joint Dysfunction - non-invasive physical therapies","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9130","description":"Temproromandibular Joint Dysfunction - non-invasive physical therapies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28X","description":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALA0","description":"ICD-NALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLD0","description":"ICD-FFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ irinotecan liposome_ 1 mg (Onivyde)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9474","description":"Injection_ irinotecan liposome_ 1 mg (Onivyde)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPE1","description":"ICD-NCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fld ped wc tltnspc w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1234","description":"Fld ped wc tltnspc w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No tdap or td or 1tet/dipth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9417","description":"No tdap or td or 1tet/dipth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"guided tissue regeneration - non-resorbable barrier_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6107","description":"guided tissue regeneration - non-resorbable barrier_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMD0","description":"ICD-CAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-cov proc_ clinical trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0294","description":"Non-cov proc_ clinical trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE211","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58410","description":"Suspension of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are receiving comfort care only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9930","description":"Patients who are receiving comfort care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMB0","description":"ICD-OGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBB0","description":"ICD-GDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Financial mgt waiver/15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2040","description":"Financial mgt waiver/15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54015","description":"Drain penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22847","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBC1","description":"ICD-CBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDE1","description":"ICD-CIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLE1","description":"ICD-FCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47785","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Homedelivered prepared meal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5170","description":"Homedelivered prepared meal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admini on the same date of service_ 5 to 15 minutes time Medicaid only.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0310","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admini on the same date of service_ 5 to 15 minutes time Medicaid only.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27596","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change nephroureteral cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50387","description":"Change nephroureteral cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68320","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Water circ heat pad w pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0217","description":"Water circ heat pad w pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE105","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESB0","description":"ICD-CESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBB0","description":"ICD-GCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1198","description":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPC1","description":"ICD-KFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHC1","description":"ICD-CHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQF1","description":"ICD-GBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC154","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL26","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27440","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDF1","description":"ICD-ECDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; each separate/additional lesion (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11101","description":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; each separate/additional lesion (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUF1","description":"ICD-IHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTC1","description":"ICD-BCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nhl stg 3-4 not relap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9135","description":"Onc dx nhl stg 3-4 not relap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99306","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interleukin-6 (Il-6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83529","description":"Interleukin-6 (Il-6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLA0","description":"ICD-ACLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD244","description":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00145","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","description":"CPT-00145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYB1","description":"ICD-OKYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMB1","description":"ICD-MAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQD1","description":"ICD-PLQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip wall fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27226","description":"Treat hip wall fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHA0","description":"ICD-BDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSD0","description":"ICD-KBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALD1","description":"ICD-AALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1244","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oxford Knee Score (OKS) patient reported outcome tool within three months preoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1047","description":"Functional status was measured by the Oxford Knee Score (OKS) patient reported outcome tool within three months preoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27822","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCD0","description":"ICD-NBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUC0","description":"ICD-OHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYB1","description":"ICD-CAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hot/cold h2obot/cap/col/wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9273","description":"Hot/cold h2obot/cap/col/wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 2 hd 301-450 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0807","description":"Pov group 2 hd 301-450 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKF1","description":"ICD-KFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFD0","description":"ICD-FFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0459","description":"Chest wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLE1","description":"ICD-OBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ctlso infant immobilizer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1001","description":"Ctlso infant immobilizer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUA0","description":"ICD-AGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTB1","description":"ICD-KCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imatinib 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0088","description":"Imatinib 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJF0","description":"ICD-OKJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTD0","description":"ICD-JCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCME0","description":"ICD-NCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCC0","description":"ICD-IGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lipid panel doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3011F","description":"Lipid panel doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILC1","description":"ICD-AILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tafasitamab-cxix_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9349","description":"Injection_ tafasitamab-cxix_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHA0","description":"ICD-FBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63281","description":"Bx/exc idrl spine lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imm admin by intramuscular inj of  (SARS[1]CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNALNP_ spike protein_ pres free_ 10 mcg/0.2 mL dosage; booster dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0074A","description":"Imm admin by intramuscular inj of  (SARS[1]CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNALNP_ spike protein_ pres free_ 10 mcg/0.2 mL dosage; booster dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18I","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJID1","description":"ICD-NJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEF1","description":"ICD-FHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATE0","description":"ICD-NATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMF0","description":"ICD-NHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABID0","description":"ICD-ABID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDA1","description":"ICD-FDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl soft interface_ helmet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8004","description":"Repl soft interface_ helmet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGC0","description":"ICD-NIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25905","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydromorphone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1170","description":"Hydromorphone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1166","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKF1","description":"ICD-GAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53270","description":"Removal of urethra gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93799","description":"Cardiovascular procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHND1","description":"ICD-FHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUE0","description":"ICD-ABUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBID1","description":"ICD-FBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manipulate wrist w/anesthes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25259","description":"Manipulate wrist w/anesthes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBB0","description":"ICD-NDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNF1","description":"ICD-GCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCF0","description":"ICD-ICCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJB0","description":"ICD-BFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEF0","description":"ICD-NEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/pseudobulb affect/als","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3756F","description":"Pt w/pseudobulb affect/als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOC1","description":"ICD-PJOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBA0","description":"ICD-ADBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSB0","description":"ICD-KHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0505","description":"HCPCS-A0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXB1","description":"ICD-OKXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOE0","description":"ICD-HFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIB0","description":"ICD-KGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDF1","description":"ICD-AEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLB1","description":"ICD-IGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extremity 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64642","description":"Chemodenerv 1 extremity 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2001","description":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCB0","description":"ICD-ODCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDC1","description":"ICD-NHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCA1","description":"ICD-BFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL25","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVB0","description":"ICD-GHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam dressing wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6215","description":"Foam dressing wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUA0","description":"ICD-ABUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWD0","description":"ICD-OJWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","description":"HCPCS-E0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSC1","description":"ICD-DCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus and fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43305","description":"Repair esophagus and fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFD1","description":"ICD-JFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE117","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rimantadine hcl_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9036","description":"Rimantadine hcl_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJE1","description":"ICD-CIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual cell count each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85032","description":"Manual cell count each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin fluid swing p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5824","description":"Endo knee-shin fluid swing p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16378","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16378","description":"CPT-16378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic implnt urinary 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8606","description":"Synthetic implnt urinary 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYA0","description":"ICD-GBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99307","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4408","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","description":"HCPCS-Q4408","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINC0","description":"ICD-KINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDA1","description":"ICD-JDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTD1","description":"ICD-CDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBB0","description":"ICD-KDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYA1","description":"ICD-PCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylindr 4.00d/12-2.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2103","description":"Spherocylindr 4.00d/12-2.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGD1","description":"ICD-NLGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00174","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","description":"CPT-00174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICE0","description":"ICD-IICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ls not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8662","description":"Fun stat score ls not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Range of motion measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95851","description":"Range of motion measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst base mtl >=3 surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6613","description":"Onlay cst base mtl >=3 surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETD0","description":"ICD-CETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41008","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCND1","description":"ICD-GCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXD0","description":"ICD-OIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain stem w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70551","description":"MRI brain stem w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHD1","description":"ICD-GIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC212","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct ulna/radioulnar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25337","description":"Reconstruct ulna/radioulnar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close chest after drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32810","description":"Close chest after drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPE1","description":"ICD-BHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTF0","description":"ICD-KGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYF0","description":"ICD-PCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBA1","description":"ICD-IFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risperidone_ (perseris)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2798","description":"Injection_ risperidone_ (perseris)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not have the retina attached after 6 months following only one surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9377","description":"Patient did not have the retina attached after 6 months following only one surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCND0","description":"ICD-JCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRA0","description":"ICD-PDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagosc dilate balloon 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43214","description":"Esophagosc dilate balloon 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELB0","description":"ICD-IELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAB1","description":"ICD-OBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVB1","description":"ICD-JGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33474","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9730","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Composite byp grft pros&vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35681","description":"Composite byp grft pros&vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB120","description":"Special Care High _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYB0","description":"ICD-DDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post 2 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2392","description":"Post 2 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL16","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES112","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Panoramic x-ray of jaws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70355","description":"Panoramic x-ray of jaws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADB1","description":"ICD-AADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAB1","description":"ICD-ADAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31293","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTC0","description":"ICD-NBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD201","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMD0","description":"ICD-NIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAB1","description":"ICD-NEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patients with primary headache diagnosis and imaging other than CT or MRI obtained","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1028","description":"Documentation of patients with primary headache diagnosis and imaging other than CT or MRI obtained","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNB1","description":"ICD-NDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glucose monitor platforms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4255","description":"Glucose monitor platforms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDE1","description":"ICD-JGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYE1","description":"ICD-GAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sputum specimen collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89220","description":"Sputum specimen collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUF0","description":"ICD-CFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0155","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","description":"HCPCS-Q0155","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low (or very low) risk of recurrence_ prostate cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9706","description":"Low (or very low) risk of recurrence_ prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rehabilitative support for musculoskeletal care mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1370","description":"Rehabilitative support for musculoskeletal care mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPF0","description":"ICD-CBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27495","description":"Reinforce thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein_ open or percutaneous_ including all vascular access_ catheter manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0524T","description":"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein_ open or percutaneous_ including all vascular access_ catheter manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE130","description":"Clinically Complex _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHD1","description":"ICD-MCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJF1","description":"ICD-BDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOC1","description":"ICD-GDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assess dyspnea not present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1018F","description":"Assess dyspnea not present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEC0","description":"ICD-CGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOD0","description":"ICD-HBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDC1","description":"ICD-BDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI neck spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72156","description":"MRI neck spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAC1","description":"ICD-BCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQF0","description":"ICD-GDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBB1","description":"ICD-FHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXA0","description":"ICD-JEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPD0","description":"ICD-GHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFC0","description":"ICD-KBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko swedish type pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1850","description":"Ko swedish type pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHB1","description":"ICD-JFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMA1","description":"ICD-GCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4B","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMF0","description":"ICD-NCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTE1","description":"ICD-CHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subepithelial tissue graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4273","description":"Subepithelial tissue graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hook to hand cable adapter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6670","description":"Hook to hand cable adapter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9076","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","description":"HCPCS-J9076","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQF1","description":"ICD-OAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKF0","description":"ICD-GCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Igk rearrangeabn clonal pop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81264","description":"Igk rearrangeabn clonal pop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOC1","description":"ICD-HFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruct lesion 15 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17111","description":"Destruct lesion 15 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61330","description":"Decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNE1","description":"ICD-GGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAF0","description":"ICD-NDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKC0","description":"ICD-JEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIC1","description":"ICD-MCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ppsv23 vacc 2 yrs+ subq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90732","description":"Ppsv23 vacc 2 yrs+ subq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFF1","description":"ICD-GBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARB1","description":"ICD-CARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69805","description":"Explore inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMC0","description":"ICD-CFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal with reinsertion_ non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0518","description":"Removal with reinsertion_ non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29044","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Certified translation or sign-language services per visit.","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9990","description":"Certified translation or sign-language services per visit.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWB1","description":"ICD-HDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB51","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"von Willebrand factor (VWF)_ type 2N_ factor VIII and VWF binding evaluation_ enzyme-linked immunosorbent assays (ELISA)_ plasma (Versiti™ VWD Type 2N Binding)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0284U","description":"von Willebrand factor (VWF)_ type 2N_ factor VIII and VWF binding evaluation_ enzyme-linked immunosorbent assays (ELISA)_ plasma (Versiti™ VWD Type 2N Binding)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Frequency Ultrasonic Diathermy Treatment Device For Home Use_ Includes All Components And Accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1004","description":"Low Frequency Ultrasonic Diathermy Treatment Device For Home Use_ Includes All Components And Accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHF1","description":"ICD-FAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADE0","description":"ICD-NADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGD1","description":"ICD-FBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOD1","description":"ICD-PHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNE0","description":"ICD-NBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAF1","description":"ICD-FAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYA1","description":"ICD-OLYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18I","description":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0303","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0303","description":"CDT-D0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAD0","description":"ICD-IGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTE1","description":"ICD-MFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGF0","description":"ICD-JIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHB0","description":"ICD-OCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystometrogram w/vp&up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51729","description":"Cystometrogram w/vp&up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQD1","description":"ICD-CBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHD0","description":"ICD-GFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Splint - intra-coronal; natural teeth or prosthetic crowns","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4322","description":"Splint - intra-coronal; natural teeth or prosthetic crowns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIB0","description":"ICD-EAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBC1","description":"ICD-NBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBD0","description":"ICD-FDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colon ca screen;barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0106","description":"Colon ca screen;barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILE0","description":"ICD-BILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0483U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","description":"CPT-0483U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral supply kit homemi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4222","description":"Parenteral supply kit homemi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMC0","description":"ICD-JEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD114","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIE0","description":"ICD-MJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (asceniv)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1554","description":"Injection_ immune globulin (asceniv)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBED1","description":"ICD-EBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sitz bath/equipment w/faucet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0161","description":"Sitz bath/equipment w/faucet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor_ including system activation and patient training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0308","description":"Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor_ including system activation and patient training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADB0","description":"ICD-CADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0954T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","description":"CPT-0954T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGA1","description":"ICD-JGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACF1","description":"ICD-KACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALB1","description":"ICD-JALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHA0","description":"ICD-JDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos macroalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3062F","description":"Pos macroalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITA0","description":"ICD-MITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMB0","description":"ICD-EIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40251","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAD1","description":"ICD-OFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECB1","description":"ICD-FECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEF0","description":"ICD-GBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hammertoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28285","description":"Repair of hammertoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19367","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA145","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHB1","description":"ICD-AIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFC0","description":"ICD-CFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMD1","description":"ICD-GIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAB0","description":"ICD-MEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLE0","description":"ICD-NJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEE0","description":"ICD-NCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periph field stimul perm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0283T","description":"Periph field stimul perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJB1","description":"ICD-GIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACF0","description":"ICD-FACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAB1","description":"ICD-EHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEE1","description":"ICD-AHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84392","description":"Assay of urine sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDD0","description":"ICD-NKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFD0","description":"ICD-JEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Internal eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92287","description":"Internal eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1902","description":"HCPCS-B1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKC0","description":"ICD-NKKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB21","description":"ICD-4KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMD1","description":"ICD-OCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTC0","description":"ICD-OJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise urine flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50830","description":"Revise urine flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MyOwn skin_ includes harvesting and preparation procedures_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4226","description":"MyOwn skin_ includes harvesting and preparation procedures_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDE1","description":"ICD-NEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQE0","description":"ICD-PBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01200","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","description":"CPT-01200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXA1","description":"ICD-OFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAC0","description":"ICD-OEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDA1","description":"ICD-NKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Job Coaching 1:2 to 1:4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1734","description":"Employment - Job Coaching 1:2 to 1:4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16073","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16073","description":"CPT-16073","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening buprenorphine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80348","description":"Drug screening buprenorphine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0610U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","description":"CPT-0610U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYC1","description":"ICD-CAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25B","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skn sub grft t/a/l child add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15274","description":"Skn sub grft t/a/l child add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHF1","description":"ICD-OGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGC1","description":"ICD-CCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQD1","description":"ICD-CDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSB0","description":"ICD-HBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCC1","description":"ICD-EBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport lodgng escrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0200","description":"Noner transport lodgng escrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKE1","description":"ICD-NAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27256","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sutimlimab-jome_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1302","description":"Injection_ sutimlimab-jome_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD134","description":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABE1","description":"ICD-EABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther cmpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0263T","description":"Im b1 mrw cel ther cmpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01656","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","description":"CPT-01656","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELA0","description":"ICD-EELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28G","description":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27248","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of prostaglandin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84150","description":"Assay of prostaglandin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEB1","description":"ICD-EIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bp sys <140 and dias <90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8476","description":"Bp sys <140 and dias <90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX32","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILD0","description":"ICD-JILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBD1","description":"ICD-AHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAF0","description":"ICD-JEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFE0","description":"ICD-BAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX43","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQD1","description":"ICD-PGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteopath manj 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98925","description":"Osteopath manj 1-2 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYE1","description":"ICD-GHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15A","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ascorbic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82180","description":"Assay of ascorbic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQE1","description":"ICD-ODQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVC1","description":"ICD-NEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYD0","description":"ICD-CGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDD1","description":"ICD-ECDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allergen specific IgE; qualitative_ multiallergen screen (eg_ disk_ sponge_ card)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86005","description":"Allergen specific IgE; qualitative_ multiallergen screen (eg_ disk_ sponge_ card)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Guided tiss regen nonresorb","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4267","description":"Guided tiss regen nonresorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11C","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9945","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit enteral bolus nurs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9343","description":"Hit enteral bolus nurs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX51","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of phenobarbital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80184","description":"Assay of phenobarbital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qty act diab retin mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9672","description":"Qty act diab retin mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27659","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0502","description":"HCPCS-C0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJA1","description":"ICD-NLJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHA1","description":"ICD-NBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJD1","description":"ICD-CEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41828","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Appl multlay comprs arm/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29584","description":"Appl multlay comprs arm/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of knees","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73565","description":"X-ray exam of knees","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKE0","description":"ICD-NFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWD1","description":"ICD-DHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHA1","description":"ICD-IDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXB0","description":"ICD-KDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ do","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0078","description":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ do","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUF1","description":"ICD-MGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ gold-198","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1716","description":"Brachytx_ non-str_ gold-198","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTD1","description":"ICD-GFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family psytx w/o patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90846","description":"Family psytx w/o patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSD0","description":"ICD-CCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVF0","description":"ICD-NHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTD1","description":"ICD-JHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ cholangiocarcinoma and non-small cell lung neoplasia_ DNA and RNA analysis_ 1-23 genes_ interrogation for sequence variants and rearr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0022U","description":"Targeted genomic sequence analysis panel_ cholangiocarcinoma and non-small cell lung neoplasia_ DNA and RNA analysis_ 1-23 genes_ interrogation for sequence variants and rearr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20C","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTD1","description":"ICD-BDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC31","description":"ICD-2LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETA0","description":"ICD-JETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOB1","description":"ICD-PBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOD0","description":"ICD-GGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMB0","description":"ICD-KGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGC0","description":"ICD-GCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levorphanol tartrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1960","description":"Levorphanol tartrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGD1","description":"ICD-JCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSA1","description":"ICD-PKSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUE1","description":"ICD-MKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plasmaprotein fract_5%_250ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9048","description":"Plasmaprotein fract_5%_250ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18X","description":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electro-oculography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92270","description":"Electro-oculography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDC1","description":"ICD-NFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral fludarabine phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8562","description":"Oral fludarabine phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDB0","description":"ICD-ABDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB11","description":"ICD-2KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWF1","description":"ICD-KFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECF0","description":"ICD-IECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOD1","description":"ICD-HHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHF1","description":"ICD-JHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPD1","description":"ICD-OFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq cervicothoracic inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22510","description":"Perq cervicothoracic inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB31","description":"ICD-4HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood ketone test or strip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4252","description":"Blood ketone test or strip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt tx sys bio med psori 6mth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9652","description":"Pt tx sys bio med psori 6mth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXB0","description":"ICD-KEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEF0","description":"ICD-GHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ in the ear (ITE)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5171","description":"Hearing aid_ contralateral routing device_ monaural_ in the ear (ITE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); multiple analytes_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82492","description":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); multiple analytes_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYD0","description":"ICD-LHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Serv asmnt/care plan waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2024","description":"Serv asmnt/care plan waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDB0","description":"ICD-OBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjunctive continuous glucose monitor or receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2102","description":"Adjunctive continuous glucose monitor or receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUD0","description":"ICD-KIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAC0","description":"ICD-KCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA11","description":"ICD-3EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enamel microabrasion","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9970","description":"Enamel microabrasion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ maintenance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9005","description":"Mccd_ risk adj_ maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19366","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0A","description":"High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc car modulj atr elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0410T","description":"Insj/rplc car modulj atr elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHID0","description":"ICD-EHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOD0","description":"ICD-HFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58200","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepagam b intravenous_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1573","description":"Hepagam b intravenous_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28H","description":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBA1","description":"ICD-CCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23C","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD212","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occupational therapy_ in the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9129","description":"Occupational therapy_ in the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1491","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","description":"HCPCS-M1491","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frenulotomy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54164","description":"Frenulotomy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohols biomarkers 3/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80322","description":"Alcohols biomarkers 3/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal function studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92512","description":"Nasal function studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bitolterol mesylate comp unt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7629","description":"Bitolterol mesylate comp unt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUE0","description":"ICD-GAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNA0","description":"ICD-BBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAC1","description":"ICD-MDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIB1","description":"ICD-JFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUD0","description":"ICD-KGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scratch resistant coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2760","description":"Scratch resistant coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJC1","description":"ICD-GHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1152","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDB0","description":"ICD-FIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17260","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61516","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electro hearng aid test one","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92594","description":"Electro hearng aid test one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90958","description":"Esrd srv 2-3 vsts p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB260","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB145","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQC0","description":"ICD-KHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 5/> ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64645","description":"Chemodenerv 1 extrem 5/> ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLC1","description":"ICD-BGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUE0","description":"ICD-CFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACF1","description":"ICD-BACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc opioid tx 1x at ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9579","description":"No doc opioid tx 1x at ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEB1","description":"ICD-OKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQE1","description":"ICD-OAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD124","description":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTE1","description":"ICD-GFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMF0","description":"ICD-CDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; subcutaneous electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0460T","description":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; subcutaneous electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB31","description":"Medium Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQF1","description":"ICD-OBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCF0","description":"ICD-FBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTC1","description":"ICD-IGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDD1","description":"ICD-JGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYD0","description":"ICD-CIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQC0","description":"ICD-ODQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alveoloplasty w/extract 1-3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7311","description":"Alveoloplasty w/extract 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iliac revasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37220","description":"Iliac revasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aicd_ dual chamber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1721","description":"Aicd_ dual chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NEURO MUSC DYS DMD SEQ ALYS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0218U","description":"NEURO MUSC DYS DMD SEQ ALYS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Management of a new patient with dementia_ moderate to high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0523","description":"Management of a new patient with dementia_ moderate to high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cus elbo skt in for con/atyp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6696","description":"Cus elbo skt in for con/atyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91315","description":"SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGB1","description":"ICD-BAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0D","description":"Low Rehab_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECB1","description":"ICD-BECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFC1","description":"ICD-NHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch drain 2 piece system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4426","description":"Ost pch drain 2 piece system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFA1","description":"ICD-CBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision gum each quadrant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41820","description":"Excision gum each quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISF1","description":"ICD-OISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYC1","description":"ICD-PEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coordinating Stroke Care To Promote Prevention And Cultivate Positive Outcomes Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0054","description":"Coordinating Stroke Care To Promote Prevention And Cultivate Positive Outcomes Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCA1","description":"ICD-NKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFB1","description":"ICD-KIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28D","description":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQB1","description":"ICD-HEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVD0","description":"ICD-JCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Octreotide inj_ non-depot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2354","description":"Octreotide inj_ non-depot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYC1","description":"ICD-PJYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILA0","description":"ICD-IILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIE0","description":"ICD-NCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Addl neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22552","description":"Addl neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPB0","description":"ICD-OCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crutch forearm pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0110","description":"Crutch forearm pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1342","description":"Patients who died during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20C","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVC0","description":"ICD-BHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFB1","description":"ICD-BCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHE1","description":"ICD-IBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC105","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQE0","description":"ICD-OGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastro-Enterology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4006","description":"Gastro-Enterology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post vert arthrplst 1 lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0202T","description":"Post vert arthrplst 1 lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15241","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOC0","description":"ICD-OFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDD0","description":"ICD-FEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ra disease activity low","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3470F","description":"Ra disease activity low","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKC1","description":"ICD-GCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCC1","description":"ICD-KCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chiropract manj 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98941","description":"Chiropract manj 3-4 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMF0","description":"ICD-JFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQA1","description":"ICD-OJQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVE0","description":"ICD-CAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0214T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abscess drainage under x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75989","description":"Abscess drainage under x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52305","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0202","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0202","description":"CDT-D0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXA0","description":"ICD-KCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmprs burngarment foot-knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6507","description":"Cmprs burngarment foot-knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Card MRI w/stress img & dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75563","description":"Card MRI w/stress img & dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14B","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA50","description":"Low Rehab_ ADL Index 0-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQD1","description":"ICD-KEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAA1","description":"ICD-BEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOF1","description":"ICD-OLOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOE0","description":"ICD-HGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFB0","description":"ICD-JHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0365U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKED0","description":"ICD-OKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKA1","description":"ICD-FIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKD1","description":"ICD-NEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adapt/ext_ pacing/neuro lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1883","description":"Adapt/ext_ pacing/neuro lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGA0","description":"ICD-OIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10006","description":"Fine needle aspiration biopsy_ including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB210","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transect artery sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61611","description":"Transect artery sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt scrned for inj drug use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4290F","description":"Pt scrned for inj drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQF1","description":"ICD-OGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0304","description":"HCPCS-B0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSF1","description":"ICD-KCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC21","description":"ICD-4JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33853","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRB0","description":"ICD-KDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUB0","description":"ICD-OAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLD1","description":"ICD-JBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIE0","description":"ICD-EEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAME0","description":"ICD-OAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0635U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0635U","description":"CPT-0635U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQB1","description":"ICD-OHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lifts elevation metal extens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3330","description":"Lifts elevation metal extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQC0","description":"ICD-PFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELB0","description":"ICD-OELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24A","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61592","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore abdominal vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35840","description":"Explore abdominal vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22D","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01420","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","description":"CPT-01420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPA0","description":"ICD-JGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOA1","description":"ICD-CHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40800","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUD1","description":"ICD-GFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPB0","description":"ICD-NJPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD124","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAD0","description":"ICD-KDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCB0","description":"ICD-OJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOE1","description":"ICD-DAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photochemotherapy with uv-b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96910","description":"Photochemotherapy with uv-b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove rectal obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45915","description":"Remove rectal obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic interventions that focus on cognitive function (eg_ attention_ memory_ reasoning_ executive function_ problem solving_ and/or pragmatic functioning) and compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97127","description":"Therapeutic interventions that focus on cognitive function (eg_ attention_ memory_ reasoning_ executive function_ problem solving_ and/or pragmatic functioning) and compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEB1","description":"ICD-OAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARA1","description":"ICD-GARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove lumb artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22865","description":"Remove lumb artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic digital breast tomosynthesis_ unilateral or bilateral (list separately in addition to 77065-77067)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0279","description":"Diagnostic digital breast tomosynthesis_ unilateral or bilateral (list separately in addition to 77065-77067)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-123 sod iodide mil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9509","description":"Iodine i-123 sod iodide mil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCB0","description":"ICD-BDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA20","description":"Ultra High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSA0","description":"ICD-GGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31575","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduct simple facial bone fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7680","description":"Reduct simple facial bone fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWC1","description":"ICD-LFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECB0","description":"ICD-FECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILB0","description":"ICD-MILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICC0","description":"ICD-JICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gallium Ga-68 gozetotide_ diagnostic_ (Locametz)_1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9800","description":"Gallium Ga-68 gozetotide_ diagnostic_ (Locametz)_1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14A","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARC1","description":"ICD-GARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81401","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEF1","description":"ICD-ACEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physical performance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97750","description":"Physical performance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDF1","description":"ICD-GGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSE1","description":"ICD-LBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB246","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUA0","description":"ICD-AEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKD0","description":"ICD-FAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFD1","description":"ICD-OLFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Patient Pregnancy Anytime During The Measurement Period Prior To And Including The Current Encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9997","description":"Documentation Of Patient Pregnancy Anytime During The Measurement Period Prior To And Including The Current Encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sperm cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55520","description":"Removal of sperm cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0081","description":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0623T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBB1","description":"ICD-MKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTF0","description":"ICD-NFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0489U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","description":"CPT-0489U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANE0","description":"ICD-GANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJB1","description":"ICD-KCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screen pap by tech w md supv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P3000","description":"Screen pap by tech w md supv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAA0","description":"ICD-EHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIA0","description":"ICD-MJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHC1","description":"ICD-KCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYF0","description":"ICD-CDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL32","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBD0","description":"ICD-NIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assessment of aphasia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96105","description":"Assessment of aphasia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85999","description":"Hematology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVA0","description":"ICD-ODVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUC0","description":"ICD-OLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65760","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBA0","description":"ICD-KHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescrl fuse w/ instr l5-s1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22586","description":"Prescrl fuse w/ instr l5-s1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9069","description":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle transfers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23397","description":"Muscle transfers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX13","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric partial denture fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6985","description":"Pediatric partial denture fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whlchr att- conv 1 arm drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0958","description":"Whlchr att- conv 1 arm drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9711","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAD0","description":"ICD-GFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63015","description":"Remove spine lamina >2 crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mediastinoscpy w/medstnl bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39401","description":"Mediastinoscpy w/medstnl bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAC0","description":"ICD-GDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPE1","description":"ICD-GDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31505","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFA1","description":"ICD-NCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Atropine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7636","description":"Atropine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15017","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","description":"CPT-15017","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53605","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUF1","description":"ICD-AHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPC1","description":"ICD-KCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Couns potent glauc impct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4174F","description":"Couns potent glauc impct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVD0","description":"ICD-KEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Statin not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9442","description":"Statin not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJB0","description":"ICD-OLJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASF1","description":"ICD-CASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPA0","description":"ICD-GCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA13","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLB1","description":"ICD-KBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral_ with volume adjustment of intragastric bariatric balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0813T","description":"Esophagogastroduodenoscopy_ flexible_ transoral_ with volume adjustment of intragastric bariatric balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMF1","description":"ICD-NCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dimenhydrinate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1240","description":"Dimenhydrinate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHE1","description":"ICD-FFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAME0","description":"ICD-IAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trim skin lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11055","description":"Trim skin lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antepartum manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59412","description":"Antepartum manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTA0","description":"ICD-NLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYF1","description":"ICD-LAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of facial/other nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64866","description":"Fusion of facial/other nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEC1","description":"ICD-FIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWE1","description":"ICD-PKWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTB1","description":"ICD-OLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOF1","description":"ICD-OKOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJC0","description":"ICD-CHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB21","description":"ICD-4EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMA0","description":"ICD-OHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0568","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","description":"HCPCS-G0568","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFE1","description":"ICD-GGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAA0","description":"ICD-NHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leuprolide acetate injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9218","description":"Leuprolide acetate injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTC0","description":"ICD-IDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj metaraminol bitartrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0380","description":"Inj metaraminol bitartrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIC1","description":"ICD-OLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTC0","description":"ICD-KFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHB0","description":"ICD-NGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWC1","description":"ICD-PDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHA0","description":"ICD-NCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTE0","description":"ICD-FBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ceftazidime and avibactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0714","description":"Ceftazidime and avibactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLB0","description":"ICD-JDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIA0","description":"ICD-MGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantable/insertable device for device intensive procedure_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1889","description":"Implantable/insertable device for device intensive procedure_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJF1","description":"ICD-OJJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient receiving hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9690","description":"Patient receiving hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Face tent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4619","description":"Face tent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67906","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert pessary/other device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57160","description":"Insert pessary/other device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCF1","description":"ICD-MGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLC1","description":"ICD-NBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOF0","description":"ICD-OFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKF1","description":"ICD-CEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPB1","description":"ICD-GAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALA1","description":"ICD-JALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCF1","description":"ICD-MJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC31","description":"ICD-4GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCA1","description":"ICD-MGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMB1","description":"ICD-OLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (baxter)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9059","description":"Injection_ bendamustine hydrochloride (baxter)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; Without Mediastinal Lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21602","description":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; Without Mediastinal Lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUA1","description":"ICD-CBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQB0","description":"ICD-LEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0462T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC116","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHF1","description":"ICD-MAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient And/Or Care Partner Decline Referral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0041","description":"Patient And/Or Care Partner Decline Referral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Covers for upright each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1120","description":"Covers for upright each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21461","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Docking station for use with oral device/appliance used to reduce upper airway collapsibility","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1037","description":"Docking station for use with oral device/appliance used to reduce upper airway collapsibility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRB0","description":"ICD-CFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLF1","description":"ICD-NCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec med comp dev_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1505","description":"Elec med comp dev_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1330","description":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYD1","description":"ICD-DIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam pad_ any size or shape_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6601","description":"Gradient compression bandaging supply_ high density foam pad_ any size or shape_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55400","description":"Repair of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWB0","description":"ICD-HDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOD0","description":"ICD-OIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHA0","description":"ICD-GFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/dye_ upper extremity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8934","description":"Mra_ w/dye_ upper extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADA0","description":"ICD-CADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQD0","description":"ICD-KBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD213","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKD1","description":"ICD-JIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deli/install chrg hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1600","description":"Deli/install chrg hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA31","description":"ICD-3AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87812","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","description":"CPT-87812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67974","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB21","description":"ICD-3LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAC1","description":"ICD-NAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHA0","description":"ICD-CEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQD0","description":"ICD-LHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPE1","description":"ICD-BGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev breast add strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19284","description":"Perq dev breast add strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILB0","description":"ICD-CILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOA1","description":"ICD-KEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21209","description":"Reduction of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Splicing of ureters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50770","description":"Splicing of ureters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYC0","description":"ICD-OHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6558","description":"Gradient compression stocking_ thigh length_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4369","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","description":"HCPCS-Q4369","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete aca_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4302","description":"Complete aca_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 20 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP20","description":"Auto test panel pricing code_ 20 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD201","description":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC231","description":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICD1","description":"ICD-FICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQB0","description":"ICD-KBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ flow cytometry_ sputum_ 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP]_ CD206_ CD66b_ CD3_ CD19)_ algorithm reported as likelihood of lung cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0406U","description":"Oncology (lung)_ flow cytometry_ sputum_ 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP]_ CD206_ CD66b_ CD3_ CD19)_ algorithm reported as likelihood of lung cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8E","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABC1","description":"ICD-MABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22B","description":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXB1","description":"ICD-NIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFB0","description":"ICD-NHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0084U","description":"Red blood cell antigen typing_ DNA_ genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Norsn not first line amox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9314","description":"Norsn not first line amox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection ext venography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36005","description":"Injection ext venography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXC1","description":"ICD-BFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYE0","description":"ICD-OIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ efgartigimod alfa_ 2 mg and hyaluronidase-qvfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9334","description":"Injection_ efgartigimod alfa_ 2 mg and hyaluronidase-qvfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23675","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00914","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","description":"CPT-00914","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDC1","description":"ICD-BGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAF0","description":"ICD-KEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUF1","description":"ICD-BHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sf3B1 (Splicing Factor [3B] Subunit B1) (Eg_ Myelodysplastic Syndrome/Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ A672T_ E622D_ L833F_ R625C_ R625L)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81347","description":"Sf3B1 (Splicing Factor [3B] Subunit B1) (Eg_ Myelodysplastic Syndrome/Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ A672T_ E622D_ L833F_ R625C_ R625L)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOD0","description":"ICD-GDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE215","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84300","description":"Assay of urine sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUC0","description":"ICD-MEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLA1","description":"ICD-BCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNF0","description":"ICD-KGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTE1","description":"ICD-OCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86052","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENA0","description":"ICD-GENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVC1","description":"ICD-OBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE114","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAC1","description":"ICD-FAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBE0","description":"ICD-OCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETC1","description":"ICD-AETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01170","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","description":"CPT-01170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAE0","description":"ICD-EBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQB0","description":"ICD-CEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40842","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAE1","description":"ICD-EDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUA1","description":"ICD-JHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKB0","description":"ICD-KAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEB1","description":"ICD-AHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIA0","description":"ICD-MAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOC0","description":"ICD-PDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYF0","description":"ICD-GCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 9 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP09","description":"Auto.test pane pricing code_ 9 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pontic titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6214","description":"Pontic titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTB0","description":"ICD-IBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACE0","description":"ICD-BACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWC0","description":"ICD-GAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJE1","description":"ICD-FDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat skull fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62005","description":"Treat skull fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIF0","description":"ICD-OBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENC0","description":"ICD-NENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCD1","description":"ICD-FGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOF0","description":"ICD-HGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAF0","description":"ICD-NCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTA0","description":"ICD-EBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0538U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","description":"CPT-0538U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug delivery system <=50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4306","description":"Drug delivery system <=50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAE0","description":"ICD-ABAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reproductive Medicine (Preimplantation Genetic Assessment)_ Analysis Of 24 Chromosomes Using Embryonic Dna Genomic Sequence Analysis For Aneuploidy_ And A Mitochondrial Dna Sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0254U","description":"Reproductive Medicine (Preimplantation Genetic Assessment)_ Analysis Of 24 Chromosomes Using Embryonic Dna Genomic Sequence Analysis For Aneuploidy_ And A Mitochondrial Dna Sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISE1","description":"ICD-OISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAC1","description":"ICD-NGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWB1","description":"ICD-PDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIC1","description":"ICD-AIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1283","description":"Patient screened for tobacco use and identified as a tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB117","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amphetamines 3or 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80325","description":"Amphetamines 3or 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEE0","description":"ICD-GEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trabectedin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9352","description":"Injection_ trabectedin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO elbow_ wrist or hand intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9737","description":"Patient unable to complete the FOTO elbow_ wrist or hand intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Sequencing And Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Tissue_ Blood_ Or Bone Marrow_ Comparative Sequenc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0300U","description":"Oncology (Pan Tumor)_ Whole Genome Sequencing And Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Tissue_ Blood_ Or Bone Marrow_ Comparative Sequenc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA116","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHE1","description":"ICD-GEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPB0","description":"ICD-FCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBC0","description":"ICD-MFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68801","description":"Dilate tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suprv interfacilty transport","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99485","description":"Suprv interfacilty transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAB1","description":"ICD-KIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1010T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","description":"CPT-1010T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27503","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYD0","description":"ICD-HHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 6 genotyping (HPA-6w)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa_ antigen CD61] [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ po","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81110","description":"Human Platelet Antigen 6 genotyping (HPA-6w)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa_ antigen CD61] [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ po","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methsuximide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6054","description":"Methsuximide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gear reduction drive wheel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2227","description":"Gear reduction drive wheel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUA1","description":"ICD-ABUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVA1","description":"ICD-JFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compact travel hemodialyzer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1635","description":"Compact travel hemodialyzer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCF1","description":"ICD-EBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/renal strict","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52346","description":"Cystouretero w/renal strict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYA1","description":"ICD-KHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of metatarsals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28309","description":"Incision of metatarsals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed total elec w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0266","description":"Hosp bed total elec w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ready gradient gauntlet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8428","description":"Ready gradient gauntlet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4424","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","description":"HCPCS-Q4424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00402","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","description":"CPT-00402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIB1","description":"ICD-CFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28E","description":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spine surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22899","description":"Spine surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl & rplcmt dfb gen 2 lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33263","description":"Rmvl & rplcmt dfb gen 2 lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEF1","description":"ICD-CHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXF1","description":"ICD-JIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEF0","description":"ICD-EDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFA1","description":"ICD-NLFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl & rpl car modulj pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0414T","description":"Rmvl & rpl car modulj pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLD1","description":"ICD-JHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC05","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bone for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20900","description":"Removal of bone for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXA1","description":"ICD-OGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hgb >= 10 g/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8976","description":"Hgb >= 10 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDF0","description":"ICD-IHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKF0","description":"ICD-NLKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQF1","description":"ICD-DIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of procainamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80192","description":"Assay of procainamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA53","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQF1","description":"ICD-OIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBC0","description":"ICD-JGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dexamethasone acetate_ per 1mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1095","description":"Injection_ dexamethasone acetate_ per 1mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDF0","description":"ICD-ADDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFME0","description":"ICD-NFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNF0","description":"ICD-GGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urethral insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4336","description":"Urethral insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYE1","description":"ICD-PGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lo sag ri an/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0627","description":"Lo sag ri an/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIB1","description":"ICD-AHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIA0","description":"ICD-EIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain chest lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21502","description":"Drain chest lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0510U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","description":"CPT-0510U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERF1","description":"ICD-GERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBED1","description":"ICD-KBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37299","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","description":"CPT-37299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWA0","description":"ICD-LAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTB0","description":"ICD-MBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6087","description":"Implant Supported Crown - Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rhophylac injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2791","description":"Rhophylac injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXE1","description":"ICD-BAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSB1","description":"ICD-PFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tah rad debulk/lymph remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58954","description":"Tah rad debulk/lymph remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQB0","description":"ICD-OHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50365","description":"Transplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBC0","description":"ICD-KBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chiropract manj 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98940","description":"Chiropract manj 1-2 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea stimj ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0430T","description":"Rmvl nstim apnea stimj ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37274","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","description":"CPT-37274","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0203","description":"HCPCS-B0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCD0","description":"ICD-KBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastro/jejuno tube_ low-pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4088","description":"Gastro/jejuno tube_ low-pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDE1","description":"ICD-GIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXE1","description":"ICD-KDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWF1","description":"ICD-PGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hc pro phone call 21-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98968","description":"Hc pro phone call 21-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI orbit/face/neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70540","description":"MRI orbit/face/neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26180","description":"Removal of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBB1","description":"ICD-MGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQB1","description":"ICD-CGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKND1","description":"ICD-NKND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUD1","description":"ICD-MBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0803","description":"HCPCS-A0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC220","description":"Reduced Physical Function _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL25","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSC1","description":"ICD-GFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pmp22 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81325","description":"Pmp22 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMD1","description":"ICD-NDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVD1","description":"ICD-CHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILB0","description":"ICD-OILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCC0","description":"ICD-ACCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non coring needle or stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4212","description":"Non coring needle or stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOF1","description":"ICD-HFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ autologous white blood cell concentrate (autologous protein solution)_ any site_ including image guidance_ harvesting and preparation_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0481T","description":"Injection(s)_ autologous white blood cell concentrate (autologous protein solution)_ any site_ including image guidance_ harvesting and preparation_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWD1","description":"ICD-DAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRD0","description":"ICD-CGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFD0","description":"ICD-KAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAD1","description":"ICD-GFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove neuroreceiver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63688","description":"Revise/remove neuroreceiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27235","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13A","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBD0","description":"ICD-AEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQB0","description":"ICD-DBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9906","description":"Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Legion pneumo dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87540","description":"Legion pneumo dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRB1","description":"ICD-PBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALE1","description":"ICD-NALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETA1","description":"ICD-BETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECA0","description":"ICD-JECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCV2 10MCG TRS-SUCR 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072A","description":"ADM SARSCV2 10MCG TRS-SUCR 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1801","description":"HCPCS-B1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPF0","description":"ICD-GAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post >=4srfc resinbase cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2394","description":"Post >=4srfc resinbase cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of leg at hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27295","description":"Amputation of leg at hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVF1","description":"ICD-NKVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFB0","description":"ICD-CFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDA0","description":"ICD-GGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood ph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82800","description":"Blood ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove skin nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64788","description":"Remove skin nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIF1","description":"ICD-IGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ infliximab-axxq_ biosimilar_ (AVSOLA)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5121","description":"Injection_ infliximab-axxq_ biosimilar_ (AVSOLA)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA125","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrogastrography w/test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91133","description":"Electrogastrography w/test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKB0","description":"ICD-GGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55060","description":"Repair of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (apotex)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9058","description":"Injection_ bendamustine hydrochloride (apotex)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDC0","description":"ICD-NGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOA1","description":"ICD-DIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4015","description":"Neurology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLID0","description":"ICD-NLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILF0","description":"ICD-EILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDA0","description":"ICD-NFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLB0","description":"ICD-NDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOF1","description":"ICD-HDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart failure composite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001F","description":"Heart failure composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTB1","description":"ICD-CCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compression stocking bk40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6532","description":"Compression stocking bk40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-pkrb_ biosimilar_ (herzuma)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5113","description":"Injection_ trastuzumab-pkrb_ biosimilar_ (herzuma)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTE0","description":"ICD-OKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2036","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","description":"HCPCS-A2036","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFC0","description":"ICD-NGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHE0","description":"ICD-JFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASE0","description":"ICD-OASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD105","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9191","description":"Pt reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj gadoterate meglumi 0.1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9575","description":"Inj gadoterate meglumi 0.1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0302","description":"HCPCS-C0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ranitidine hydrochloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2780","description":"Ranitidine hydrochloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below elbow myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6935","description":"Below elbow myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Miroderm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4175","description":"Miroderm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUB0","description":"ICD-IDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nfct agent detection gi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87505","description":"Nfct agent detection gi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVC0","description":"ICD-NDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complex lymphedema therapy_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8950","description":"Complex lymphedema therapy_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emer rspns sys serv permonth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5161","description":"Emer rspns sys serv permonth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIB0","description":"ICD-MFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNA0","description":"ICD-NHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQA1","description":"ICD-PFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVA1","description":"ICD-GAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJC0","description":"ICD-CAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0904","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0904","description":"CDT-D0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCC1","description":"ICD-IFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCF0","description":"ICD-ACCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AmnioCyte Plus_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4242","description":"AmnioCyte Plus_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVE0","description":"ICD-OCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23D","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00866","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","description":"CPT-00866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA14","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDA0","description":"ICD-BIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEA1","description":"ICD-ABEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGA0","description":"ICD-KAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compatibility test spin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86920","description":"Compatibility test spin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLE0","description":"ICD-OGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTA0","description":"ICD-BCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLA1","description":"ICD-NGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noncovered ambulance mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0888","description":"Noncovered ambulance mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD110","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBE0","description":"ICD-CFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUA1","description":"ICD-IAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apheresis platelets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36513","description":"Apheresis platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJA1","description":"ICD-BIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJD1","description":"ICD-NFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHC1","description":"ICD-FBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig footwear evaluatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8416","description":"Pt inelig footwear evaluatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETB1","description":"ICD-IETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vedolizumab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80280","description":"Vedolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTD1","description":"ICD-OHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEE0","description":"ICD-IBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETF1","description":"ICD-KETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ inf_ per/cent/midline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1751","description":"Cath_ inf_ per/cent/midline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth anorectal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90251","description":"Anesth anorectal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIE0","description":"ICD-ABIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBE1","description":"ICD-JEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELF1","description":"ICD-MELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAE0","description":"ICD-BFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGD0","description":"ICD-KDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJE1","description":"ICD-NCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAF1","description":"ICD-EFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMA0","description":"ICD-KCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak/knee disartic acrylic soc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5631","description":"Ak/knee disartic acrylic soc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient was not admitted to the ICU in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9854","description":"Patient was not admitted to the ICU in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93592","description":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abd imag w/o liv/kid/adr les","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9551","description":"Abd imag w/o liv/kid/adr les","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGC0","description":"ICD-KHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AMNIOREPAIR or AltiPly_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4235","description":"AMNIOREPAIR or AltiPly_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of mesentery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44850","description":"Repair of mesentery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCC0","description":"ICD-MLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal monitor w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59050","description":"Fetal monitor w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEF1","description":"ICD-KDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28C","description":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLB1","description":"ICD-MCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBD1","description":"ICD-MKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01966","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","description":"CPT-01966","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAC1","description":"ICD-KDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATD0","description":"ICD-MATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRA0","description":"ICD-HDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNF0","description":"ICD-OCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debridement_ bone including epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed_ first 20 sq cm or less with manual preparation and insertion of deep (e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7500","description":"Debridement_ bone including epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed_ first 20 sq cm or less with manual preparation and insertion of deep (e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMA0","description":"ICD-FIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOC0","description":"ICD-LDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFB1","description":"ICD-GFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1499","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","description":"HCPCS-M1499","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0104","description":"HCPCS-C0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hpv types 16 & 18 only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87625","description":"Hpv types 16 & 18 only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acquisition_ interpretation_ and report; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0470T","description":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acquisition_ interpretation_ and report; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac MRI w/stress img","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75559","description":"Cardiac MRI w/stress img","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay iga/igd/igg/igm each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82784","description":"Assay iga/igd/igg/igm each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACA0","description":"ICD-GACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAA0","description":"ICD-NAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXC0","description":"ICD-OGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mast simple complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19303","description":"Mast simple complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray measurement of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74710","description":"X-ray measurement of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVB1","description":"ICD-FBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply hand/wrist cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29085","description":"Apply hand/wrist cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24C","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLC1","description":"ICD-JCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILF1","description":"ICD-JILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFA0","description":"ICD-KGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Activated carbon filter_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4680","description":"Activated carbon filter_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","description":"HCPCS-J0169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEF0","description":"ICD-ABEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00860","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","description":"CPT-00860","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc serum pretx incubj/inhib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86977","description":"Rbc serum pretx incubj/inhib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11A","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYE1","description":"ICD-HAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJB0","description":"ICD-BHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA33","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orth foot non-stndard size/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3254","description":"Orth foot non-stndard size/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with no clinical indications for imaging of the head","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1031","description":"Patients with no clinical indications for imaging of the head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIE0","description":"ICD-BGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hib-hepb vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90748","description":"Hib-hepb vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXA0","description":"ICD-KGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMA0","description":"ICD-BHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30468","description":"Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightwt foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1260","description":"Wheelchair lightwt foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNC1","description":"ICD-KBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCD0","description":"ICD-FCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHA0","description":"ICD-KHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFA0","description":"ICD-KHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDME1","description":"ICD-CDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWE1","description":"ICD-DDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15A","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEE1","description":"ICD-GBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27550","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEE0","description":"ICD-JFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICA1","description":"ICD-BICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCC0","description":"ICD-CDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58943","description":"Removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt silver oxide 3 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0602","description":"Repl batt silver oxide 3 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALE1","description":"ICD-IALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKD1","description":"ICD-FGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQD0","description":"ICD-DGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDA1","description":"ICD-ABDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMC0","description":"ICD-KEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLD1","description":"ICD-OLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGA0","description":"ICD-GFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVD0","description":"ICD-JEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL50","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTA0","description":"ICD-FHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection Bezlotoxumab 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9490","description":"Injection Bezlotoxumab 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQA1","description":"ICD-PIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTC1","description":"ICD-JBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIB1","description":"ICD-EEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMA0","description":"ICD-GHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3D","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2A","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLB1","description":"ICD-NLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1403","description":"HCPCS-B1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFD1","description":"ICD-OEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht care plan doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4050F","description":"Ht care plan doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31760","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance_ unilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0718T","description":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance_ unilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVD0","description":"ICD-OLVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64680","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung perfusion differential","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78597","description":"Lung perfusion differential","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPB1","description":"ICD-KDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0424T","description":"Insj/rplc nstim apnea compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99326","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXB0","description":"ICD-CGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virus antibody nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86790","description":"Virus antibody nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29425","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTB1","description":"ICD-FDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44384","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIF0","description":"ICD-CHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt instr no bd rest 4 days/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4248F","description":"Pt instr no bd rest 4 days/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAE0","description":"ICD-ACAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection into hemorrhoid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46500","description":"Injection into hemorrhoid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAA1","description":"ICD-OFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCD0","description":"ICD-ICCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Isoproterenol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7660","description":"Isoproterenol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57335","description":"Repair vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Management of established patient with dementia_ moderate to high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0528","description":"Management of established patient with dementia_ moderate to high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVB1","description":"ICD-BFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAC1","description":"ICD-EGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJF0","description":"ICD-OJJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCB0","description":"ICD-NDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin splt grft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15100","description":"Skin splt grft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTF0","description":"ICD-OGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43135","description":"Removal of esophagus pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryocautery of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57511","description":"Cryocautery of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDC1","description":"ICD-MLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQC1","description":"ICD-ODQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso r fram soft pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0467","description":"Tlso r fram soft pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDD1","description":"ICD-ACDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vena cava filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1880","description":"Vena cava filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreservation ovary tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0058T","description":"Cryopreservation ovary tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPC0","description":"ICD-BBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIE0","description":"ICD-MLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGA1","description":"ICD-BGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKF1","description":"ICD-KBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUF1","description":"ICD-JHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cultr bacteria except blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87075","description":"Cultr bacteria except blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","description":"HCPCS-J2802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTB0","description":"ICD-FDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXF0","description":"ICD-BEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGC1","description":"ICD-GCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECA0","description":"ICD-MECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEE1","description":"ICD-MEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64656","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","description":"CPT-64656","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGC0","description":"ICD-KBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGC0","description":"ICD-BCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATC0","description":"ICD-BATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEC0","description":"ICD-AGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAA1","description":"ICD-ICAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML52","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJE0","description":"ICD-BDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81541","description":"Oncology (prostate)_ mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e._ patient has an abnormal neurological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9536","description":"Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e._ patient has an abnormal neurological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUF0","description":"ICD-OGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICA1","description":"ICD-AICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBC0","description":"ICD-JCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBD0","description":"ICD-CEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBF0","description":"ICD-EHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHC1","description":"ICD-GHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysterectomy/revise vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58275","description":"Hysterectomy/revise vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAE0","description":"ICD-BAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACF0","description":"ICD-NACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFB0","description":"ICD-FHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTB1","description":"ICD-GHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imp/abut rem dent part max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6112","description":"Imp/abut rem dent part max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFB1","description":"ICD-KCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of hemosiderin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83070","description":"Assay of hemosiderin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEF1","description":"ICD-JEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral antiplatelet therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4011F","description":"Oral antiplatelet therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lacosamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80235","description":"Lacosamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33964","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain open lung lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32200","description":"Drain open lung lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLF0","description":"ICD-AHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUC1","description":"ICD-NIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28C","description":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-fpgk (stimufend)_ biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5127","description":"Injection_ pegfilgrastim-fpgk (stimufend)_ biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Slitting of prepuce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54000","description":"Slitting of prepuce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACD1","description":"ICD-EACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDD1","description":"ICD-FFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspirate pleura w/ imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32555","description":"Aspirate pleura w/ imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTF0","description":"ICD-JFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23184","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63020","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_autosys and md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0141","description":"Scr c/v cyto_autosys and md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUA1","description":"ICD-IFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogen_ semiquantitative identification_ DNA from 16 bacterial organisms and 1 fungal organism_ multip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0371U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogen_ semiquantitative identification_ DNA from 16 bacterial organisms and 1 fungal organism_ multip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVF0","description":"ICD-NEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27266","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENA1","description":"ICD-BENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDB0","description":"ICD-NLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPD1","description":"ICD-BFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Mrna_ Next-Generation Sequencing Gene Expression Profiling Of 70 Content Genes And 31 Housekeeping Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81523","description":"Oncology (Breast)_ Mrna_ Next-Generation Sequencing Gene Expression Profiling Of 70 Content Genes And 31 Housekeeping Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTC0","description":"ICD-JGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENA1","description":"ICD-JENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatology (nonalcoholic fatty liver disease [NAFLD])_ semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0344U","description":"Hepatology (nonalcoholic fatty liver disease [NAFLD])_ semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAA1","description":"ICD-OLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1168","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEE1","description":"ICD-NBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83721","description":"Assay of blood lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIF1","description":"ICD-CGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon metas noevid dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9088","description":"Onc dx colon metas noevid dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVC0","description":"ICD-GBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJF0","description":"ICD-JDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthodontic treatment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8690","description":"Orthodontic treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBD0","description":"ICD-OLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAE1","description":"ICD-JEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE241","description":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFB1","description":"ICD-ODFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL53","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL40","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1902","description":"HCPCS-C1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antid glbln rcvd w/in 26wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4178F","description":"Antid glbln rcvd w/in 26wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB251","description":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB21","description":"ICD-2JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resp virus 6-11 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87632","description":"Resp virus 6-11 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGA1","description":"ICD-KEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYD0","description":"ICD-OJYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAID0","description":"ICD-AAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A5104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5104","description":"HCPCS-A5104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient has copd symptoms (e.g._ dyspnea_ cough/sputum_ wheezing)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1218","description":"Patient has copd symptoms (e.g._ dyspnea_ cough/sputum_ wheezing)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQA0","description":"ICD-LIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYD0","description":"ICD-PIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28F","description":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15933","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYA0","description":"ICD-GFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise low back nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64714","description":"Revise low back nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Left hrt cath w/ventrclgrphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93452","description":"Left hrt cath w/ventrclgrphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCE0","description":"ICD-GBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHC1","description":"ICD-ECHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTD0","description":"ICD-KHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rsect hip tum incl femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27078","description":"Rsect hip tum incl femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTE1","description":"ICD-KHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA21","description":"ICD-4LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTD0","description":"ICD-KGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAE0","description":"ICD-IBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD214","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18D","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUD0","description":"ICD-EIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0532U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","description":"CPT-0532U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMA0","description":"ICD-KEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIE1","description":"ICD-EHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJE0","description":"ICD-OFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elastase_ Pancreatic (El-1)_ Fecal; Quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82653","description":"Elastase_ Pancreatic (El-1)_ Fecal; Quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Res care_ nos waiver/month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2032","description":"Res care_ nos waiver/month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Case presentation_ subsequent to detailed and extensive treatment planning","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9450","description":"Case presentation_ subsequent to detailed and extensive treatment planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBC1","description":"ICD-EGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBE1","description":"ICD-NCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61320","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMA1","description":"ICD-AHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGD1","description":"ICD-BAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCD0","description":"ICD-CHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELE0","description":"ICD-OELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEB1","description":"ICD-JEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28261","description":"Revision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic analysis of cochlear implant_ patient younger than 7 years of age; subsequent reprogramming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92602","description":"Diagnostic analysis of cochlear implant_ patient younger than 7 years of age; subsequent reprogramming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHE0","description":"ICD-NHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6030","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","description":"HCPCS-L6030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYA1","description":"ICD-HDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVE1","description":"ICD-GCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28E","description":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Had A Prior Influenza Virus Vaccine Adverse Reaction Any Time Before Or During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2164","description":"Patient Had A Prior Influenza Virus Vaccine Adverse Reaction Any Time Before Or During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLA1","description":"ICD-MDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB241","description":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMD0","description":"ICD-NBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTD1","description":"ICD-JFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treprostinil_ non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7686","description":"Treprostinil_ non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGD1","description":"ICD-OLGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97036","description":"Hydrotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICD1","description":"ICD-BICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEA1","description":"ICD-IAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFF0","description":"ICD-OGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDID0","description":"ICD-IDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMB0","description":"ICD-FAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Term dev modifier wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6805","description":"Term dev modifier wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath cell enhance tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88112","description":"Cytopath cell enhance tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVF1","description":"ICD-OJVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEA0","description":"ICD-JCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNB1","description":"ICD-OGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMD0","description":"ICD-IGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVE0","description":"ICD-NHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair iris & ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66680","description":"Repair iris & ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWF0","description":"ICD-PHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin k","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84597","description":"Assay of vitamin k","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Additional supplies_ materials_ and clinical staff time over and above those usually included in an office visit or other non-facility service(s)_ when performed during a PHE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99072","description":"Additional supplies_ materials_ and clinical staff time over and above those usually included in an office visit or other non-facility service(s)_ when performed during a PHE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALE0","description":"ICD-OALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKD0","description":"ICD-BAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWD0","description":"ICD-OIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place perm pacing cardiovert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0448","description":"Place perm pacing cardiovert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELB0","description":"ICD-NELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELB0","description":"ICD-EELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEA0","description":"ICD-BGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity prosthes nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7499","description":"Upper extremity prosthes nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLB0","description":"ICD-OLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ntiol category 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q1005","description":"Ntiol category 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILE1","description":"ICD-JILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEB1","description":"ICD-OCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1362","description":"Patients who died during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct vena cava","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34502","description":"Reconstruct vena cava","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINF0","description":"ICD-BINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","description":"HCPCS-J2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMA0","description":"ICD-NHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEB0","description":"ICD-OHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5C","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSE0","description":"ICD-DHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRF0","description":"ICD-GDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerv sr 2pc thor ext pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0174","description":"Cerv sr 2pc thor ext pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crutch and cane holder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2207","description":"Crutch and cane holder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of toe joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28272","description":"Release of toe joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart symp image plnr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0331T","description":"Heart symp image plnr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTE0","description":"ICD-NHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMD0","description":"ICD-MAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ercp stent exchange w/dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43276","description":"Ercp stent exchange w/dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace lensshield cartridge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4257","description":"Replace lensshield cartridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWB0","description":"ICD-LGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUE0","description":"ICD-IIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36585","description":"Replace picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for hip x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27095","description":"Injection for hip x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHID0","description":"ICD-MHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOB1","description":"ICD-DHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOC0","description":"ICD-KAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABF0","description":"ICD-IABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLA0","description":"ICD-BBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Medicalis_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1003","description":"Clinical Decision Support Mechanism Medicalis_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCA0","description":"ICD-AGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJC0","description":"ICD-OFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFC1","description":"ICD-NLFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cold agglutinin screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86156","description":"Cold agglutinin screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43860","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQF0","description":"ICD-KEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVD1","description":"ICD-GGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Procenta_ per 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4244","description":"Procenta_ per 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKB1","description":"ICD-JCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNE1","description":"ICD-NKNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cultured chondrocytes implnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7330","description":"Cultured chondrocytes implnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJF1","description":"ICD-KAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNE1","description":"ICD-CHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg art-vein six or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33523","description":"Cabg art-vein six or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTA0","description":"ICD-OLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPD1","description":"ICD-FHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28A","description":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRA1","description":"ICD-DHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Supply","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0702T","description":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNB1","description":"ICD-JBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBC0","description":"ICD-IGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEB1","description":"ICD-BAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52276","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCD1","description":"ICD-FBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81414","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA120","description":"Clinically Complex _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDB0","description":"ICD-CEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWC0","description":"ICD-KEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMD0","description":"ICD-IHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclr rx interstit colloid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79300","description":"Nuclr rx interstit colloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAE1","description":"ICD-OLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILE0","description":"ICD-FILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHC0","description":"ICD-EBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTA0","description":"ICD-NFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leucovorin calcium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0640","description":"Leucovorin calcium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFC0","description":"ICD-CEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat trigeminal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61790","description":"Treat trigeminal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary artery graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33503","description":"Coronary artery graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSC0","description":"ICD-LCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLB1","description":"ICD-CGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0624U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","description":"CPT-0624U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMF0","description":"ICD-OCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC145","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinnervate larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31590","description":"Reinnervate larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIC1","description":"ICD-KAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFE1","description":"ICD-CHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tdap or td or 1tet/dipth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9416","description":"Tdap or td or 1tet/dipth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVD0","description":"ICD-GBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWD1","description":"ICD-PHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFF0","description":"ICD-OEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABA0","description":"ICD-JABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJF0","description":"ICD-NCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1108","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1C","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5C","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenomic Neoplasia (Genome-Wide) Microarray Analysis_ Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants For Chromosomal Abnormalities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81277","description":"Cytogenomic Neoplasia (Genome-Wide) Microarray Analysis_ Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants For Chromosomal Abnormalities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA CRYPTOCOCCUS NEOFORMANS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87327","description":"IAAD IA CRYPTOCOCCUS NEOFORMANS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neg press wound tx >50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97608","description":"Neg press wound tx >50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNF1","description":"ICD-KHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver image (3d) with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78206","description":"Liver image (3d) with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21B","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUD1","description":"ICD-NKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPD1","description":"ICD-FAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPD1","description":"ICD-KCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFD0","description":"ICD-JHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDE1","description":"ICD-JEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Topical app of fluoride","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1208","description":"Topical app of fluoride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHD0","description":"ICD-EDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLA1","description":"ICD-AHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADE0","description":"ICD-AADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 4 vsts p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90954","description":"Esrd serv 4 vsts p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO general orthopedic intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibilit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9739","description":"Patient unable to complete the FOTO general orthopedic intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43415","description":"Repair esophagus wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGB0","description":"ICD-FCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHF1","description":"ICD-FIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28H","description":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc (colorectal)_ quant assess of three urine metabolites  by liq chromatography w tandem mass spectro (LC-MS/MS) using multireaction monitoring acquisition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002U","description":"Onc (colorectal)_ quant assess of three urine metabolites  by liq chromatography w tandem mass spectro (LC-MS/MS) using multireaction monitoring acquisition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 2 std up to 300lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0806","description":"Pov group 2 std up to 300lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQE0","description":"ICD-CIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLA1","description":"ICD-MKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUA0","description":"ICD-EBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95722","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHF1","description":"ICD-KBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE131","description":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6561","description":"Gradient compression stocking_ full length/chap style_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-76017","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","description":"CPT-76017","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXF0","description":"ICD-FFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCD1","description":"ICD-EDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Max ultrasound image capture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0386","description":"Max ultrasound image capture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUB1","description":"ICD-EIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWA1","description":"ICD-DEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCID0","description":"ICD-FCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immediate mandibular partial denture - flexible base (including any clasps_ rests and teeth)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5228","description":"Immediate mandibular partial denture - flexible base (including any clasps_ rests and teeth)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAD1","description":"ICD-BDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGB1","description":"ICD-OJGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHND1","description":"ICD-OHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft axillary-axilry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35518","description":"Art byp grft axillary-axilry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0233T","description":"Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOC0","description":"ICD-DFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQA1","description":"ICD-GBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNB0","description":"ICD-BCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJF0","description":"ICD-OHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTF0","description":"ICD-KHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJF1","description":"ICD-JHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54324","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec stim unattend for press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0281","description":"Elec stim unattend for press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I131 tositumomab_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9544","description":"I131 tositumomab_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72157","description":"MRI chest spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0525","description":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOE1","description":"ICD-OEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERE1","description":"ICD-KERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWD1","description":"ICD-LFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNC1","description":"ICD-ODNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXA0","description":"ICD-JBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2203","description":"Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGA1","description":"ICD-OFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release thumb contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26508","description":"Release thumb contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOC1","description":"ICD-HHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMF0","description":"ICD-EIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ carboxymethyllysine_ methylglyoxal hydroimidazolone_ and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0384U","description":"Nephrology (chronic kidney disease)_ carboxymethyllysine_ methylglyoxal hydroimidazolone_ and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEC0","description":"ICD-GGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDF0","description":"ICD-CBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shunt accessory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4740","description":"Shunt accessory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYB0","description":"ICD-OCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDB0","description":"ICD-KIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ferric pyrophosphate citrate powder_ 0.1mg of iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1444","description":"Injection_ ferric pyrophosphate citrate powder_ 0.1mg of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23D","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDE0","description":"ICD-JCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21245","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABF0","description":"ICD-OABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA215","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC11","description":"ICD-3IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser in situ keratomileusis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0800","description":"Laser in situ keratomileusis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt no tx sys bio rx 6 mths","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9653","description":"Pt no tx sys bio rx 6 mths","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIC1","description":"ICD-BCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILC1","description":"ICD-GILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64902","description":"Nerve graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12B","description":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHF1","description":"ICD-EEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12C","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo plas doub free knee mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2036","description":"Kafo plas doub free knee mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prothrombin time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85610","description":"Prothrombin time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8G","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTD1","description":"ICD-CHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKA0","description":"ICD-NIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg <=16 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6237","description":"Hydrocolld drg <=16 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18C","description":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILC1","description":"ICD-IILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUD0","description":"ICD-KFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33694","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIA1","description":"ICD-NAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD236","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFC1","description":"ICD-GBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDD0","description":"ICD-JIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0182","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGB1","description":"ICD-JHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMF1","description":"ICD-AFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain external ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69000","description":"Drain external ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEA0","description":"ICD-BIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder lock actuator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6647","description":"Shoulder lock actuator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITA1","description":"ICD-CITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Managem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0703T","description":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Managem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYC1","description":"ICD-HAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23A","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXF1","description":"ICD-NGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRB0","description":"ICD-OCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX24","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8G","description":"Low Rehab_ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBE1","description":"ICD-NKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUE0","description":"ICD-MKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRA0","description":"ICD-KIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB121","description":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA15","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant (teva) not therapeutically equivalent to j9395_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9393","description":"Injection_ fulvestrant (teva) not therapeutically equivalent to j9395_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect radius/ulnar tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25170","description":"Resect radius/ulnar tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEE0","description":"ICD-NHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHE1","description":"ICD-GFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0D","description":"High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRB1","description":"ICD-OFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37270","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","description":"CPT-37270","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMC1","description":"ICD-OAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNA1","description":"ICD-GCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alkalin batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4233","description":"Alkalin batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28465","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMF0","description":"ICD-BAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEF1","description":"ICD-BEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYD1","description":"ICD-DBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRB1","description":"ICD-DHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMD0","description":"ICD-MIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31050","description":"Exploration sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-op asst not doc_ rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9617","description":"Pre-op asst not doc_ rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling_ peritoneal washings_ peritoneal biopsy(ies)_ omentectomy_ and diaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38573","description":"Laparoscopy_ surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling_ peritoneal washings_ peritoneal biopsy(ies)_ omentectomy_ and diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKB0","description":"ICD-KGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAE0","description":"ICD-MLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIF1","description":"ICD-OBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSA1","description":"ICD-GBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACA0","description":"ICD-CACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWE0","description":"ICD-OJWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUE1","description":"ICD-EHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGE0","description":"ICD-OLGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD134","description":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAE0","description":"ICD-BIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFE0","description":"ICD-NGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maxillofacial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5999","description":"Maxillofacial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUC0","description":"ICD-JEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPB1","description":"ICD-BGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSD0","description":"ICD-LBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDF0","description":"ICD-ICDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQE0","description":"ICD-DHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66940","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture typing added method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87158","description":"Culture typing added method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1490","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","description":"HCPCS-M1490","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGE1","description":"ICD-BBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0595","description":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTB0","description":"ICD-KHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ infliximab-qbtx_ biosimilar_ (Ixifi)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5109","description":"Injection_ infliximab-qbtx_ biosimilar_ (Ixifi)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDD1","description":"ICD-OHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBF1","description":"ICD-KCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVC1","description":"ICD-GBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHC0","description":"ICD-KIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNB0","description":"ICD-FHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHC1","description":"ICD-ODHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0597U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","description":"CPT-0597U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27258","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHB0","description":"ICD-EFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe outflare wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3390","description":"Shoe outflare wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leukocyte assessment fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89055","description":"Leukocyte assessment fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIC1","description":"ICD-ICIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEA1","description":"ICD-EAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRD0","description":"ICD-ODRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYC0","description":"ICD-KHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDC0","description":"ICD-GIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp add on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99150","description":"Mod sed diff phys/qhp add on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATB0","description":"ICD-EATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metatarsal joint implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8641","description":"Metatarsal joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33427","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1503","description":"HCPCS-A1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sub pt/ot d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8995","description":"Sub pt/ot d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVF0","description":"ICD-KCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKE0","description":"ICD-JBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPB0","description":"ICD-NKPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJB0","description":"ICD-GBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB40","description":"Very High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01140","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","description":"CPT-01140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISA1","description":"ICD-GISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bladder wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51865","description":"Repair of bladder wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59851","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAE0","description":"ICD-NJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCED1","description":"ICD-CCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12B","description":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5098","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","description":"HCPCS-Q5098","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dtap-ipv-hib-hepb vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90697","description":"Dtap-ipv-hib-hepb vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8I","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4295","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","description":"HCPCS-A4295","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide for heart biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76932","description":"Echo guide for heart biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBF1","description":"ICD-AEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALD0","description":"ICD-BALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert xdrl body crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63300","description":"Remove vert xdrl body crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUA1","description":"ICD-ECUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pedcle fh/ch/ch/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15574","description":"Pedcle fh/ch/ch/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKB1","description":"ICD-NKKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calcium glycer & lact/10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0620","description":"Calcium glycer & lact/10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dyspnea not screened","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3452F","description":"Dyspnea not screened","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome study additional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88289","description":"Chromosome study additional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext ecg scan w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0297T","description":"Ext ecg scan w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch urine w lock flng/ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4434","description":"Ost pch urine w lock flng/ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rasburicase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2783","description":"Rasburicase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAND0","description":"ICD-FAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13C","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intrvasc us noncoronary addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37253","description":"Intrvasc us noncoronary addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICB1","description":"ICD-CICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADF1","description":"ICD-EADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA260","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINF1","description":"ICD-NINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTA1","description":"ICD-CBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIF1","description":"ICD-NAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gum graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41870","description":"Gum graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUE1","description":"ICD-CCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBD0","description":"ICD-ODBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUA0","description":"ICD-FBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOC0","description":"ICD-OAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla i & ii typing hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81378","description":"Hla i & ii typing hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIC0","description":"ICD-ECIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTB0","description":"ICD-OBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGF0","description":"ICD-BFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAA1","description":"ICD-AAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCD1","description":"ICD-JGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreservation oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89337","description":"Cryopreservation oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNE1","description":"ICD-GDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSD0","description":"ICD-CDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXA1","description":"ICD-NAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXC0","description":"ICD-OAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBND1","description":"ICD-BBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVB1","description":"ICD-ODVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNF0","description":"ICD-JBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELB1","description":"ICD-JELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQD0","description":"ICD-KGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLC0","description":"ICD-JBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0C","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHF1","description":"ICD-FHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBE0","description":"ICD-MIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGE0","description":"ICD-OGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNF1","description":"ICD-CGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELB0","description":"ICD-BELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no lipid profile","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8726","description":"Doc reas no lipid profile","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair modified fontan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33615","description":"Repair modified fontan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYE0","description":"ICD-OJYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBD1","description":"ICD-NHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerv semi-rig adj molded chn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0150","description":"Cerv semi-rig adj molded chn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUE1","description":"ICD-BCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67830","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDF0","description":"ICD-FEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","description":"HCPCS-Q4392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQF1","description":"ICD-CIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins mark abd/pel for rt perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49411","description":"Ins mark abd/pel for rt perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTE1","description":"ICD-FCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKF0","description":"ICD-NBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9987","description":"Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJA0","description":"ICD-GFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJA1","description":"ICD-OIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"REvenfenacin inhalation solution_ FDA-approved final product_ noncompounded_administered through DME_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7677","description":"REvenfenacin inhalation solution_ FDA-approved final product_ noncompounded_administered through DME_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/subs interv >30 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0397","description":"Alcohol/subs interv >30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8C","description":"Medium Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAC0","description":"ICD-OKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac mgmt adheres guide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9056","description":"Onc prac mgmt adheres guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9962","description":"Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQF0","description":"ICD-HEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQE1","description":"ICD-PJQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYC0","description":"ICD-DEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52260","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHC1","description":"ICD-ACHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mecp2 gene known variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81303","description":"Mecp2 gene known variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLC1","description":"ICD-MLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDF1","description":"ICD-ODDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fungus isolation culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87102","description":"Fungus isolation culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ first 30 minutes in a month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2214","description":"Initial or subsequent psychiatric collaborative care management_ first 30 minutes in a month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60252","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQB1","description":"ICD-PKQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXB0","description":"ICD-FGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37296","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","description":"CPT-37296","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPD1","description":"ICD-OIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21120","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRB1","description":"ICD-GHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES231","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNB0","description":"ICD-BDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDA1","description":"ICD-CBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMF0","description":"ICD-KDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJE0","description":"ICD-BFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair rectum & vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57250","description":"Repair rectum & vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69643","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64742","description":"Incision of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRB0","description":"ICD-LGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJED1","description":"ICD-MJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGE1","description":"ICD-NEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJD1","description":"ICD-GFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFC0","description":"ICD-OKFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBD1","description":"ICD-GIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEC1","description":"ICD-IGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQB1","description":"ICD-GBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ doxercalciferol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1270","description":"Injection_ doxercalciferol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 9","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA56","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99242","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFE0","description":"ICD-NEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4271","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (liver)_ surveillance for hepatocellular carcinoma (HCC) in high-risk patients_ analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0333U","description":"Oncology (liver)_ surveillance for hepatocellular carcinoma (HCC) in high-risk patients_ analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL05","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTB0","description":"ICD-OJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIC0","description":"ICD-ADIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Above knee leather socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5642","description":"Above knee leather socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDC1","description":"ICD-CBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQB0","description":"ICD-PEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr); Following Liquid Enrichment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0302U","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr); Following Liquid Enrichment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIC0","description":"ICD-IBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIC1","description":"ICD-JEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech therapy_ in the home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9128","description":"Speech therapy_ in the home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68440","description":"Incise tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL05","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23472","description":"Reconstruct shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2930","description":"Methylprednisolone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug outreach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0023","description":"Alcohol and/or drug outreach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEE0","description":"ICD-ICEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of percutaneous transhepatic catheter for biliary drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47510","description":"Introduction of percutaneous transhepatic catheter for biliary drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA205","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0668U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0668U","description":"CPT-0668U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sperm procure init visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4030","description":"Sperm procure init visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methadone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6053","description":"Methadone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54865","description":"Explore epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEB1","description":"ICD-OLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47553","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conductive gel or paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4558","description":"Conductive gel or paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGE1","description":"ICD-GDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIE1","description":"ICD-CDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2253","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","description":"HCPCS-J2253","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHA1","description":"ICD-OJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam drg > 48 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6214","description":"Foam drg > 48 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct larynx & pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31395","description":"Reconstruct larynx & pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction By Neurolytic Agent_ Genicular Nerve Branches Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64624","description":"Destruction By Neurolytic Agent_ Genicular Nerve Branches Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RFC1 (replication factor C subunit 1)_ repeat expansion variant analysis by traditional and repeat-primed PCR_ blood_ saliva_ or buccal swab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0378U","description":"RFC1 (replication factor C subunit 1)_ repeat expansion variant analysis by traditional and repeat-primed PCR_ blood_ saliva_ or buccal swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Assessment_ Or Re-Assessment (Ie_ Health-Focused Clinical Interview_ Behavioral Observations_ Clinical Decision Making)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96156","description":"Health Behavior Assessment_ Or Re-Assessment (Ie_ Health-Focused Clinical Interview_ Behavioral Observations_ Clinical Decision Making)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPA1","description":"ICD-KCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped term dev_ hand_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6714","description":"Ped term dev_ hand_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nontherm electromgntc device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0761","description":"Nontherm electromgntc device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0151A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kras gene addl variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81276","description":"Kras gene addl variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEE0","description":"ICD-JGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYD0","description":"ICD-LAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWD1","description":"ICD-KFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dimethadione","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6048","description":"Dimethadione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33935","description":"Transplantation heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGID1","description":"ICD-FGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tebentafusp-tebn_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9274","description":"Injection_ tebentafusp-tebn_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37259","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","description":"CPT-37259","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1087T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1087T","description":"CPT-1087T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWC1","description":"ICD-OCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOD0","description":"ICD-LHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam ribs/chest4/> vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71111","description":"X-ray exam ribs/chest4/> vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXF1","description":"ICD-OEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 10 MCG/0.2 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0154A","description":"IMM ADMN SARSCOV2 BIVALENT 10 MCG/0.2 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDF0","description":"ICD-MCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTC0","description":"ICD-FFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28735","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLB1","description":"ICD-JGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial hospitalization serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0201","description":"Partial hospitalization serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGB0","description":"ICD-OHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCA1","description":"ICD-EHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTE1","description":"ICD-JDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAB0","description":"ICD-NDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXF1","description":"ICD-FDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUC1","description":"ICD-NHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25D","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34708","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDD0","description":"ICD-GCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSA0","description":"ICD-KHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray strenoclavic jt 3/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71130","description":"X-ray strenoclavic jt 3/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thromboplastin inhibition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85705","description":"Thromboplastin inhibition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA212","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Next Gen aco model>20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9870","description":"Next Gen aco model>20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sc r ant/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0650","description":"Lso sc r ant/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC11","description":"ICD-1CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Energy storing foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5976","description":"Energy storing foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat scor nek/ts pt no e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8673","description":"Fun stat scor nek/ts pt no e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1002","description":"HCPCS-B1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOB1","description":"ICD-LIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIA1","description":"ICD-AIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHF0","description":"ICD-OBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE213","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVD0","description":"ICD-NHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syphilis test non-trep qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86592","description":"Syphilis test non-trep qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETC0","description":"ICD-KETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); single analyte not elsewhere specified_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82491","description":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); single analyte not elsewhere specified_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIF0","description":"ICD-OHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove part lumbar vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22102","description":"Remove part lumbar vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOC0","description":"ICD-GHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXF1","description":"ICD-NDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTC0","description":"ICD-FDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWE1","description":"ICD-PFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Storage/year embryo(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89342","description":"Storage/year embryo(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epiandrosterone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6049","description":"Epiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEC0","description":"ICD-EHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE216","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cover eye w/membrane suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65779","description":"Cover eye w/membrane suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHID0","description":"ICD-IHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXD1","description":"ICD-OHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIC0","description":"ICD-MFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUB1","description":"ICD-GEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQE0","description":"ICD-PJQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVD1","description":"ICD-JIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0015","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPF1","description":"ICD-CFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSD0","description":"ICD-OBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37289","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","description":"CPT-37289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLD1","description":"ICD-FDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post and core cast + crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2952","description":"Post and core cast + crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Front caster assem complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0077","description":"Front caster assem complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagectomy_ total or near total_ with thoracoscopic mobilization of the upper_ middle_ and lower mediastinal esophagus_ with separate laparoscopic proximal gastrectomy_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43288","description":"Esophagectomy_ total or near total_ with thoracoscopic mobilization of the upper_ middle_ and lower mediastinal esophagus_ with separate laparoscopic proximal gastrectomy_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tongue removal neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41145","description":"Tongue removal neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63011","description":"Remove spine lamina 1/2 scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAB0","description":"ICD-NBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68335","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgigraft-dual_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4219","description":"Surgigraft-dual_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33425","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRF1","description":"ICD-HHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTA1","description":"ICD-KHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33952","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icut allergy titrate-airborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95027","description":"Icut allergy titrate-airborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBE0","description":"ICD-KBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin pump initiation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9145","description":"Insulin pump initiation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"4vhpv vaccine 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90649","description":"4vhpv vaccine 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCF0","description":"ICD-GFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDME1","description":"ICD-EDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glucagon tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80424","description":"Glucagon tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore orbit/remove lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61333","description":"Explore orbit/remove lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing no","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0384T","description":"External heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic shoe modifica nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3649","description":"Orthopedic shoe modifica nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dmd dup/delet analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81161","description":"Dmd dup/delet analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFE0","description":"ICD-OAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARC0","description":"ICD-CARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33410","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC31","description":"ICD-1BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEND1","description":"ICD-FEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise spermatic cord veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55530","description":"Revise spermatic cord veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25500","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATE0","description":"ICD-AATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSF1","description":"ICD-KGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27514","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA144","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Axicabtage neciloleucel_ up to 200 million autologous anti-CD19 CAR T Cells_ including leukapheresis and dose preparation procedures_ per infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2041","description":"Axicabtage neciloleucel_ up to 200 million autologous anti-CD19 CAR T Cells_ including leukapheresis and dose preparation procedures_ per infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt immunity to hep b docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3216F","description":"Pt immunity to hep b docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLE0","description":"ICD-BCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYC1","description":"ICD-DBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap revision perm ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49325","description":"Lap revision perm ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9986","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRF1","description":"ICD-CCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGA0","description":"ICD-OEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vbac class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9439","description":"Vbac class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFF0","description":"ICD-GDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIE0","description":"ICD-AIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMC1","description":"ICD-ACMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB36","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rad w/backup non inv intrfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0471","description":"Rad w/backup non inv intrfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antibio rx w in 10d of sympt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9286","description":"Antibio rx w in 10d of sympt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJF1","description":"ICD-FBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86756","description":"Respiratory virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJA1","description":"ICD-GBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjustable chair for esrd pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1570","description":"Adjustable chair for esrd pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAB0","description":"ICD-CEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74251","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSF1","description":"ICD-GCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUA0","description":"ICD-OHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMF0","description":"ICD-FFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDC0","description":"ICD-EFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOA0","description":"ICD-OIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCA0","description":"ICD-GCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMB1","description":"ICD-AHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastroesophageal reflux test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91034","description":"Gastroesophageal reflux test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCC0","description":"ICD-GDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIE1","description":"ICD-IFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment_ sensor placement_ hook-u","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95249","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment_ sensor placement_ hook-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal biophys profil w/o nst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76819","description":"Fetal biophys profil w/o nst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJF1","description":"ICD-OBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor viii reltd antgn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85244","description":"Clot factor viii reltd antgn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metabolic panel ionized ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80047","description":"Metabolic panel ionized ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Atomic absorption","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82190","description":"Atomic absorption","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00400","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","description":"CPT-00400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB21","description":"ICD-2EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECB1","description":"ICD-OECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMD0","description":"ICD-EBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray guide for gi tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74340","description":"X-ray guide for gi tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Busulfan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0594","description":"Busulfan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brca1 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81215","description":"Brca1 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVB0","description":"ICD-BEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cholangiography_ percutaneous_ transhepatic_ radiological supervisionand interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74320","description":"Cholangiography_ percutaneous_ transhepatic_ radiological supervisionand interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITA0","description":"ICD-EITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVF1","description":"ICD-GCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthro w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29861","description":"Hip arthro w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXB0","description":"ICD-OIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB104","description":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1135","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXA0","description":"ICD-OFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOA0","description":"ICD-OCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60522","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQC1","description":"ICD-LHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJA0","description":"ICD-BHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLF0","description":"ICD-FGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFND0","description":"ICD-BFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICC1","description":"ICD-EICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDC1","description":"ICD-BBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA21","description":"ICD-1EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12C","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJC0","description":"ICD-JBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWA0","description":"ICD-PBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVF0","description":"ICD-NJVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUB1","description":"ICD-OFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gi nuclear procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78299","description":"Gi nuclear procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWB1","description":"ICD-LHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICD0","description":"ICD-KICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66700","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogate crtd sns dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0272T","description":"Interrogate crtd sns dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHA0","description":"ICD-NEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA21","description":"ICD-3AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATA1","description":"ICD-NATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUB0","description":"ICD-IIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periradicular surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3427","description":"Periradicular surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMB1","description":"ICD-BCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syphilis test non-trep quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86593","description":"Syphilis test non-trep quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep renal graft/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50327","description":"Prep renal graft/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBB1","description":"ICD-GHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNF1","description":"ICD-FDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc abd tum over 10 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49205","description":"Exc abd tum over 10 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00172","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","description":"CPT-00172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1242","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHA0","description":"ICD-AAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lower limb pros vacuum pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5781","description":"Lower limb pros vacuum pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pasrr level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2011","description":"Pasrr level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFE1","description":"ICD-FEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBD0","description":"ICD-KIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFB1","description":"ICD-OAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD150","description":"Reduced Physical Function _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBF0","description":"ICD-ECBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fem urinary collect pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4328","description":"Fem urinary collect pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC101","description":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACE0","description":"ICD-AACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0566U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","description":"CPT-0566U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQD0","description":"ICD-OCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of sternum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21620","description":"Partial removal of sternum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISB0","description":"ICD-PISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVF0","description":"ICD-KFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no pos air press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8849","description":"Doc reas no pos air press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIB0","description":"ICD-OAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compressor air power source","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0565","description":"Compressor air power source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sotrovimab_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0247","description":"Injection_ sotrovimab_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNB0","description":"ICD-OKNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Splint elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8452","description":"Splint elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHF0","description":"ICD-OJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33681","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve annulus reconstruction_ with implantation of adjustable annulus reconstruction device_ percutaneous approach including transseptal puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0544T","description":"Transcatheter mitral valve annulus reconstruction_ with implantation of adjustable annulus reconstruction device_ percutaneous approach including transseptal puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprssion thxpy prescribed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4267F","description":"Comprssion thxpy prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSB0","description":"ICD-HCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYD1","description":"ICD-OCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERF0","description":"ICD-HERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8A","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bedside drainage bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4357","description":"Bedside drainage bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYF0","description":"ICD-DHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSE1","description":"ICD-KCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDC0","description":"ICD-MEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACB1","description":"ICD-OACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63276","description":"Bx/exc xdrl spine lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ 1 mg (Aristada)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9470","description":"Injection_ aripiprazole lauroxil_ 1 mg (Aristada)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJF0","description":"ICD-FAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12B","description":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJC1","description":"ICD-BEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBF0","description":"ICD-JEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including An Implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0674T","description":"Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including An Implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATD0","description":"ICD-NATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special reports or forms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99080","description":"Special reports or forms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1084","description":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24C","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0549U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","description":"CPT-0549U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUA1","description":"ICD-JDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEB1","description":"ICD-GFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arm/leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64857","description":"Repair arm/leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism_ Qualified Tool Not Otherwise Specified_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1011","description":"Clinical Decision Support Mechanism_ Qualified Tool Not Otherwise Specified_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cervix/repair pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57545","description":"Remove cervix/repair pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBE1","description":"ICD-EBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDD1","description":"ICD-FHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2080","description":"Laup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper arm/elbow surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24999","description":"Upper arm/elbow surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32310","description":"Removal of chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNF0","description":"ICD-OBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human fibrinogen conc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7178","description":"Human fibrinogen conc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Throat surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42999","description":"Throat surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTC0","description":"ICD-GCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBD0","description":"ICD-OJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEB1","description":"ICD-CHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow stump activated lock h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6130","description":"Elbow stump activated lock h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEF1","description":"ICD-IHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEB1","description":"ICD-FAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB31","description":"ICD-3LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33321","description":"Repair major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost be/wd_ ultlite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7400","description":"Add ue prost be/wd_ ultlite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWD1","description":"ICD-HGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High mount flip-up footrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0037","description":"High mount flip-up footrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTD1","description":"ICD-EBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC31","description":"ICD-3LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQF1","description":"ICD-HAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4540","description":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1345","description":"Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Utility services waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2035","description":"Utility services waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAC0","description":"ICD-EAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETE1","description":"ICD-NETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inirs each vessel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0205T","description":"Inirs each vessel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15011","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","description":"CPT-15011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNC0","description":"ICD-BHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; first 30 minutes of technician time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0364T","description":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; first 30 minutes of technician time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDC0","description":"ICD-MBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWB0","description":"ICD-GHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMC0","description":"ICD-OGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQE0","description":"ICD-GDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGE1","description":"ICD-NCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGC1","description":"ICD-GBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No documentation of a chlamydia screening test with proper follow-up","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9821","description":"No documentation of a chlamydia screening test with proper follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXA1","description":"ICD-JHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Static or dynami afo pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4397","description":"Static or dynami afo pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Permanent Fallopian Tube Occlusion With Degradable Biopolymer Implant_ Transcervical Approach_ Including Transvaginal Ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0567T","description":"Permanent Fallopian Tube Occlusion With Degradable Biopolymer Implant_ Transcervical Approach_ Including Transvaginal Ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of bioprosthetic valve_ open_ femoral vein_ including duplex ultrasound imaging guidance_ when performed_ including autogenous or nonautogenous patch graft (eg_ poly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0744T","description":"Insertion of bioprosthetic valve_ open_ femoral vein_ including duplex ultrasound imaging guidance_ when performed_ including autogenous or nonautogenous patch graft (eg_ poly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEA0","description":"ICD-EAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAID1","description":"ICD-JAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Paclitaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9267","description":"Paclitaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1B","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRB0","description":"ICD-DCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXD1","description":"ICD-GFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50081","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPE0","description":"ICD-CHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOB1","description":"ICD-DDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPA1","description":"ICD-CCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEF1","description":"ICD-ODEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAD1","description":"ICD-MCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unclassified biologics","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3590","description":"Unclassified biologics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGA1","description":"ICD-KHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreservation sperm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89259","description":"Cryopreservation sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth abdomen vessel surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88051","description":"Anesth abdomen vessel surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPE0","description":"ICD-KIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCF0","description":"ICD-BCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1087","description":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Janssen Covid-19 Vaccine Administration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0031A","description":"Janssen Covid-19 Vaccine Administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXF1","description":"ICD-KHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunofluorescence_ per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0845T","description":"Digitization of glass microscope slides for immunofluorescence_ per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pros sock single ply ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8480","description":"Pros sock single ply ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYC0","description":"ICD-OFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ot evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97003","description":"Ot evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat combo pwr shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1008","description":"Pwr seat combo pwr shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAD0","description":"ICD-FDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLB1","description":"ICD-ACLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tisotumab vedotin-tftv_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9273","description":"Injection_ tisotumab vedotin-tftv_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDB1","description":"ICD-KIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of bronchus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31770","description":"Repair/graft of bronchus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFF1","description":"ICD-NLFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABA1","description":"ICD-JABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHE1","description":"ICD-AEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIE1","description":"ICD-FIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLED1","description":"ICD-OLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fem/popl revas w/ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37225","description":"Fem/popl revas w/ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXE0","description":"ICD-OFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc antibody elution","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86860","description":"Rbc antibody elution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIA1","description":"ICD-GBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEE0","description":"ICD-MJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg digital analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95957","description":"Eeg digital analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLD0","description":"ICD-MGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opps/php;activity therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0176","description":"Opps/php;activity therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methylphenidate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80360","description":"Methylphenidate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Greater Than 22 And Functional Status Measured","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2143","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Greater Than 22 And Functional Status Measured","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization adm by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vac_ mRNA\u0002LNP_ spike_ third dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0083A","description":"Immunization adm by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vac_ mRNA\u0002LNP_ spike_ third dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOB0","description":"ICD-ODOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXA0","description":"ICD-BBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJC0","description":"ICD-JFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mechanical chest wall oscill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94669","description":"Mechanical chest wall oscill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWD0","description":"ICD-PEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXB0","description":"ICD-GAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEB1","description":"ICD-CAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin b12 injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3420","description":"Vitamin b12 injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of folic acid rbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82747","description":"Assay of folic acid rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE106","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWD0","description":"ICD-OFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGC1","description":"ICD-FEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endometrial sampling or hysteroscopy with biopsy and results documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9823","description":"Endometrial sampling or hysteroscopy with biopsy and results documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVA1","description":"ICD-NAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4426","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","description":"HCPCS-Q4426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENF1","description":"ICD-JENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTE0","description":"ICD-EDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWF1","description":"ICD-HHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exam synovial fluid crystals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89060","description":"Exam synovial fluid crystals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7525","description":"Tracheostomy mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adhesion barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1765","description":"Adhesion barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVA0","description":"ICD-KDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Free omental flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49906","description":"Free omental flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMA1","description":"ICD-OEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27690","description":"Revise lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"R hrt art/grft angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93457","description":"R hrt art/grft angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQB0","description":"ICD-OIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring_ radiofrequency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58674","description":"Laparoscopy_ surgical_ ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring_ radiofrequency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKB1","description":"ICD-GFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOC0","description":"ICD-PAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5B","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth skin ext/per/atrunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40051","description":"Anesth skin ext/per/atrunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEA0","description":"ICD-ODEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILA0","description":"ICD-EILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCID1","description":"ICD-CCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQD0","description":"ICD-GGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic elbow sequential","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7180","description":"Electronic elbow sequential","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEA0","description":"ICD-BEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPF1","description":"ICD-FCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1002","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1002","description":"CDT-D1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17262","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0640T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA221","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUF1","description":"ICD-JBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEE1","description":"ICD-FIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLC1","description":"ICD-OGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMA0","description":"ICD-JAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHB0","description":"ICD-ABHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRB1","description":"ICD-KIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKA0","description":"ICD-JBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDC1","description":"ICD-FFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETC1","description":"ICD-EETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB31","description":"ICD-2EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALC0","description":"ICD-GALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEC0","description":"ICD-MKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMD1","description":"ICD-KEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biological materials","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3431","description":"Biological materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEC1","description":"ICD-MJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHC1","description":"ICD-KIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAB0","description":"ICD-ODAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1806","description":"HCPCS-A1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRD0","description":"ICD-PKRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCA0","description":"ICD-IGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy remove for body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46608","description":"Anoscopy remove for body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-P9027","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","description":"HCPCS-P9027","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/over 6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2110","description":"Spherocylinder 4.25d/over 6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBC1","description":"ICD-MBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43193","description":"Esophagoscp rig trnso biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HISTOPLASM CAPSULATUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87385","description":"IAAD IA HISTOPLASM CAPSULATUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental bitewing single film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0270","description":"Dental bitewing single film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24410","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUE1","description":"ICD-GEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA14","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore deep node(s) neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38542","description":"Explore deep node(s) neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair hand deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26580","description":"Repair hand deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28C","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEID0","description":"ICD-EEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLA0","description":"ICD-MBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chron care mgmt srvc 20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99490","description":"Chron care mgmt srvc 20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDF1","description":"ICD-CHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAC1","description":"ICD-CHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUA0","description":"ICD-IFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUA1","description":"ICD-JBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARC1","description":"ICD-PARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD156","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate unknwn nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9083","description":"Onc dx prostate unknwn nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVB1","description":"ICD-KCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fev >/=40% predicted value","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3042F","description":"Fev >/=40% predicted value","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFF0","description":"ICD-CHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUA0","description":"ICD-NLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc rectal tumor endoscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0184T","description":"Exc rectal tumor endoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Above knee manual lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5925","description":"Above knee manual lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHA1","description":"ICD-MGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLD1","description":"ICD-IGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHB0","description":"ICD-GCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67901","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1821","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","description":"HCPCS-L1821","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trans care mgmt 14 day disch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99495","description":"Trans care mgmt 14 day disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMB0","description":"ICD-MDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHE0","description":"ICD-IGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10C","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genome re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81427","description":"Genome re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEA0","description":"ICD-MAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBA1","description":"ICD-GEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ moderate complexity_ requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical acti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97170","description":"Athletic training evaluation_ moderate complexity_ requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical acti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Als1-emergency","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0427","description":"Als1-emergency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJE0","description":"ICD-CCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGF0","description":"ICD-OCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPD0","description":"ICD-OJPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unspecified diagnostic proce","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0999","description":"Unspecified diagnostic proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPC1","description":"ICD-OFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAC1","description":"ICD-JFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYF1","description":"ICD-CCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strep a dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87652","description":"Strep a dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI angio abdom w orw/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74185","description":"MRI angio abdom w orw/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA52","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIE1","description":"ICD-BCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTD1","description":"ICD-FHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFD1","description":"ICD-OFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHC1","description":"ICD-OKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKB1","description":"ICD-FEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDA1","description":"ICD-NLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWC0","description":"ICD-HDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSF1","description":"ICD-LGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXE0","description":"ICD-OIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete ft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4271","description":"Complete ft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5B","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHE1","description":"ICD-MBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXD1","description":"ICD-JDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3503","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDF0","description":"ICD-NEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21435","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl trifocal over 12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2314","description":"Lens sphcyl trifocal over 12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0977T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","description":"CPT-0977T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40490","description":"Biopsy of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prenatal care atrisk assessm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1000","description":"Prenatal care atrisk assessm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKE0","description":"ICD-KBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic analysis of vestibular implant_ unilateral; with initial programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0728T","description":"Diagnostic analysis of vestibular implant_ unilateral; with initial programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOC1","description":"ICD-DEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMD0","description":"ICD-BHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 12 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP12","description":"Auto.test pane pricing code_ 12 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYE0","description":"ICD-PBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI orbt/fac/nck w/o &w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70543","description":"MRI orbt/fac/nck w/o &w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Joint device (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1776","description":"Joint device (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBA0","description":"ICD-CGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGB1","description":"ICD-JEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27280","description":"Fusion of sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHB1","description":"ICD-ICHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGB1","description":"ICD-CAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGE0","description":"ICD-GCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOF0","description":"ICD-PLOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50340","description":"Removal of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ gene expression profiling by next-generation sequencing of 101 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as a tripl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0153U","description":"Oncology (breast)_ mRNA_ gene expression profiling by next-generation sequencing of 101 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as a tripl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKA0","description":"ICD-KGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35142","description":"Repair artery rupture thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient receiving an anti-TNF agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9914","description":"Patient receiving an anti-TNF agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQB0","description":"ICD-DCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYF0","description":"ICD-CCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cranial cervical torticollis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0113","description":"Cranial cervical torticollis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skilled services of a registered nurse (RN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requires skil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0493","description":"Skilled services of a registered nurse (RN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requires skil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Piperacillin/tazobactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2543","description":"Piperacillin/tazobactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGD0","description":"ICD-BEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open ablate liver tumor cryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47381","description":"Open ablate liver tumor cryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBA1","description":"ICD-MFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIC0","description":"ICD-IGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDB0","description":"ICD-BHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped size brief/diaper sm/med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4529","description":"Ped size brief/diaper sm/med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1804","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1804","description":"CDT-D1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAF0","description":"ICD-ICAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52317","description":"Remove bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67430","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC104","description":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBND0","description":"ICD-BBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADD1","description":"ICD-EADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ meropenem (b. braun) not therapeutically equivalent to j2185_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2184","description":"Injection_ meropenem (b. braun) not therapeutically equivalent to j2185_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44010","description":"Incision of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCID1","description":"ICD-OCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct abd & pelv 1/> regns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74178","description":"Ct abd & pelv 1/> regns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWF0","description":"ICD-KEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPF0","description":"ICD-BHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27498","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTF1","description":"ICD-CGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJB1","description":"ICD-GCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of fluoride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82735","description":"Assay of fluoride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive chest wall surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19272","description":"Extensive chest wall surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainable plstic pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4377","description":"Drainable plstic pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSE0","description":"ICD-PFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","description":"HCPCS-Q4391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin substitute_ FDA-cleared as a device_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4100","description":"Skin substitute_ FDA-cleared as a device_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate (Jylamvo)_ oral_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8611","description":"Methotrexate (Jylamvo)_ oral_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0318","description":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (genitourinary pathogens)_ antibiotic-resistance gene detection_ multiplex amplified probe technique_ urine_ reported as an antimicrobial stewardship risk s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0372U","description":"Infectious disease (genitourinary pathogens)_ antibiotic-resistance gene detection_ multiplex amplified probe technique_ urine_ reported as an antimicrobial stewardship risk s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom fabricate w/c cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2609","description":"Custom fabricate w/c cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26607","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANA1","description":"ICD-OANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18X","description":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWD0","description":"ICD-HCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDB0","description":"ICD-NKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSD1","description":"ICD-KHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inner ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69949","description":"Inner ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac rehabilitation progr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9472","description":"Cardiac rehabilitation progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJE0","description":"ICD-KAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYC0","description":"ICD-KFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rails bed side full length","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0310","description":"Rails bed side full length","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPA1","description":"ICD-CIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61305","description":"Open skull for exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJE0","description":"ICD-JBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKME1","description":"ICD-OKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVC0","description":"ICD-KAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWA1","description":"ICD-KBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAC1","description":"ICD-AEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0882T","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26130","description":"Remove wrist joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0B","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBND1","description":"ICD-NBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise diaphragm nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64746","description":"Incise diaphragm nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFB1","description":"ICD-FBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBC1","description":"ICD-JBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nadofaragene firadenovec-vncg_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9029","description":"Injection_ nadofaragene firadenovec-vncg_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis of a patient-specific panel_ cell-free DNA_ subsequent assessment with comparison to pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0307U","description":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis of a patient-specific panel_ cell-free DNA_ subsequent assessment with comparison to pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBC1","description":"ICD-NDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4D","description":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI joint of lwr extr w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73722","description":"MRI joint of lwr extr w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ using magnetic-guided arterial and venous catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2171","description":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ using magnetic-guided arterial and venous catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom grad glove heavy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8426","description":"Custom grad glove heavy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALD0","description":"ICD-NALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELC0","description":"ICD-MELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEF0","description":"ICD-OKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acute venous thrombus image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78456","description":"Acute venous thrombus image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63266","description":"Excise intrspinl lesion thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPB1","description":"ICD-JBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWF1","description":"ICD-HCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAB0","description":"ICD-NFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9984","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRD0","description":"ICD-KGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFF1","description":"ICD-CIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB31","description":"Very High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQB0","description":"ICD-DAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat sesamoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28530","description":"Treat sesamoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O2 contents liquid lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8121","description":"O2 contents liquid lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICE0","description":"ICD-FICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYC1","description":"ICD-DDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFA1","description":"ICD-BIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX14","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGC1","description":"ICD-FIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPD0","description":"ICD-FIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABB1","description":"ICD-GABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKD0","description":"ICD-FBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTF1","description":"ICD-JDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB50","description":"Low Rehab_ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incis spine 3 column thorac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22206","description":"Incis spine 3 column thorac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLC0","description":"ICD-FHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64567","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","description":"CPT-64567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient not screened for tobacco use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1312","description":"Patient not screened for tobacco use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93590","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excursion amplifier lever ty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6642","description":"Excursion amplifier lever ty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla class i phenotype qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86830","description":"Hla class i phenotype qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC160","description":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD135","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVA1","description":"ICD-CHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct head/brain w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70460","description":"Ct head/brain w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOE1","description":"ICD-PDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cysto w/up stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52342","description":"Cysto w/up stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iv oct for proc addl vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0292T","description":"Iv oct for proc addl vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOA0","description":"ICD-LIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of protein other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84157","description":"Assay of protein other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epstein-barr capsid vca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86665","description":"Epstein-barr capsid vca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCC0","description":"ICD-JFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEA1","description":"ICD-OAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCD0","description":"ICD-AHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fo pip dip no jt spr pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3927","description":"Fo pip dip no jt spr pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUB0","description":"ICD-MGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJC1","description":"ICD-CEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECB0","description":"ICD-JECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPE0","description":"ICD-FEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPF1","description":"ICD-NIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOE1","description":"ICD-LCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ neurostim test kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1897","description":"Lead_ neurostim test kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75731","description":"Artery x-rays adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXB1","description":"ICD-OAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAD1","description":"ICD-JEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYD1","description":"ICD-HIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tumor immunohistochem/comput","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88361","description":"Tumor immunohistochem/comput","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXA1","description":"ICD-GFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert aqueous drain device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0253T","description":"Insert aqueous drain device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retreat root canal anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3346","description":"Retreat root canal anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOA0","description":"ICD-CFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open aortofemor prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34832","description":"Open aortofemor prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis_ nuclear-encoded mitochondrial gene a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0417U","description":"Rare diseases (constitutional/heritable disorders)_ whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis_ nuclear-encoded mitochondrial gene a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKME1","description":"ICD-NKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGD1","description":"ICD-GHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUC0","description":"ICD-GFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTA1","description":"ICD-MGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSF1","description":"ICD-OGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac mgmt dif pt comorb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9060","description":"Onc prac mgmt dif pt comorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1423","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","description":"HCPCS-M1423","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPF0","description":"ICD-KEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVD0","description":"ICD-GHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Fetal Monitoring Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0621","description":"Hospital Special Treatment Room Support Component (Hstrsc) Fetal Monitoring Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ear mold/insert_ disp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5265","description":"Ear mold/insert_ disp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematopoietic nuclear tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79403","description":"Hematopoietic nuclear tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel-bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44661","description":"Repair bowel-bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42836","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of semen fructose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82757","description":"Assay of semen fructose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ includes angiopla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9764","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ includes angiopla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel dsg>16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6232","description":"Hydrogel dsg>16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18I","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBA1","description":"ICD-EFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allergy/immunology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0060","description":"Allergy/immunology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIF0","description":"ICD-KEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAB0","description":"ICD-EBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak/ft power asst incl motors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5969","description":"Ak/ft power asst incl motors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4380","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","description":"HCPCS-Q4380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPF1","description":"ICD-CIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical foods for noninborn errors of metabolism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9432","description":"Medical foods for noninborn errors of metabolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57130","description":"Remove vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68510","description":"Biopsy of tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28725","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40761","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq tx nasoethmoid fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21340","description":"Perq tx nasoethmoid fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sex chromatin identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88130","description":"Sex chromatin identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANE1","description":"ICD-BANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUB1","description":"ICD-OEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYD1","description":"ICD-DAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMB1","description":"ICD-MFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC134","description":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55712","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","description":"CPT-55712","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correct metacarpal flaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26565","description":"Correct metacarpal flaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo iv push addl drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96411","description":"Chemo iv push addl drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXF1","description":"ICD-CFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64792","description":"Removal of nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAC0","description":"ICD-BCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50650","description":"Removal of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTE0","description":"ICD-BDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No card tamp e/in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9409","description":"No card tamp e/in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPF1","description":"ICD-FAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCID1","description":"ICD-JCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBA1","description":"ICD-ADBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKE0","description":"ICD-GEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWE1","description":"ICD-HEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0996T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","description":"CPT-0996T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOF1","description":"ICD-OIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","description":"HCPCS-E1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65091","description":"Revise eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocollator unit portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0239","description":"Hydrocollator unit portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telecare equipment installation and removal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W2024","description":"Telecare equipment installation and removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD210","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA255","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB234","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA31","description":"ICD-1HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caspofungin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0637","description":"Caspofungin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Dalbavancin_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9443","description":"Injection_ Dalbavancin_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung and colon cancer)_ DNA_ qualitative_ next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes_ formalin-fixed par","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0448U","description":"Oncology (lung and colon cancer)_ DNA_ qualitative_ next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes_ formalin-fixed par","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alloskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4115","description":"Alloskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of hand bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25820","description":"Fusion of hand bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lidocaine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80176","description":"Assay of lidocaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEB1","description":"ICD-CBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tendon excision palm/finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26145","description":"Tendon excision palm/finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle-skin graft head/neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15732","description":"Muscle-skin graft head/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cognit assessed and reviewed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1494F","description":"Cognit assessed and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIB1","description":"ICD-JCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAF0","description":"ICD-BFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular dev_ intraop_ det ret","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1784","description":"Ocular dev_ intraop_ det ret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21C","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 11 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0447U","description":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 11 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEA0","description":"ICD-JAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMB1","description":"ICD-OFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWC0","description":"ICD-GIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj ia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96373","description":"Ther/proph/diag inj ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE124","description":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQB0","description":"ICD-GHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYA0","description":"ICD-HEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKC1","description":"ICD-NAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 4.12-7.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2301","description":"Lens sphere trifocal 4.12-7.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXB1","description":"ICD-OLXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65285","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid uptake measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78012","description":"Thyroid uptake measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEB0","description":"ICD-GCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hook/hand_ hvy dty_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6721","description":"Hook/hand_ hvy dty_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMF1","description":"ICD-JDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tooth pin retention","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2951","description":"Tooth pin retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4048F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGA0","description":"ICD-BBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKA1","description":"ICD-NGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11646","description":"Exc f/e/e/n/l mal+mrg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEC0","description":"ICD-AFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXA1","description":"ICD-CGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 20 targets (adenovirus_ coronavirus 229E_ coronaviru","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0099U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 20 targets (adenovirus_ coronavirus 229E_ coronaviru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHF0","description":"ICD-GGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNC1","description":"ICD-NBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9096","description":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHC1","description":"ICD-EIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILB1","description":"ICD-OILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cysto w/prst8 commissurotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0619T","description":"Cysto w/prst8 commissurotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0105","description":"HCPCS-B0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAE0","description":"ICD-CHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amiodarone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80151","description":"Amiodarone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUC0","description":"ICD-IDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEF1","description":"ICD-CBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11446","description":"Exc face-mm b9+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSE1","description":"ICD-GDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXD0","description":"ICD-NBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFC0","description":"ICD-JGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of aldolase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82085","description":"Assay of aldolase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHID1","description":"ICD-FHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cranial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5924","description":"Cranial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair ventrl hern reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49565","description":"Rerepair ventrl hern reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATA0","description":"ICD-NATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWC1","description":"ICD-DAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2180","description":"Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHC1","description":"ICD-OLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36810","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compatibility test electric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86923","description":"Compatibility test electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMC1","description":"ICD-AEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJA0","description":"ICD-CEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCE0","description":"ICD-FFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTC1","description":"ICD-EHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2135","description":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFA0","description":"ICD-FAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54304","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICB0","description":"ICD-JICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ omadacycline_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9051","description":"Injection_ omadacycline_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLD1","description":"ICD-GDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIC1","description":"ICD-BIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 25 mcg/0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91321","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 25 mcg/0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj tendon sheath/ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20550","description":"Inj tendon sheath/ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDD1","description":"ICD-JHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below knee cuff suspension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5666","description":"Below knee cuff suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUC0","description":"ICD-OGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compression form shoe insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5510","description":"Compression form shoe insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOE1","description":"ICD-PFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81163","description":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial valve remov addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31649","description":"Bronchial valve remov addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Thyroid)_ Dna And Mrna_ Next-Generation Sequencing Analysis Of 112 Genes_ Fine Needle Aspirate Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Algorithmic Predict","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0287U","description":"Oncology (Thyroid)_ Dna And Mrna_ Next-Generation Sequencing Analysis Of 112 Genes_ Fine Needle Aspirate Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Algorithmic Predict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXD0","description":"ICD-OEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFE0","description":"ICD-JIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Kovaltry)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7211","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Kovaltry)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mastoidectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69501","description":"Mastoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRD0","description":"ICD-GFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0701","description":"HCPCS-B0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonemergency transport air","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0140","description":"Nonemergency transport air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELE0","description":"ICD-GELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replantation thumb complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20824","description":"Replantation thumb complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ avalglucosidase alfa-ngpt_ 4 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0219","description":"Injection_ avalglucosidase alfa-ngpt_ 4 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVC1","description":"ICD-BBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAB1","description":"ICD-NGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRD0","description":"ICD-DCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWD1","description":"ICD-GFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADA0","description":"ICD-EADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0609U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","description":"CPT-0609U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debride skin at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11010","description":"Debride skin at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJC1","description":"ICD-OHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJA1","description":"ICD-OCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGF0","description":"ICD-GEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy faceplt/silicone ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4384","description":"Ostomy faceplt/silicone ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEC0","description":"ICD-JHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5658","description":"Socket insert above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of throat abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42725","description":"Drainage of throat abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHA0","description":"ICD-OKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVE0","description":"ICD-CBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of arsenic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82175","description":"Assay of arsenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHD0","description":"ICD-OCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove neuroreceiver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61888","description":"Revise/remove neuroreceiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1A","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert major vessel graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33335","description":"Insert major vessel graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBF1","description":"ICD-NJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDD0","description":"ICD-JFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPA0","description":"ICD-JAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare donor heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33933","description":"Prepare donor heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXD1","description":"ICD-CGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDB0","description":"ICD-OFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBF1","description":"ICD-MLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of apolipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82172","description":"Assay of apolipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low pecarn ped head trauma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9593","description":"Low pecarn ped head trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47555","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise lesion skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61616","description":"Resect/excise lesion skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHA1","description":"ICD-MKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDC1","description":"ICD-FIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3D","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEE0","description":"ICD-NAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBD1","description":"ICD-OFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBD1","description":"ICD-KHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lipid panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80061","description":"Lipid panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNC0","description":"ICD-BGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65710","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGF1","description":"ICD-NCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITA0","description":"ICD-BITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of calcium in urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82340","description":"Assay of calcium in urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTD0","description":"ICD-KBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parathyrd planar w/spect&ct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78072","description":"Parathyrd planar w/spect&ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Needle Insertion(S) Without Injection(S); 3 Or More Muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20561","description":"Needle Insertion(S) Without Injection(S); 3 Or More Muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50970","description":"Ureter endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJD1","description":"ICD-OCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISF1","description":"ICD-CISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHE1","description":"ICD-FCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB140","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69421","description":"Incision of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42950","description":"Reconstruction of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49618","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIB1","description":"ICD-IEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pin finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26756","description":"Pin finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral - complete series of radiographic images - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0709","description":"Intraoral - complete series of radiographic images - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-91323","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","description":"CPT-91323","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBE0","description":"ICD-AGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin mnl lck ultra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5811","description":"Endo knee-shin mnl lck ultra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRD0","description":"ICD-DBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert heart pm atrial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33206","description":"Insert heart pm atrial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVE0","description":"ICD-JGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWC0","description":"ICD-LBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUB1","description":"ICD-JEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERD0","description":"ICD-CERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Capsaicin 8% patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7336","description":"Capsaicin 8% patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJA0","description":"ICD-JCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBME1","description":"ICD-MBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33702","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXA0","description":"ICD-CIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ by tissue approximation using thermal resistance e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2170","description":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ by tissue approximation using thermal resistance e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48150","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQF0","description":"ICD-GBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Keroxx (2.5 g/cc)_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4202","description":"Keroxx (2.5 g/cc)_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTF0","description":"ICD-NDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair heavy duty fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1285","description":"Wheelchair heavy duty fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knuckle joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26517","description":"Fusion of knuckle joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt alkaline 1.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0603","description":"Repl batt alkaline 1.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB120","description":"Reduced Physical Function _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit noc per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9379","description":"Hit noc per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUC1","description":"ICD-KDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUC1","description":"ICD-MKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBA1","description":"ICD-EGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA56","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPF0","description":"ICD-CFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj tedizolid phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3090","description":"Inj tedizolid phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art trnsposj carotid subclav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35695","description":"Art trnsposj carotid subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRC1","description":"ICD-OKRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHC0","description":"ICD-GBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUC0","description":"ICD-EFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX17","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIB1","description":"ICD-NJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGB0","description":"ICD-GIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ nerve(s) and accompanying structures throughout their entire anatomic course in one extremity_ comprehensive_ including real-time cine imaging with image documenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76883","description":"Ultrasound_ nerve(s) and accompanying structures throughout their entire anatomic course in one extremity_ comprehensive_ including real-time cine imaging with image documenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSA0","description":"ICD-DHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIC0","description":"ICD-KAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain cerebro spinal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62272","description":"Drain cerebro spinal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous or minimally invasive (indirect visualization)_ with image guidance_ placement of transfixing device(s) and intra-articular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0809T","description":"Arthrodesis_ sacroiliac joint_ percutaneous or minimally invasive (indirect visualization)_ with image guidance_ placement of transfixing device(s) and intra-articular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27560","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23105","description":"Remove shoulder joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVB1","description":"ICD-FCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28C","description":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES354","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of ankle bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28302","description":"Incision of ankle bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place cath subclavian art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36225","description":"Place cath subclavian art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPA1","description":"ICD-KEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom shape cvr hip disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5707","description":"Custom shape cvr hip disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEA1","description":"ICD-JIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ready gradient sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8424","description":"Ready gradient sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not receive cervical cytology or an HPV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9807","description":"Patients who did not receive cervical cytology or an HPV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVC0","description":"ICD-NCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLA0","description":"ICD-GFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ ERBB2 (HER2) copy number by FISH_ tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0009U","description":"Oncology (breast cancer)_ ERBB2 (HER2) copy number by FISH_ tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0235","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","description":"HCPCS-Q0235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDB1","description":"ICD-CBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOF1","description":"ICD-LHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX33","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33959","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep b vac injxn admin/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4149F","description":"Hep b vac injxn admin/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWF0","description":"ICD-PDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILD1","description":"ICD-MILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIC0","description":"ICD-FIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICA1","description":"ICD-IICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anal/urinary muscle study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51785","description":"Anal/urinary muscle study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAF0","description":"ICD-IIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing care not medically possible because the patient was  discharged early due to specific medical events_ documented in the medical record_ such as the patient became hosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1147","description":"Ongoing care not medically possible because the patient was  discharged early due to specific medical events_ documented in the medical record_ such as the patient became hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98006","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","description":"CPT-98006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKD1","description":"ICD-BAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trim nail(s) any number","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11719","description":"Trim nail(s) any number","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harvesting of donor multivis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2055","description":"Harvesting of donor multivis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXD1","description":"ICD-KGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genetic testing for severe inherited conditions (eg_ cystic fibrosis_ Ashkenazi Jewish-associated disorders [eg_ Bloom syndrome_ Canavan disease_ Fanconi anemia type C_ mucoli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81443","description":"Genetic testing for severe inherited conditions (eg_ cystic fibrosis_ Ashkenazi Jewish-associated disorders [eg_ Bloom syndrome_ Canavan disease_ Fanconi anemia type C_ mucoli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMA1","description":"ICD-FGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepa vacc ped/adol 3 dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90634","description":"Hepa vacc ped/adol 3 dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMC0","description":"ICD-NLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMF0","description":"ICD-MCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQD0","description":"ICD-CCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXC1","description":"ICD-NIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMF1","description":"ICD-OIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIF0","description":"ICD-KIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOF0","description":"ICD-LCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28C","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYD1","description":"ICD-LAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC03","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96165","description":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEC0","description":"ICD-MLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHF0","description":"ICD-MBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hmatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4134","description":"Hmatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB22","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALF0","description":"ICD-JALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYF1","description":"ICD-DHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9483","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla class ii semiquant panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86835","description":"Hla class ii semiquant panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28D","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBB0","description":"ICD-MIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoelectrophoresis assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86327","description":"Immunoelectrophoresis assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24147","description":"Partial removal of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEA1","description":"ICD-AFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQE1","description":"ICD-HIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implnt/abut remov dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6110","description":"Implnt/abut remov dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PABPN1 (poly[A] binding protein nuclear 1) (eg_ oculopharyngeal muscular dystrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81312","description":"PABPN1 (poly[A] binding protein nuclear 1) (eg_ oculopharyngeal muscular dystrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65765","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-precision abutment - placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6191","description":"Semi-precision abutment - placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRE1","description":"ICD-KBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy inject material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52327","description":"Cystoscopy inject material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDF0","description":"ICD-KGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFA0","description":"ICD-GAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 2 piece rigid shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0491","description":"Tlso 2 piece rigid shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOC1","description":"ICD-HEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); binding antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86041","description":"Acetylcholine receptor (AChR); binding antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61708","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDD1","description":"ICD-KFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUC0","description":"ICD-JIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ ep_ diag/abl_ 3d/vect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1732","description":"Cath_ ep_ diag/abl_ 3d/vect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Prostate)_ Mrna_ Microarray Gene Expression Profiling Of 22 Content Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported As Metastasis Risk S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81542","description":"Oncology (Prostate)_ Mrna_ Microarray Gene Expression Profiling Of 22 Content Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported As Metastasis Risk S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ (Nuwiq)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7209","description":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ (Nuwiq)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41112","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRE1","description":"ICD-PGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploratory heart surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33315","description":"Exploratory heart surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy ablate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45320","description":"Proctosigmoidoscopy ablate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMC1","description":"ICD-JDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22612","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPE1","description":"ICD-FCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGC0","description":"ICD-KEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug confirmation_ each procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6058","description":"Drug confirmation_ each procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29806","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tpa initi w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8600","description":"Tpa initi w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPE1","description":"ICD-KAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA245","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKD1","description":"ICD-ODKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLF1","description":"ICD-IDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSF0","description":"ICD-CCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystometrogram w/up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51727","description":"Cystometrogram w/up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRC1","description":"ICD-DIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G9871","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","description":"HCPCS-G9871","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJB1","description":"ICD-BCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGD1","description":"ICD-KFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAC1","description":"ICD-BDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mometasone sinus implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1090","description":"Mometasone sinus implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asthma discharge plan presnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5250F","description":"Asthma discharge plan presnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLF0","description":"ICD-GFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIA0","description":"ICD-GFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26372","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx px nfrosgrm &/urtrgrm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50431","description":"Njx px nfrosgrm &/urtrgrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPA0","description":"ICD-JHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28X","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit diuretic infus diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9361","description":"Hit diuretic infus diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKE1","description":"ICD-OEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice/home hlth_ place nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5009","description":"Hospice/home hlth_ place nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0539U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","description":"CPT-0539U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA25","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICB0","description":"ICD-MICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBE0","description":"ICD-OHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAE1","description":"ICD-FGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSB0","description":"ICD-GGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHC1","description":"ICD-IBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMB1","description":"ICD-CFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB115","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEF0","description":"ICD-IBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply rem fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20660","description":"Apply rem fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11A","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of biceps tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24340","description":"Repair of biceps tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albumin (human)_ 5%_ 250 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9045","description":"Albumin (human)_ 5%_ 250 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5125","description":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace implantable hrt syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053T","description":"Replace implantable hrt syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRD1","description":"ICD-KIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDB1","description":"ICD-NLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSC0","description":"ICD-KFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic lightbox tabletp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0203","description":"Therapeutic lightbox tabletp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phq-9 >9 during 12m time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9511","description":"Phq-9 >9 during 12m time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVE1","description":"ICD-FFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTE1","description":"ICD-EDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOA1","description":"ICD-GCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKB1","description":"ICD-CFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHD0","description":"ICD-OIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBF0","description":"ICD-NEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBD0","description":"ICD-FHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUF1","description":"ICD-EDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKB0","description":"ICD-KIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46942","description":"Treatment of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger)_ including ultrasound guidance_ when performed_ unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34713","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger)_ including ultrasound guidance_ when performed_ unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score hip pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8653","description":"Fun stat score hip pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB31","description":"ICD-3DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx gastr intub w/asp spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43754","description":"Dx gastr intub w/asp spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRB0","description":"ICD-PFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEME0","description":"ICD-BEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNE0","description":"ICD-JGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILA1","description":"ICD-AILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anter chamber intraocul lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2630","description":"Anter chamber intraocul lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKD0","description":"ICD-GGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immed max part dent metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5223","description":"Immed max part dent metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8001","description":"HCPCS-C8001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFC1","description":"ICD-GIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Long qt synd known fam var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81281","description":"Long qt synd known fam var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Valrubicin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9357","description":"Valrubicin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXA1","description":"ICD-BEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQE0","description":"ICD-PAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52281","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHC1","description":"ICD-BDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cst bse mtl inlay 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6604","description":"Cst bse mtl inlay 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCF0","description":"ICD-OJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYF0","description":"ICD-DDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teclistamab-cqyv_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9148","description":"Injection_ teclistamab-cqyv_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFB0","description":"ICD-NEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting_ including assessment_ referral to ongoing care_ and arranging access to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2213","description":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting_ including assessment_ referral to ongoing care_ and arranging access to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of ankle joint open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27870","description":"Fusion of ankle joint open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8B","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJA1","description":"ICD-CAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63275","description":"Bx/exc xdrl spine lesn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHD1","description":"ICD-FAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQA1","description":"ICD-PEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCND0","description":"ICD-FCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No rx ace/arb therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8937","description":"No rx ace/arb therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFB1","description":"ICD-KGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colpopexy extraperitoneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57282","description":"Colpopexy extraperitoneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD251","description":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLC0","description":"ICD-FCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"App topical fluoride varnish","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99188","description":"App topical fluoride varnish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25420","description":"Repair/graft radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01937","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","description":"CPT-01937","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYA1","description":"ICD-LIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTB0","description":"ICD-BBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAC0","description":"ICD-ACAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITD1","description":"ICD-CITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJC1","description":"ICD-GCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJC1","description":"ICD-NDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIE1","description":"ICD-GIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUE1","description":"ICD-OFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy br/wa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44381","description":"Small bowel endoscopy br/wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMF0","description":"ICD-ACMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Death occurring after discharge from the hospital but within 30 days post procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9816","description":"Death occurring after discharge from the hospital but within 30 days post procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTB1","description":"ICD-KBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69632","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE245","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Additive for enteral formula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4104","description":"Additive for enteral formula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive preoperative assessment performed for cataract surgery with i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0122U","description":"Comprehensive preoperative assessment performed for cataract surgery with i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast add lesion strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19082","description":"Bx breast add lesion strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1040T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1040T","description":"CPT-1040T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITC1","description":"ICD-KITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVF1","description":"ICD-JDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy shoulder tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23065","description":"Biopsy shoulder tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIC0","description":"ICD-JCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAA1","description":"ICD-KIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQF0","description":"ICD-KIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88016","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXC1","description":"ICD-KBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVC1","description":"ICD-BFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt prgrm for implt neurostim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8681","description":"Pt prgrm for implt neurostim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFND1","description":"ICD-KFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXF1","description":"ICD-NIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26236","description":"Partial removal finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBC0","description":"ICD-JIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMC0","description":"ICD-ACMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21A","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSC1","description":"ICD-PBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures rebase part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5720","description":"Dentures rebase part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIA1","description":"ICD-NHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRB1","description":"ICD-OGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25B","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCF0","description":"ICD-KDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow aspirate &biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0364","description":"Bone marrow aspirate &biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Is Using Palliative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9994","description":"Patient Is Using Palliative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMC0","description":"ICD-GEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit anti-tnf per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9359","description":"Hit anti-tnf per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Betadine/phisohex solution","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4246","description":"Betadine/phisohex solution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ekg for initial prevent exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0403","description":"Ekg for initial prevent exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVB0","description":"ICD-NAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVA0","description":"ICD-BEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGA0","description":"ICD-KHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRC1","description":"ICD-PJRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBF0","description":"ICD-EFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert emergency airway","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31500","description":"Insert emergency airway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMA1","description":"ICD-BFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIF0","description":"ICD-AGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDD0","description":"ICD-NDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMB0","description":"ICD-GAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIF1","description":"ICD-MBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bp out of nrml limits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9274","description":"Bp out of nrml limits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj benztropine mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0515","description":"Inj benztropine mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUB0","description":"ICD-NLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHD0","description":"ICD-JGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLB0","description":"ICD-OFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIB0","description":"ICD-MBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXE0","description":"ICD-BFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQA1","description":"ICD-OHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD236","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelets_ hla-m_ l/r_ unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9052","description":"Platelets_ hla-m_ l/r_ unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and atherectomy_ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9766","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and atherectomy_ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6073","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNA1","description":"ICD-BHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1001T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","description":"CPT-1001T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2106","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLB1","description":"ICD-CDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove aortic assist device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33968","description":"Remove aortic assist device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMC1","description":"ICD-IEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"non - surgical sialolithotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7979","description":"non - surgical sialolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physical therapy treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97039","description":"Physical therapy treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSF0","description":"ICD-CGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23921","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUF1","description":"ICD-CHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg/ankle surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27899","description":"Leg/ankle surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRF1","description":"ICD-KHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20D","description":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBD1","description":"ICD-IIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23505","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPC0","description":"ICD-FCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMC0","description":"ICD-JGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQE1","description":"ICD-KDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRD1","description":"ICD-PFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJC0","description":"ICD-NKJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJF1","description":"ICD-NGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDC1","description":"ICD-ACDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA11","description":"ICD-3KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary hvy plstc pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4382","description":"Urinary hvy plstc pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cad meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8498","description":"Cad meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24D","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUB1","description":"ICD-KHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Testosterone pellet 75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0189","description":"Testosterone pellet 75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPA1","description":"ICD-KBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBD1","description":"ICD-EBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g._ pregnancy_ history of angioedema to ace-i_ oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1201","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g._ pregnancy_ history of angioedema to ace-i_ oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVB0","description":"ICD-CIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARF0","description":"ICD-HARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4B","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYA0","description":"ICD-OKYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pros info op rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9304","description":"Pros info op rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBB1","description":"ICD-EIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEC0","description":"ICD-MCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNF0","description":"ICD-CDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB244","description":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEF0","description":"ICD-GAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMA0","description":"ICD-NIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm adult fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4010","description":"Cast sup sht arm adult fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical social work mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0066","description":"Clinical social work mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBB1","description":"ICD-CHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC21","description":"ICD-2IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGE0","description":"ICD-KBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAC0","description":"ICD-MAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9898","description":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVC0","description":"ICD-BGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHB1","description":"ICD-IIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLA0","description":"ICD-GBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNF0","description":"ICD-GCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUE1","description":"ICD-NAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKA0","description":"ICD-BAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of arm artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35045","description":"Repair defect of arm artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBED0","description":"ICD-CBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBB1","description":"ICD-MDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIE1","description":"ICD-MBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBF1","description":"ICD-MEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vis 20/40/> w/in 90 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4175F","description":"Vis 20/40/> w/in 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAC1","description":"ICD-KBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBC1","description":"ICD-GDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCB1","description":"ICD-EHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Agalsidase beta injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0180","description":"Agalsidase beta injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAA0","description":"ICD-FGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64610","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ovulation mgmt per cycle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4042","description":"Ovulation mgmt per cycle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracranial uni/ltd study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93882","description":"Extracranial uni/ltd study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIE1","description":"ICD-GHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXC1","description":"ICD-CBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD245","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MYD88 (myeloid differentiation primary response 88) (eg_ Waldenstrom_s macroglobulinemia_ lymphoplasmacytic leukemia) gene analysis_ p.Leu265Pro (L265P) variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81305","description":"MYD88 (myeloid differentiation primary response 88) (eg_ Waldenstrom_s macroglobulinemia_ lymphoplasmacytic leukemia) gene analysis_ p.Leu265Pro (L265P) variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVF0","description":"ICD-FGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9943","description":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo unilat torsion ball br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2090","description":"Hkafo unilat torsion ball br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACB0","description":"ICD-GACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant connecting bar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6055","description":"Implant connecting bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYB1","description":"ICD-LAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAB0","description":"ICD-FAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA51","description":"Very High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUC1","description":"ICD-JCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMD1","description":"ICD-IEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Integra meshed bil wound mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9363","description":"Integra meshed bil wound mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDD1","description":"ICD-AGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHF0","description":"ICD-MEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0540","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","description":"HCPCS-G0540","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD240","description":"Clinically Complex _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72147","description":"MRI chest spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD255","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dexrazoxane hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1190","description":"Dexrazoxane hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 3 MCG TRS-SUCR","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91308","description":"SARSCOV2 VAC 3 MCG TRS-SUCR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50715","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYE0","description":"ICD-GBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYE1","description":"ICD-OIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9804","description":"Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","description":"CPT-92638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX40","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCD0","description":"ICD-OCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0237","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","description":"HCPCS-Q0237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fats/lipids feces quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82710","description":"Fats/lipids feces quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66605","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP)_ urine_ reported as likelihood of blad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0452U","description":"Oncology (bladder)_ methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP)_ urine_ reported as likelihood of blad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who have had a hysterectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9774","description":"Patients who have had a hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQD0","description":"ICD-KDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUC0","description":"ICD-CAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFC0","description":"ICD-GGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35182","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4030F","description":"Oxygen therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18G","description":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86710","description":"Influenza virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep ak ischial thermo mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5580","description":"Prep ak ischial thermo mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metaproterenol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7667","description":"Metaproterenol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair wide w/ leg rests","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1092","description":"Wheelchair wide w/ leg rests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methylenedioxyamphetamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80359","description":"Methylenedioxyamphetamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rolapitant_ oral_ 1mg (Varubi)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9981","description":"Rolapitant_ oral_ 1mg (Varubi)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Influenza","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87804","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Influenza","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHB1","description":"ICD-GFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHB0","description":"ICD-JCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuromuscular reeducation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97112","description":"Neuromuscular reeducation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8046","description":"Partial facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2027","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","description":"HCPCS-A2027","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aducanumab-avwa_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0172","description":"Injection_ aducanumab-avwa_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIA0","description":"ICD-IDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUE0","description":"ICD-MBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter implantation of coronary sinus reduction device including vascular access and closure_ right heart catheterization_ venous angiography_ coronary sinus angiograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0645T","description":"Transcatheter implantation of coronary sinus reduction device including vascular access and closure_ right heart catheterization_ venous angiography_ coronary sinus angiograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hg a1c level 7.0-9.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3045F","description":"Hg a1c level 7.0-9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sysrsn no dicom srch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9344","description":"Sysrsn no dicom srch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDA1","description":"ICD-EGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERD1","description":"ICD-DERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOE1","description":"ICD-OHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Piflufolastat F-18_ Diagnostic_ 1 Millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9595","description":"Piflufolastat F-18_ Diagnostic_ 1 Millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL41","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dynamic fine wire emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96003","description":"Dynamic fine wire emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had a transplant prior to initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1262","description":"Patients who had a transplant prior to initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAB1","description":"ICD-MEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAE1","description":"ICD-ODAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUB1","description":"ICD-OBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAA0","description":"ICD-OJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXF1","description":"ICD-KDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4348","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","description":"HCPCS-Q4348","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB131","description":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLC0","description":"ICD-NDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch clsd w/o bar w filtr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4418","description":"Ost pch clsd w/o bar w filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient is not on a statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9797","description":"Patient is not on a statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor viii vw antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85246","description":"Clot factor viii vw antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJA1","description":"ICD-FIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33362","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNC0","description":"ICD-OCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSD1","description":"ICD-LBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9807","description":"HCPCS-C9807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNE1","description":"ICD-BBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise lip or cheek fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40819","description":"Excise lip or cheek fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQE1","description":"ICD-OKQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso s/c shell/panel prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0639","description":"Lso s/c shell/panel prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ceftriaxone sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0696","description":"Ceftriaxone sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDA1","description":"ICD-NCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-prxd rsk et al docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3018F","description":"Pre-prxd rsk et al docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQC1","description":"ICD-HEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJE1","description":"ICD-ODJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8I","description":"Medium Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMD0","description":"ICD-GEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45905","description":"Dilation of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10A","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHF1","description":"ICD-OCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12B","description":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor liver whole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47143","description":"Prep donor liver whole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRB0","description":"ICD-KFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAF1","description":"ICD-IFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSB0","description":"ICD-HHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLB0","description":"ICD-IFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUD1","description":"ICD-NDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLD0","description":"ICD-MDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth pharyngeal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17451","description":"Anesth pharyngeal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67105","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIE0","description":"ICD-JEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001M","description":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug/bio noc part b drug cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4082","description":"Drug/bio noc part b drug cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sp bone agrft local add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20936","description":"Sp bone agrft local add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBF0","description":"ICD-IGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic sock multi ply ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8430","description":"Prosthetic sock multi ply ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pilonidal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10080","description":"Drainage of pilonidal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNE0","description":"ICD-FDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGF0","description":"ICD-GIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITC0","description":"ICD-CITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88366","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXA1","description":"ICD-OKXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIB0","description":"ICD-MGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIED1","description":"ICD-MIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMD0","description":"ICD-OCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISF1","description":"ICD-KISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computer-Aided Mapping Of Cervix Uteri During Colposcopy_ Including Optical Dynamic Spectral Imaging And Algorithmic Quantification Of The Acetowhitening Effect (List Separate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57465","description":"Computer-Aided Mapping Of Cervix Uteri During Colposcopy_ Including Optical Dynamic Spectral Imaging And Algorithmic Quantification Of The Acetowhitening Effect (List Separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tissue expander(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11960","description":"Insert tissue expander(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1305","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA11","description":"ICD-1LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEE0","description":"ICD-KCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unspecified preventive proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1999","description":"Unspecified preventive proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2043","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","description":"HCPCS-A2043","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health Care Practitioners Rendering Treatment In Place (Tip)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2021","description":"Health Care Practitioners Rendering Treatment In Place (Tip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTE0","description":"ICD-GGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec knee-shin swing/stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5856","description":"Elec knee-shin swing/stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEB0","description":"ICD-NHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGE1","description":"ICD-GCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0918T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","description":"CPT-0918T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biovance tri-layer or biovance 3l_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4283","description":"Biovance tri-layer or biovance 3l_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB141","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indiv pdc not > 0.8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9513","description":"Indiv pdc not > 0.8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQC0","description":"ICD-PCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBD1","description":"ICD-MCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA256","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGC0","description":"ICD-JGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHE0","description":"ICD-BEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht muscle image spect mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78452","description":"Ht muscle image spect mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOA1","description":"ICD-KGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8D","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDF0","description":"ICD-FCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJE1","description":"ICD-CAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDE1","description":"ICD-NJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac mgmt pt opt alterna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9059","description":"Onc prac mgmt pt opt alterna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0007","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sho lift taper to metatarsal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3300","description":"Sho lift taper to metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXC1","description":"ICD-FDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCE1","description":"ICD-EDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQC0","description":"ICD-OHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJD0","description":"ICD-NHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA45","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNB1","description":"ICD-GFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBE0","description":"ICD-BIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr adpt pneum vad_ rep veh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0504","description":"Pwr adpt pneum vad_ rep veh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gonadorelin hydroch/ 100 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1620","description":"Gonadorelin hydroch/ 100 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVE0","description":"ICD-GIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECME0","description":"ICD-ECME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28450","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plan care lipid control docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0556F","description":"Plan care lipid control docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23C","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24535","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWE0","description":"ICD-KGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDF0","description":"ICD-NKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip joint adjustable flexion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2622","description":"Hip joint adjustable flexion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions)_ DNA_ 22 drug metabolism and transporter genes_ real-time PCR_ blood or buccal swab_ genotype and metabolizer status for therapeutic d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015U","description":"Drug metabolism (adverse drug reactions)_ DNA_ 22 drug metabolism and transporter genes_ real-time PCR_ blood or buccal swab_ genotype and metabolizer status for therapeutic d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5913","description":"Nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJF1","description":"ICD-JAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled air analysis o2/co2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94681","description":"Exhaled air analysis o2/co2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYD0","description":"ICD-LFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXD0","description":"ICD-GAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWF1","description":"ICD-OCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27825","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Daptomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0878","description":"Daptomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sterile gauze <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6402","description":"Sterile gauze <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAA0","description":"ICD-JAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1736","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1736","description":"HCPCS-C1736","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBE1","description":"ICD-JFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHE0","description":"ICD-OFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAME1","description":"ICD-IAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9897","description":"Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYF1","description":"ICD-HHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Air fluidized bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0194","description":"Air fluidized bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ copy number variants_ common variants with reflex to targeted sequence anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0028U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ copy number variants_ common variants with reflex to targeted sequence anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mon cable elec/pneum vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0486","description":"Mon cable elec/pneum vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9818","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9818","description":"HCPCS-C9818","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOE0","description":"ICD-OFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASA1","description":"ICD-PASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCF1","description":"ICD-FGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWA0","description":"ICD-OGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCC1","description":"ICD-IGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLC1","description":"ICD-MFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKC1","description":"ICD-BGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lang express current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9162","description":"Lang express current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth facial bone surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19251","description":"Anesth facial bone surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc viral load <200","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9243","description":"Doc viral load <200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAD1","description":"ICD-KAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELF1","description":"ICD-AELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFC1","description":"ICD-NGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTB0","description":"ICD-EFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27334","description":"Remove knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1492","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","description":"HCPCS-M1492","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11760","description":"Repair of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBC0","description":"ICD-JFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immune complex assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86332","description":"Immune complex assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy thru stoma spx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44388","description":"Colonoscopy thru stoma spx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOA1","description":"ICD-PJOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA21","description":"ICD-2KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytomeg dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87495","description":"Cytomeg dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBC1","description":"ICD-KDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAE1","description":"ICD-FDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL16","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFD1","description":"ICD-GDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBD0","description":"ICD-JEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGD0","description":"ICD-NAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA240","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELF1","description":"ICD-CELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEE0","description":"ICD-FGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXE0","description":"ICD-GFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDB0","description":"ICD-BCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01951","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","description":"CPT-01951","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not recvng antiv hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4151F","description":"Pt not recvng antiv hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB236","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSB1","description":"ICD-GDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct scan for therapy guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77014","description":"Ct scan for therapy guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj trimetrexate glucoronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3305","description":"Inj trimetrexate glucoronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20D","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSA0","description":"ICD-HHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug_ generic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5000","description":"Prescription drug_ generic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGD0","description":"ICD-FCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE251","description":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSA1","description":"ICD-HHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTD0","description":"ICD-BGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj estrogen conjugate 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1410","description":"Inj estrogen conjugate 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vacc 3 dose immunsup im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90740","description":"Hepb vacc 3 dose immunsup im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUC0","description":"ICD-MLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIA0","description":"ICD-EBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peginesatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0890","description":"Peginesatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOC0","description":"ICD-HGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28555","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"John cunningham antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86711","description":"John cunningham antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17284","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRD0","description":"ICD-PFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBB0","description":"ICD-GFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ncntc r-t fluor wnd img 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0598T","description":"Ncntc r-t fluor wnd img 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCC1","description":"ICD-MHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interdental fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21110","description":"Interdental fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAID0","description":"ICD-JAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDC0","description":"ICD-JHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43825","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temp fml iu vlv-pmp 1st insj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0596T","description":"Temp fml iu vlv-pmp 1st insj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATA1","description":"ICD-BATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extraoral posterior image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0251","description":"Extraoral posterior image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWB1","description":"ICD-DEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAID1","description":"ICD-EAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-97009","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","description":"CPT-97009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEC0","description":"ICD-IGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPD1","description":"ICD-CBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX56","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval cardiac modulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0417T","description":"Prgrmg eval cardiac modulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFD0","description":"ICD-OFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCE0","description":"ICD-JHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHB1","description":"ICD-OCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIF1","description":"ICD-IBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWE1","description":"ICD-CCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ONC BRST CA DNA PIK3CA 11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0177U","description":"ONC BRST CA DNA PIK3CA 11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLD0","description":"ICD-KBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammo result com to pt 5 day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5062F","description":"Mammo result com to pt 5 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aerosol inhalation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94642","description":"Aerosol inhalation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDC0","description":"ICD-CGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJF1","description":"ICD-OAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUE0","description":"ICD-CDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJA1","description":"ICD-BFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEA1","description":"ICD-EFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBE0","description":"ICD-BEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAA1","description":"ICD-GAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIF0","description":"ICD-EIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJC1","description":"ICD-CDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVD1","description":"ICD-JHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastroenterology (Barrett esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 DNA methylation analysis using PCR_ formalin-fixed paraffin-embedded (FFPE) tissue_ algorithm reported as risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0398U","description":"Gastroenterology (Barrett esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 DNA methylation analysis using PCR_ formalin-fixed paraffin-embedded (FFPE) tissue_ algorithm reported as risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMB1","description":"ICD-CDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSA0","description":"ICD-OJSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCF0","description":"ICD-MJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transverse aortic arch graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33870","description":"Transverse aortic arch graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYB1","description":"ICD-CCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11310","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBE0","description":"ICD-NLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABC1","description":"ICD-AABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOF1","description":"ICD-GGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4365","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","description":"HCPCS-Q4365","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Counterimmunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86185","description":"Counterimmunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ercp ea duct/ampulla dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43277","description":"Ercp ea duct/ampulla dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Omental flap intra-abdom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49905","description":"Omental flap intra-abdom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA141","description":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHME1","description":"ICD-EHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMB0","description":"ICD-EBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDD1","description":"ICD-IGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRE0","description":"ICD-CIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFND0","description":"ICD-CFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITC0","description":"ICD-KITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEE1","description":"ICD-NHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ each additional 15 minutes_ provided remotely by hospital staff who are licensed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7902","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ each additional 15 minutes_ provided remotely by hospital staff who are licensed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUD1","description":"ICD-IBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJA0","description":"ICD-JIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crgvr prov w/ ed addl rsrcs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4322F","description":"Crgvr prov w/ ed addl rsrcs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 22 targets (Campylobacter [C. jejuni/C. coli/C.","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0097U","description":"Gastrointestinal pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 22 targets (Campylobacter [C. jejuni/C. coli/C.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove by ligat int hem grps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46946","description":"Remove by ligat int hem grps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGB1","description":"ICD-KFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNF1","description":"ICD-JFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0404","description":"HCPCS-B0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Atten current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9165","description":"Atten current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHC0","description":"ICD-CHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVD0","description":"ICD-KIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDE0","description":"ICD-JEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below knee acrylic socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5629","description":"Below knee acrylic socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKA1","description":"ICD-NIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERB0","description":"ICD-OERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHND1","description":"ICD-KHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colon ca scrn; barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0122","description":"Colon ca scrn; barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQC1","description":"ICD-PHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIA1","description":"ICD-IEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Administration of home sleep apnea test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9956","description":"Administration of home sleep apnea test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00922","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","description":"CPT-00922","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYA1","description":"ICD-LHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITB0","description":"ICD-AITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67101","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelet survival","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78191","description":"Platelet survival","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln part maxil chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5740","description":"Denture reln part maxil chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ncntc r-t fluor wnd img ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0599T","description":"Ncntc r-t fluor wnd img ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glycopyrrolate comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7643","description":"Glycopyrrolate comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOA1","description":"ICD-PEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobramycin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3260","description":"Tobramycin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frozen blood prep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86930","description":"Frozen blood prep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLC1","description":"ICD-IGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15953","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELF1","description":"ICD-NELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Streptomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3000","description":"Streptomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLB1","description":"ICD-KFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYD1","description":"ICD-OBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-38225","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","description":"CPT-38225","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21083","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKD1","description":"ICD-FEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXE1","description":"ICD-FCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPA0","description":"ICD-CAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cell cryopreserve/storage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88240","description":"Cell cryopreserve/storage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt recvd aspirin w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4563F","description":"Pt recvd aspirin w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with ligation of sphenopalatine artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31241","description":"Nasal/sinus endoscopy_ surgical; with ligation of sphenopalatine artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAE1","description":"ICD-MBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAF0","description":"ICD-OEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITA0","description":"ICD-JITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl nasal pillow comb mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7029","description":"Repl nasal pillow comb mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSC1","description":"ICD-LGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBD1","description":"ICD-MLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTC1","description":"ICD-BFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVF1","description":"ICD-FAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPB0","description":"ICD-NLPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transport parking fees/tolls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0170","description":"Transport parking fees/tolls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove contraceptive capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11976","description":"Remove contraceptive capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDND0","description":"ICD-NDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mandibular flange prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5934","description":"Mandibular flange prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUB0","description":"ICD-EHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDE1","description":"ICD-GEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subtalar arthro w/fb rmvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29904","description":"Subtalar arthro w/fb rmvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAF0","description":"ICD-MFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVC0","description":"ICD-NGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDD0","description":"ICD-KFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITF0","description":"ICD-EITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68362","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Child sitting services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1009","description":"Child sitting services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Detect agent nos dna amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87798","description":"Detect agent nos dna amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSC1","description":"ICD-KBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAND0","description":"ICD-JAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC20","description":"Medium Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise breast duct fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19112","description":"Excise breast duct fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMF0","description":"ICD-IEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36012","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dextroamphetamine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0160","description":"Dextroamphetamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0115U","description":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ image analysis of at least 128 histologic features and clinical factors_ prognostic algorithm determining the risk of distant metastases_ and prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0376U","description":"Oncology (prostate cancer)_ image analysis of at least 128 histologic features and clinical factors_ prognostic algorithm determining the risk of distant metastases_ and prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1933","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","description":"HCPCS-L1933","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEA1","description":"ICD-KFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0017","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPE0","description":"ICD-OJPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGB1","description":"ICD-BIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extension per extension per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2760","description":"Extension per extension per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ torso/shoulder_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6569","description":"Gradient compression garment_ torso/shoulder_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22A","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIB1","description":"ICD-ACIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL32","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA224","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Angiotensin i enzyme test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82164","description":"Angiotensin i enzyme test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens trifocal seg width > 28","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2319","description":"Lens trifocal seg width > 28","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHB0","description":"ICD-IAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHB1","description":"ICD-FBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 21_ and 18) DNA sequence analysis of selected reg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0112U","description":"Fetal aneuploidy (trisomy 21_ and 18) DNA sequence analysis of selected reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip socket fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27220","description":"Treat hip socket fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEF1","description":"ICD-GBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWE0","description":"ICD-HHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIB1","description":"ICD-FFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUC0","description":"ICD-OIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRB0","description":"ICD-GIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy w/biopsy(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31625","description":"Bronchoscopy w/biopsy(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75978","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSF1","description":"ICD-GHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (fungi)_ fungal pathogen identification_ DNA (15 fungal targets)_ blood culture_ amplified probe technique_ each target reported as detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0140U","description":"Infectious disease (fungi)_ fungal pathogen identification_ DNA (15 fungal targets)_ blood culture_ amplified probe technique_ each target reported as detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRB0","description":"ICD-OJRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sec art thrombectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37186","description":"Sec art thrombectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVC0","description":"ICD-KFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whole mitochondrial genome","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81460","description":"Whole mitochondrial genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPD0","description":"ICD-OHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL23","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNC1","description":"ICD-FFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulm fx w/in 12 mon b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3038F","description":"Pulm fx w/in 12 mon b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHF1","description":"ICD-AAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKA1","description":"ICD-OHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29844","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon t1-4 no dx prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9086","description":"Onc dx colon t1-4 no dx prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKA0","description":"ICD-BGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDB1","description":"ICD-FDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam/fabric leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5114","description":"Foam/fabric leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart flow reserve measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93571","description":"Heart flow reserve measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEB1","description":"ICD-OIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hsv dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87529","description":"Hsv dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSC1","description":"ICD-GDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31365","description":"Removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise vag graft open abd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57296","description":"Revise vag graft open abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCA0","description":"ICD-GGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQD0","description":"ICD-HFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTE1","description":"ICD-BHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFME0","description":"ICD-OFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIE1","description":"ICD-GFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQE1","description":"ICD-GFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous stimulation or sens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33279","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous stimulation or sens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4A","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver disease_ 10 biochemical assays (a2-macroglobulin_ haptoglobin_ apolipoprotein A1_ bilirubin_ GGT_ ALT_ AST_ triglycerides_ cholesterol_ fasting glucose) and biometric an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0166U","description":"Liver disease_ 10 biochemical assays (a2-macroglobulin_ haptoglobin_ apolipoprotein A1_ bilirubin_ GGT_ ALT_ AST_ triglycerides_ cholesterol_ fasting glucose) and biometric an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD206","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Idet single level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22526","description":"Idet single level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA20","description":"Very High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fosphenytoin sodi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0078","description":"Injection_ fosphenytoin sodi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysat sol fld vol > 999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4721","description":"Dialysat sol fld vol > 999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recement cast or prefab post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2915","description":"Recement cast or prefab post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX11","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB21","description":"ICD-1JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvef < 40% or lvsd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8923","description":"Lvef < 40% or lvsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No record of HBV results documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9915","description":"No record of HBV results documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous breast biopsies using magnetic resonance guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7502","description":"Percutaneous breast biopsies using magnetic resonance guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXA0","description":"ICD-KHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0271T","description":"Rev/remvl crtd sns dev gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA43","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIF0","description":"ICD-JEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIA0","description":"ICD-OJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRF0","description":"ICD-OJRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJA1","description":"ICD-GAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cl mult vsd w/rem pul band","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33677","description":"Cl mult vsd w/rem pul band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTF1","description":"ICD-GHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHC0","description":"ICD-OBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOE0","description":"ICD-CIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incis spine 3 column lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22207","description":"Incis spine 3 column lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2053","description":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIA0","description":"ICD-JHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRE1","description":"ICD-CCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCA0","description":"ICD-OGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periton dialysis plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0507F","description":"Periton dialysis plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPD0","description":"ICD-KIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAB0","description":"ICD-FIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal t3 n0 no prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9091","description":"Onc dx rectal t3 n0 no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVF0","description":"ICD-BBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41016","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Renal biopsy perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50200","description":"Renal biopsy perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc prostate prob score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0010M","description":"Onc prostate prob score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVC1","description":"ICD-OGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNF0","description":"ICD-JDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62281","description":"Treat spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis_ cell-free DNA_ initial (baseline) assessment to determine a patient specific panel for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0306U","description":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis_ cell-free DNA_ initial (baseline) assessment to determine a patient specific panel for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5148","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","description":"HCPCS-Q5148","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient_s current functional status when there is a documented change;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97172","description":"Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient_s current functional status when there is a documented change;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hippotherapy per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8940","description":"Hippotherapy per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXE1","description":"ICD-CAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop app non-wgt bear dsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5460","description":"Postop app non-wgt bear dsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDE1","description":"ICD-NIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"remove erupted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7210","description":"remove erupted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXB1","description":"ICD-BHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXE1","description":"ICD-BFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDE1","description":"ICD-BCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54125","description":"Removal of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cultr oocyte/embryo <4 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89251","description":"Cultr oocyte/embryo <4 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFD1","description":"ICD-BAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped crit care age 2-5 init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99475","description":"Ped crit care age 2-5 init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLE0","description":"ICD-EGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYD0","description":"ICD-CHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not rcvng esa thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4172F","description":"Pt not rcvng esa thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria w/bypass add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33259","description":"Ablate atria w/bypass add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC41","description":"Very High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic implant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8699","description":"Prosthetic implant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHC0","description":"ICD-JHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIE0","description":"ICD-JGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRB1","description":"ICD-DGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSC1","description":"ICD-DGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJE0","description":"ICD-CFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILC0","description":"ICD-CILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2B","description":"Low Rehab_ ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFC1","description":"ICD-JGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Agglutinins febrile antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86000","description":"Agglutinins febrile antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTB0","description":"ICD-ABTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAB1","description":"ICD-AEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRF1","description":"ICD-DGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKE0","description":"ICD-JAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUD0","description":"ICD-JCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUA1","description":"ICD-JFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWE1","description":"ICD-DHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOE1","description":"ICD-DEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES331","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cst hgh nble mtl inlay 2 srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6602","description":"Cst hgh nble mtl inlay 2 srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy with injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9742","description":"Laryngoscopy with injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cxr doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3006F","description":"Cxr doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBD1","description":"ICD-MDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whole blood for transfusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9010","description":"Whole blood for transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRA0","description":"ICD-CDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXD1","description":"ICD-KFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBB0","description":"ICD-AEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHC0","description":"ICD-MBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPD1","description":"ICD-CCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3C","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEA0","description":"ICD-NDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peak expiratory flow rate (p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8110","description":"Peak expiratory flow rate (p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ burosumab-twza_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0584","description":"Injection_ burosumab-twza_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3C","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD224","description":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB134","description":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dna antibody native","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86225","description":"Dna antibody native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise foot tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28088","description":"Excise foot tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ppps_ subseq visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0439","description":"Ppps_ subseq visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht musc image planar mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78454","description":"Ht musc image planar mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of foot tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28226","description":"Release of foot tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology tx decision-mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9051","description":"Oncology tx decision-mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove esophagus obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74235","description":"Remove esophagus obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leishmania antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86717","description":"Leishmania antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGE1","description":"ICD-GHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysate solution_ non-dex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4728","description":"Dialysate solution_ non-dex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA245","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLD0","description":"ICD-CHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA60","description":"Medium Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCA0","description":"ICD-IDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAB0","description":"ICD-FGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA50","description":"Very High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAF1","description":"ICD-IHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ microarray gene expression profiling of 70 content genes and 465 housekeeping genes_ utilizing fresh frozen or formalin-fixed paraffin-embedded tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81521","description":"Oncology (breast)_ mRNA_ microarray gene expression profiling of 70 content genes and 465 housekeeping genes_ utilizing fresh frozen or formalin-fixed paraffin-embedded tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBB0","description":"ICD-IDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICE1","description":"ICD-BICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Accessory for gradient compression garment or wrap with adjustable straps_ non-otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6593","description":"Accessory for gradient compression garment or wrap with adjustable straps_ non-otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01963","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","description":"CPT-01963","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis glass test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81020","description":"Urinalysis glass test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBE0","description":"ICD-ACBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELD0","description":"ICD-GELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFF0","description":"ICD-BDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biodfence dryflex_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4138","description":"Biodfence dryflex_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self-mgmt educ/train 5-8 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98962","description":"Self-mgmt educ/train 5-8 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEED1","description":"ICD-EEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC117","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAB1","description":"ICD-CGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOB1","description":"ICD-PJOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA34","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Fixed Unilateral Space Maintainer - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1556","description":"Removal Of Fixed Unilateral Space Maintainer - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSE0","description":"ICD-LFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBE0","description":"ICD-KDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath ren art 1st unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36251","description":"Ins cath ren art 1st unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asympt carot/vrtbrbas sten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9005F","description":"Asympt carot/vrtbrbas sten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance; prostate volume greater or equal to 50 mL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0867T","description":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance; prostate volume greater or equal to 50 mL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETE1","description":"ICD-AETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYB0","description":"ICD-OJYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colchicine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0760","description":"Colchicine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJE1","description":"ICD-BEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0304","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0304","description":"CDT-D0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFF0","description":"ICD-GHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Filtered speech hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92571","description":"Filtered speech hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBB0","description":"ICD-NGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDF0","description":"ICD-IIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTD1","description":"ICD-FBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ spesolimab-sbzo_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1747","description":"Injection_ spesolimab-sbzo_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBF1","description":"ICD-ICBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30000","description":"Drainage of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDB0","description":"ICD-BGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ana crown exp 4 or> per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4230","description":"Ana crown exp 4 or> per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4542","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resin infiltration of lesion","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2990","description":"Resin infiltration of lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc cryo ablate renal tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50593","description":"Perc cryo ablate renal tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Particle agglut antbdy titr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86406","description":"Particle agglut antbdy titr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGD1","description":"ICD-FCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26665","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect hip tum incl acetabul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27076","description":"Resect hip tum incl acetabul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUF0","description":"ICD-BIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEC0","description":"ICD-IBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVA0","description":"ICD-JDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSB1","description":"ICD-LGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUD1","description":"ICD-GIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNC1","description":"ICD-GFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8E","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIE1","description":"ICD-NCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADB0","description":"ICD-KADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epsd bk pain for >6 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1135F","description":"Epsd bk pain for >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SEPT9 (Septin9) (eg_ colorectal cancer) methylation analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81327","description":"SEPT9 (Septin9) (eg_ colorectal cancer) methylation analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ benralizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9466","description":"Injection_ benralizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAC0","description":"ICD-GEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable liner/shield/pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4535","description":"Disposable liner/shield/pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHF1","description":"ICD-IEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYF0","description":"ICD-OKYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAE0","description":"ICD-ECAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABE0","description":"ICD-FABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWC1","description":"ICD-PCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGE1","description":"ICD-FEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62256","description":"Remove brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE240","description":"Special Care High _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANB1","description":"ICD-NANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of ureter & kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50740","description":"Fusion of ureter & kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65880","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of skull seams","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61552","description":"Release of skull seams","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELC1","description":"ICD-FELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABB1","description":"ICD-BABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bilobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32482","description":"Bilobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26235","description":"Partial removal finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOA1","description":"ICD-OFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNA1","description":"ICD-KGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAA1","description":"ICD-MEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDE0","description":"ICD-NCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWC0","description":"ICD-HIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXE1","description":"ICD-OJXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/ch access det adj armrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0973","description":"W/ch access det adj armrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ lyophilized_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9319","description":"Injection_ romidepsin_ lyophilized_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMA1","description":"ICD-IDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPD0","description":"ICD-KBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr wc dr wh motor/gear comb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2370","description":"Pwr wc dr wh motor/gear comb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp ilio-celiac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35632","description":"Art byp ilio-celiac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15951","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11A","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKD0","description":"ICD-JEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/biopsy eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67400","description":"Explore/biopsy eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEE1","description":"ICD-BAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYD1","description":"ICD-PIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDID0","description":"ICD-JDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBF1","description":"ICD-ODBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMA1","description":"ICD-KIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATE1","description":"ICD-FATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aerosol compressor adjust pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0572","description":"Aerosol compressor adjust pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Melatonin levels test_ sleep study_ 7 or 9 sample melatonin profile (cortisol optional)_ enzyme-linked immunosorbent assay (ELISA)_ saliva_ screening/preliminary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0462U","description":"Melatonin levels test_ sleep study_ 7 or 9 sample melatonin profile (cortisol optional)_ enzyme-linked immunosorbent assay (ELISA)_ saliva_ screening/preliminary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (warfarin drug response)_ targeted sequence analysis (ie_ CYP2C9_ CYP4F2_ VKORC1_ rs12777823)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0030U","description":"Drug metabolism (warfarin drug response)_ targeted sequence analysis (ie_ CYP2C9_ CYP4F2_ VKORC1_ rs12777823)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy bilobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32670","description":"Thoracoscopy bilobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQA1","description":"ICD-CIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rep partial denture clasp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5630","description":"Rep partial denture clasp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFD0","description":"ICD-NEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - comprehensive series of radiographic images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0372","description":"intraoral tomosynthesis - comprehensive series of radiographic images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX12","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc leukocytes reduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9016","description":"Rbc leukocytes reduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANA0","description":"ICD-OANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/o dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8932","description":"Mra_ w/o dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of rectal narrowing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45910","description":"Dilation of rectal narrowing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tagraxofusp-erzs_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9269","description":"Injection_ tagraxofusp-erzs_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice continuous home care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2043","description":"Hospice continuous home care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWE0","description":"ICD-OGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric electric hook","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7045","description":"Pediatric electric hook","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHC1","description":"ICD-JEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKC0","description":"ICD-CFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE244","description":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB114","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vaginal hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94451","description":"Anesth vaginal hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFD1","description":"ICD-FGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPC0","description":"ICD-FGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair_ any appr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49623","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair_ any appr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGC1","description":"ICD-NCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total or near total esophagectomy_ with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy_ with or without pyloroplasty (ie_ McKeown esophagectomy or tri-i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43112","description":"Total or near total esophagectomy_ with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy_ with or without pyloroplasty (ie_ McKeown esophagectomy or tri-i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Personal Emergency Response System (Installation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1894","description":"Personal Emergency Response System (Installation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHD0","description":"ICD-GDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPE1","description":"ICD-GCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBF0","description":"ICD-KBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINF1","description":"ICD-BINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77290","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVC1","description":"ICD-KAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKA0","description":"ICD-FDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronch ebus samplng 3/> node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31653","description":"Bronch ebus samplng 3/> node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHD1","description":"ICD-NFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAE0","description":"ICD-JFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ prostate cancer_ mRNA expression assay of 12 genes (10 content and 2 housekeeping)_ RT-PCR test utilizing blood plasma and/or urine_ algorithms to predict high-grade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011M","description":"Oncology_ prostate cancer_ mRNA expression assay of 12 genes (10 content and 2 housekeeping)_ RT-PCR test utilizing blood plasma and/or urine_ algorithms to predict high-grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sm 153 lexidronam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9604","description":"Sm 153 lexidronam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSD1","description":"ICD-PHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTC0","description":"ICD-AHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monthly supplies for use of device coded at K1016","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1017","description":"Monthly supplies for use of device coded at K1016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE255","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33736","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCB1","description":"ICD-GHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB45","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJC1","description":"ICD-OAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3751","description":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHF1","description":"ICD-FFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95974","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLB1","description":"ICD-OBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0B","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med nutrition indiv subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97803","description":"Med nutrition indiv subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVE1","description":"ICD-JIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICF1","description":"ICD-OICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECB1","description":"ICD-MECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E3200","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","description":"HCPCS-E3200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAE1","description":"ICD-FEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYB0","description":"ICD-CDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUD1","description":"ICD-IIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eld mal scrn pos no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8735","description":"Eld mal scrn pos no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIB1","description":"ICD-JGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECD1","description":"ICD-JECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB06","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0103","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0103","description":"CDT-D0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath indw foley 3 way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4346","description":"Cath indw foley 3 way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1103","description":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laetrile amygdalin vit b17","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3570","description":"Laetrile amygdalin vit b17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX50","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOC1","description":"ICD-GAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25355","description":"Revision of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tprnl Plmt Biodegradable Matrl Periprostatic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0438T","description":"Tprnl Plmt Biodegradable Matrl Periprostatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vte prophylaxis rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4069F","description":"Vte prophylaxis rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPA1","description":"ICD-OLPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0997T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","description":"CPT-0997T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECF1","description":"ICD-BECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHC0","description":"ICD-EHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC15","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"D5w/0.45ns w kcl and mgs04","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5014","description":"D5w/0.45ns w kcl and mgs04","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38129","description":"Laparoscope proc spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFID0","description":"ICD-JFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza immunization was not administered_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1308","description":"Influenza immunization was not administered_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHID1","description":"ICD-GHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26992","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLB1","description":"ICD-OCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXB1","description":"ICD-BAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXA0","description":"ICD-JIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trans care mgmt 7 day disch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99496","description":"Trans care mgmt 7 day disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd us fine needle bx/aspir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43238","description":"Egd us fine needle bx/aspir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Derm autograft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15130","description":"Derm autograft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVD1","description":"ICD-OIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test def 15-21 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0482","description":"Drug test def 15-21 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICME0","description":"ICD-ICME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUA1","description":"ICD-NKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDF1","description":"ICD-IEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXC1","description":"ICD-FHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILB0","description":"ICD-GILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0458","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","description":"HCPCS-J0458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21085","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDC1","description":"ICD-GBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJE0","description":"ICD-FCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24C","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIB0","description":"ICD-ABIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetaminophen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80143","description":"Acetaminophen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWB0","description":"ICD-PLWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFD1","description":"ICD-FDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj cutting of a muscle","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7856","description":"Tmj cutting of a muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1083T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1083T","description":"CPT-1083T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPD1","description":"ICD-NAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso full corset","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0974","description":"Tlso full corset","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCE1","description":"ICD-IGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHF1","description":"ICD-GDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg cylinder pl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4033","description":"Cast sup lng leg cylinder pl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCF0","description":"ICD-JCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITD1","description":"ICD-BITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft een & lips","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15260","description":"Skin full graft een & lips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVF1","description":"ICD-OAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRE1","description":"ICD-LBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSD1","description":"ICD-PBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKB0","description":"ICD-OKKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCE1","description":"ICD-ABCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0205","description":"HCPCS-B0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lodging costs (e.g. hotel ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9994","description":"Lodging costs (e.g. hotel ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/reline occlusal guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9942","description":"Repair/reline occlusal guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecg/review interpret only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93272","description":"Ecg/review interpret only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diphtheria toxoid_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90719","description":"Diphtheria toxoid_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIE0","description":"ICD-IBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBE1","description":"ICD-NJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iron stain peripheral blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85536","description":"Iron stain peripheral blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28510","description":"Treatment of toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIE1","description":"ICD-FDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWC0","description":"ICD-LAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNB1","description":"ICD-NJNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHC1","description":"ICD-OBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICD0","description":"ICD-BICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mcoln1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81290","description":"Mcoln1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18A","description":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI upper extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73218","description":"MRI upper extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIA1","description":"ICD-NDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCD0","description":"ICD-KFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC11","description":"ICD-2HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBE1","description":"ICD-NEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWA1","description":"ICD-DBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not rcvng glucoco thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4192F","description":"Pt not rcvng glucoco thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEB1","description":"ICD-JBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYD0","description":"ICD-PEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove torus mandibularis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7473","description":"Remove torus mandibularis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77063","description":"Breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0486T","description":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDF1","description":"ICD-JEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2A","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABE1","description":"ICD-NABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28220","description":"Release of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAA0","description":"ICD-MCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate (Glyrx-PF)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1597","description":"Injection_ glycopyrrolate (Glyrx-PF)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADED1","description":"ICD-ADED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTB0","description":"ICD-GHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUC0","description":"ICD-NJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBB1","description":"ICD-KBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIF1","description":"ICD-MJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYC0","description":"ICD-PBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFB1","description":"ICD-KAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSC1","description":"ICD-DDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ romosozumab-aqqg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3111","description":"Injection_ romosozumab-aqqg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infusion pump_ programmable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1772","description":"Infusion pump_ programmable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQE0","description":"ICD-PLQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20B","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth electroshock","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10451","description":"Anesth electroshock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAF0","description":"ICD-FCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIC0","description":"ICD-EAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or ili","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34709","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or ili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD104","description":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18I","description":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNF0","description":"ICD-CBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67938","description":"Remove eyelid foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYF0","description":"ICD-PLYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metered dose inhaler drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3535","description":"Metered dose inhaler drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRC1","description":"ICD-HGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No disc tx choices","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9401","description":"No disc tx choices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWA1","description":"ICD-PGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTE1","description":"ICD-IDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53220","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rho d immune globulin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2790","description":"Rho d immune globulin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDC0","description":"ICD-BBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDA1","description":"ICD-AIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMD0","description":"ICD-BFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair elbow perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24357","description":"Repair elbow perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo fluid swing ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5724","description":"Knee-shin exo fluid swing ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remov vert idrl bdy thrclmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63306","description":"Remov vert idrl bdy thrclmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUD1","description":"ICD-AIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKC0","description":"ICD-NBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHE0","description":"ICD-BGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLA1","description":"ICD-KHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht hem horm inj diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9537","description":"Ht hem horm inj diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cranial remolding orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1040","description":"Cranial remolding orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95723","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4D","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary retinal disorders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81434","description":"Hereditary retinal disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB21","description":"ICD-2GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99203","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYC1","description":"ICD-CHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee orthosis (KO)_ double upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1852","description":"Knee orthosis (KO)_ double upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1A","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pappa serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84163","description":"Pappa serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBME1","description":"ICD-IBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKE1","description":"ICD-FDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Isolation- tooth w rubb dam","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3910","description":"Isolation- tooth w rubb dam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01991","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","description":"CPT-01991","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWA1","description":"ICD-LCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGD0","description":"ICD-NFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal intraop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93318","description":"Echo transesophageal intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk imaging tst not ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3331F","description":"Bk imaging tst not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUF1","description":"ICD-NEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intervene hlth/behave indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96152","description":"Intervene hlth/behave indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIND0","description":"ICD-NIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Linezolid injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2020","description":"Linezolid injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQF1","description":"ICD-CEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLME1","description":"ICD-NLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spine disk surgery thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63078","description":"Spine disk surgery thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFE1","description":"ICD-OLFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comm psy face-face per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0036","description":"Comm psy face-face per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDE1","description":"ICD-EEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMB0","description":"ICD-KAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVB0","description":"ICD-KFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45307","description":"Proctosigmoidoscopy fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDC0","description":"ICD-IFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETF0","description":"ICD-KETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHC0","description":"ICD-IFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iadna-dna/rna probe tq 6-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87506","description":"Iadna-dna/rna probe tq 6-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dementia measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8902","description":"Dementia measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIC1","description":"ICD-AHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for lef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7539","description":"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for lef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body-worn hearing aid bone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5040","description":"Body-worn hearing aid bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYA1","description":"ICD-OHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1221","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTC1","description":"ICD-GBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion identification_ characterizatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0865T","description":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion identification_ characterizatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJA0","description":"ICD-CDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSC0","description":"ICD-KGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVD1","description":"ICD-BGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEE1","description":"ICD-OJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13B","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33781","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPE0","description":"ICD-JIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70487","description":"Ct maxillofacial w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDB1","description":"ICD-NHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep renal graft/ureteral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50329","description":"Prep renal graft/ureteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0861T","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETF0","description":"ICD-BETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJB1","description":"ICD-GHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUD0","description":"ICD-AHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKE0","description":"ICD-FIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDC0","description":"ICD-MJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWF0","description":"ICD-OFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPC1","description":"ICD-NHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy for lvrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32672","description":"Thoracoscopy for lvrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC204","description":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGF0","description":"ICD-FIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNB1","description":"ICD-OJNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEE0","description":"ICD-EGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERF0","description":"ICD-CERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKC1","description":"ICD-NEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement_ aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved con","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33440","description":"Replacement_ aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sp bone agrft morsel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20937","description":"Sp bone agrft morsel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-27458","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","description":"CPT-27458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-maly_ biosimilar_ (Alymsys)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9142","description":"Injection_ bevacizumab-maly_ biosimilar_ (Alymsys)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGA0","description":"ICD-CGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove intrauterine device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58301","description":"Remove intrauterine device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVB0","description":"ICD-GEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fosaprepitant (focinvez)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1434","description":"Injection_ fosaprepitant (focinvez)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67121","description":"Remove eye implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excavation of a tooth resulting in the determination of non-restorability","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2989","description":"Excavation of a tooth resulting in the determination of non-restorability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Encephaltis st louis antbody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86653","description":"Encephaltis st louis antbody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACD1","description":"ICD-CACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNA1","description":"ICD-GFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQF1","description":"ICD-DAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJD0","description":"ICD-FBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60545","description":"Explore adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAC1","description":"ICD-NHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFC1","description":"ICD-KCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMD1","description":"ICD-GHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDB0","description":"ICD-GEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1132","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYC0","description":"ICD-PDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOD0","description":"ICD-KFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXC0","description":"ICD-KGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15C","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2304","description":"Lens sphcy trifocal 4.0/2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20A","description":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC42","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82672","description":"Assay of estrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0666","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","description":"HCPCS-G0666","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAC0","description":"ICD-KBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDE0","description":"ICD-JHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSA1","description":"ICD-DFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAB1","description":"ICD-KEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICA0","description":"ICD-EICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD241","description":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove thyroid duct lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60280","description":"Remove thyroid duct lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD210","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelets_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9019","description":"Platelets_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art trnsposj subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35693","description":"Art trnsposj subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHF0","description":"ICD-JDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFB0","description":"ICD-CDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFB0","description":"ICD-GEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGF1","description":"ICD-GGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNA1","description":"ICD-KDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX26","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMD0","description":"ICD-CEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJD1","description":"ICD-OFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMF0","description":"ICD-OEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIC0","description":"ICD-KGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg > 48 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6256","description":"Absorpt drg > 48 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLD0","description":"ICD-ODLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECD0","description":"ICD-IECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67973","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJB1","description":"ICD-NFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVD1","description":"ICD-KIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWC1","description":"ICD-GEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBC0","description":"ICD-MJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Approp diuretic tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4190F","description":"Approp diuretic tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQE1","description":"ICD-HBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21242","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHD0","description":"ICD-BBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ciprofloxacin iv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0744","description":"Ciprofloxacin iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Serv part of phase i trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9988","description":"Serv part of phase i trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKD0","description":"ICD-BCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCB0","description":"ICD-JBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4390","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","description":"HCPCS-Q4390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcath occlusion non-cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61626","description":"Transcath occlusion non-cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJD0","description":"ICD-BEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chronic pain management and treatment_ monthly bundle including_ diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3002","description":"Chronic pain management and treatment_ monthly bundle including_ diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPE0","description":"ICD-NFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCD0","description":"ICD-OGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEB1","description":"ICD-NLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13132","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adenoma not detect screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3776F","description":"Adenoma not detect screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLF0","description":"ICD-ABLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21268","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ includes specimen verification including DNA authentication in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0007U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ includes specimen verification including DNA authentication in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcholinesterase assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82013","description":"Acetylcholinesterase assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFF0","description":"ICD-BAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHE0","description":"ICD-NLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJC0","description":"ICD-NHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht muscle image planar sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78453","description":"Ht muscle image planar sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74010","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCD0","description":"ICD-NHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXA0","description":"ICD-FIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0715","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0715","description":"HCPCS-E0715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tremelimumab-actl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9147","description":"Injection_ tremelimumab-actl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMB0","description":"ICD-MCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"So hard plas stabili pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3677","description":"So hard plas stabili pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRC0","description":"ICD-OJRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin cartridge 300 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5566","description":"Insulin cartridge 300 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUD1","description":"ICD-CAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOB1","description":"ICD-LBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15C","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAC0","description":"ICD-ODAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient not eligible due to active diagnosis of hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1290","description":"Patient not eligible due to active diagnosis of hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2108","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1C","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dimecaprol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0470","description":"Dimecaprol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXD1","description":"ICD-NFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBA0","description":"ICD-JGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breath tst attain/anal c-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78267","description":"Breath tst attain/anal c-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot arch supp premold metat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3050","description":"Foot arch supp premold metat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHC1","description":"ICD-MCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69806","description":"Explore inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27641","description":"Partial removal of fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay blood carbon dioxide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82374","description":"Assay blood carbon dioxide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUE0","description":"ICD-NAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHC1","description":"ICD-KHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKB1","description":"ICD-CDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clotting funct activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85397","description":"Clotting funct activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryopreservation oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0357T","description":"Cryopreservation oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC23","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXD0","description":"ICD-KGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVE1","description":"ICD-CHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including MR guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10012","description":"Fine needle aspiration biopsy_ including MR guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18C","description":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIC1","description":"ICD-GIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGA1","description":"ICD-CAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-38226","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","description":"CPT-38226","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40510","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ preF_ subunit_ bivalent_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90678","description":"Respiratory syncytial virus vaccine_ preF_ subunit_ bivalent_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWB1","description":"ICD-DBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHD1","description":"ICD-AGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFE1","description":"ICD-BIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIE0","description":"ICD-EDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB260","description":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBB0","description":"ICD-BGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28A","description":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand restorat thumb/1 finger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6900","description":"Hand restorat thumb/1 finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDE1","description":"ICD-MFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTA0","description":"ICD-ICTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDD1","description":"ICD-EGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVF0","description":"ICD-NBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nos flu vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2039","description":"Nos flu vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens lenticular bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2115","description":"Lens lenticular bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDC0","description":"ICD-JBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEA0","description":"ICD-IHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Mycoplasma Genitalium_ Amplified Probe Technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87563","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Mycoplasma Genitalium_ Amplified Probe Technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASE1","description":"ICD-PASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJA0","description":"ICD-GAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2290","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2290","description":"HCPCS-J2290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAF1","description":"ICD-CCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBF1","description":"ICD-OIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc back les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21931","description":"Exc back les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUD0","description":"ICD-EDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone 40 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1030","description":"Methylprednisolone 40 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBME1","description":"ICD-FBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL35","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWE1","description":"ICD-HCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDME0","description":"ICD-IDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVC1","description":"ICD-CBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lenticular lens_ bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2221","description":"Lenticular lens_ bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA54","description":"High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Procure donor sperm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4026","description":"Procure donor sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPE1","description":"ICD-JEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFA1","description":"ICD-BEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; First Le","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0627T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; First Le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD211","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUE0","description":"ICD-BDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26412","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vitrectomy_ mechanical_ pars plana approach_ with subretinal injection of pharmacologic/biologic agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9770","description":"Vitrectomy_ mechanical_ pars plana approach_ with subretinal injection of pharmacologic/biologic agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLD1","description":"ICD-MLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnicore pro_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4298","description":"Amnicore pro_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAA0","description":"ICD-FIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home mgmt gest hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9211","description":"Home mgmt gest hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEB0","description":"ICD-OLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15956","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTE1","description":"ICD-ACTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24685","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18A","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00790","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","description":"CPT-00790","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRB1","description":"ICD-PJRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKE0","description":"ICD-NEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVE0","description":"ICD-FFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLC0","description":"ICD-CHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCC0","description":"ICD-OJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74283","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKD1","description":"ICD-OCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tisagenlecleucel_ up to 250 million CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2040","description":"Tisagenlecleucel_ up to 250 million CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXC1","description":"ICD-OJXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTD1","description":"ICD-MJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8E","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB217","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMD0","description":"ICD-MGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD206","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL35","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIB0","description":"ICD-GDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adrenal tissue transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2103","description":"Adrenal tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRA1","description":"ICD-PIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARB0","description":"ICD-HARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genvisc_ inj_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9980","description":"Genvisc_ inj_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCF0","description":"ICD-GBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCB0","description":"ICD-MHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHC1","description":"ICD-KBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECA0","description":"ICD-NECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTF1","description":"ICD-NFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLC1","description":"ICD-CBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelv & thor control gluteal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2650","description":"Pelv & thor control gluteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMD1","description":"ICD-KBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain bladder by needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51100","description":"Drain bladder by needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLF0","description":"ICD-MGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHE1","description":"ICD-NHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFF1","description":"ICD-OEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEF1","description":"ICD-NJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVF0","description":"ICD-FCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWB0","description":"ICD-CAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRA0","description":"ICD-OIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJD0","description":"ICD-FIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB55","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gabapentin non-blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80355","description":"Gabapentin non-blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWC0","description":"ICD-GFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKF1","description":"ICD-GDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKA0","description":"ICD-ODKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFF0","description":"ICD-NGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJC1","description":"ICD-KIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHB1","description":"ICD-NHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVE1","description":"ICD-OAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILB0","description":"ICD-JILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and radiotracer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52250","description":"Cystoscopy and radiotracer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ occlusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2628","description":"Catheter_ occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AmnioText_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4245","description":"AmnioText_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPF0","description":"ICD-GEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQE0","description":"ICD-HDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90616","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90616","description":"CPT-90616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99328","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJF0","description":"ICD-GCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGB1","description":"ICD-BBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amoxicillin_ with or without clavulanate_ not prescribed as first line antibiotic at the time of diagnosis for documented reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9313","description":"Amoxicillin_ with or without clavulanate_ not prescribed as first line antibiotic at the time of diagnosis for documented reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAC0","description":"ICD-JHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","description":"HCPCS-M1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHF1","description":"ICD-JAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHE0","description":"ICD-OKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61514","description":"Removal of brain abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bordetella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86615","description":"Bordetella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tumor imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78802","description":"Tumor imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27759","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen system liquid station","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0440","description":"Oxygen system liquid station","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25C","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pet image w/ct full body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78816","description":"Pet image w/ct full body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQF1","description":"ICD-GIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOC1","description":"ICD-LHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5A","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYF1","description":"ICD-GCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thigh/wght bear high roll cu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2550","description":"Thigh/wght bear high roll cu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lab pathology consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80502","description":"Lab pathology consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUC0","description":"ICD-JCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove abdomen lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38780","description":"Remove abdomen lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tens suppl 2 lead per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4595","description":"Tens suppl 2 lead per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peri-px device eval & prgr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93287","description":"Peri-px device eval & prgr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFA1","description":"ICD-JHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anchor/screw bn/bn_tis/bn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1713","description":"Anchor/screw bn/bn_tis/bn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ above knee_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6585","description":"Gradient pressure wrap with adjustable straps_ above knee_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFE0","description":"ICD-NJFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE204","description":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin dispos pen 1.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5570","description":"Insulin dispos pen 1.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBF1","description":"ICD-MBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25909","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enclosed ped crib hosp grade","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0300","description":"Enclosed ped crib hosp grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Follow-up/reassessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0316","description":"Follow-up/reassessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"WoundPlus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4326","description":"WoundPlus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54230","description":"Prepare penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wcd device interrogate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93292","description":"Wcd device interrogate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rolapitant_ oral_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8670","description":"Rolapitant_ oral_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq transcath septal reduxn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93583","description":"Perq transcath septal reduxn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUC0","description":"ICD-EBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAC0","description":"ICD-NBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc gastro 51 gene nomogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0007M","description":"Onc gastro 51 gene nomogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie_ previously diagnosed) tissue(s) for molecular analysis (eg_ KRAS mutational an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0847T","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie_ previously diagnosed) tissue(s) for molecular analysis (eg_ KRAS mutational an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDF1","description":"ICD-OBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGF1","description":"ICD-GIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDD1","description":"ICD-BBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2003","description":"HCPCS-A2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIB0","description":"ICD-NHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42227","description":"Lengthening of palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Athletic train reeval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97006","description":"Athletic train reeval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70360","description":"X-ray exam of neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFA0","description":"ICD-GGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYC0","description":"ICD-OCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBED0","description":"ICD-GBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrst mold sock w/exp interfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6055","description":"Wrst mold sock w/exp interfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA31","description":"ICD-4LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mucopolysaccharides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83864","description":"Mucopolysaccharides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHC1","description":"ICD-KFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVF0","description":"ICD-JEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIA1","description":"ICD-NGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKE0","description":"ICD-NGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJE0","description":"ICD-FAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAF1","description":"ICD-KBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEC1","description":"ICD-EBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWC0","description":"ICD-ODWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIE1","description":"ICD-OIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQE1","description":"ICD-LHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLB0","description":"ICD-NFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputate upper arm & implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24931","description":"Amputate upper arm & implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE113","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunofluorescent study_ each antibody; indirect method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88347","description":"Immunofluorescent study_ each antibody; indirect method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTE1","description":"ICD-GCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low- dose computed tomography for lung cancer screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8032","description":"Low- dose computed tomography for lung cancer screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKF0","description":"ICD-CFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep c ab test confirm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86804","description":"Hep c ab test confirm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00604","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","description":"CPT-00604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIF0","description":"ICD-OLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEF1","description":"ICD-MIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol 74-100 gm pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4197","description":"Parenteral sol 74-100 gm pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant; with biopsy_ polypectomy or debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0407T","description":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant; with biopsy_ polypectomy or debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Received At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After The Pat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2160","description":"Patient Received At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After The Pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit simple cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5498","description":"Hit simple cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vanomycin dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87500","description":"Vanomycin dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYB1","description":"ICD-DAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQE1","description":"ICD-GDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAB0","description":"ICD-KIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25491","description":"Reinforce ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUA1","description":"ICD-JCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMF1","description":"ICD-AIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who achieved a net increase in pam score of at least 3 points in a 6 to 12 month period (passing)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1347","description":"Patients who achieved a net increase in pam score of at least 3 points in a 6 to 12 month period (passing)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEF1","description":"ICD-KCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUD1","description":"ICD-OAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0229T","description":"Njx tfrml eprl w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE244","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65870","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUE0","description":"ICD-ECUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUB1","description":"ICD-AAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIA0","description":"ICD-MBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Segmentectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32484","description":"Segmentectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKC1","description":"ICD-GDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12057","description":"Intmd rpr face/mm >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion or replacement of permanent leadless pacemaker_ right ventricular_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ ventriculography_ fe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33274","description":"Transcatheter insertion or replacement of permanent leadless pacemaker_ right ventricular_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ ventriculography_ fe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA36","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDB0","description":"ICD-KDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25B","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWB1","description":"ICD-PKWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00539","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","description":"CPT-00539","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMF1","description":"ICD-MFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7556","description":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGB0","description":"ICD-JIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photopheresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36522","description":"Photopheresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rgd ped wc adjstabl w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1237","description":"Rgd ped wc adjstabl w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMF1","description":"ICD-BAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rocker bottom_ contact afo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2232","description":"Rocker bottom_ contact afo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc arm/elbow les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24075","description":"Exc arm/elbow les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinogen activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85384","description":"Fibrinogen activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITF1","description":"ICD-MITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFE0","description":"ICD-BBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYF0","description":"ICD-KHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFB0","description":"ICD-OIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22B","description":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA21","description":"ICD-2LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBF1","description":"ICD-MGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt has docd immun to hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3515F","description":"Pt has docd immun to hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ sacral_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0787T","description":"Revision or removal of neurostimulator electrode array_ sacral_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSA1","description":"ICD-GCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIE0","description":"ICD-FGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPA0","description":"ICD-KCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30120","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28G","description":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA31","description":"ICD-4DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft ilioiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35563","description":"Art byp grft ilioiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0204","description":"HCPCS-A0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLC1","description":"ICD-GFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ilr device interrogate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93291","description":"Ilr device interrogate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracostomy w/rib resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32035","description":"Thoracostomy w/rib resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of lower eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15821","description":"Revision of lower eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77770","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/drug screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0049","description":"Alcohol/drug screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt lft inpt fac w/in 60 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1110F","description":"Pt lft inpt fac w/in 60 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8H","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96542","description":"Chemotherapy injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD110","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDB1","description":"ICD-BDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQD1","description":"ICD-CCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCD1","description":"ICD-MKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARD1","description":"ICD-PARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bortezomib_ not otherwise specified_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9044","description":"Injection_ bortezomib_ not otherwise specified_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Audiometry air & bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0209T","description":"Audiometry air & bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATA1","description":"ICD-MATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albumin (human)_ 25%_ 50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9047","description":"Albumin (human)_ 25%_ 50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; screening and interpretation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0832T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; screening and interpretation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPA0","description":"ICD-GGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUF1","description":"ICD-OJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIC0","description":"ICD-CEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEND1","description":"ICD-OEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermacell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4122","description":"Dermacell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUD0","description":"ICD-GHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFE0","description":"ICD-OGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thrombolytic therapy stroke","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37195","description":"Thrombolytic therapy stroke","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXA1","description":"ICD-BIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMD0","description":"ICD-ADMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imaging Of Retina For Detection Or Monitoring Of Disease; Point-Of-Care Automated Analysis And Report_ Unilateral Or Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92229","description":"Imaging Of Retina For Detection Or Monitoring Of Disease; Point-Of-Care Automated Analysis And Report_ Unilateral Or Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5D","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extended culture of oocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89272","description":"Extended culture of oocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45303","description":"Proctosigmoidoscopy dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit 2.5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12041","description":"Intmd rpr n-hf/genit 2.5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDC0","description":"ICD-ODDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0546","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","description":"HCPCS-G0546","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0803","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0803","description":"CDT-D0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMA1","description":"ICD-KEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIE1","description":"ICD-GDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIE0","description":"ICD-BIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSE1","description":"ICD-LDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise/repair mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40814","description":"Excise/repair mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score le pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8657","description":"Fun stat score le pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26392","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC154","description":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabazitaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9043","description":"Cabazitaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20A","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non cutaneous loc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9295","description":"Non cutaneous loc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01952","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","description":"CPT-01952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28515","description":"Treatment of toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWA1","description":"ICD-HBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL40","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTC0","description":"ICD-NFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE231","description":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVB0","description":"ICD-FAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWF0","description":"ICD-LAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES111","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-93896","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","description":"CPT-93896","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHB0","description":"ICD-OEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert ant segment drain int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0376T","description":"Insert ant segment drain int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIB0","description":"ICD-AEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWB0","description":"ICD-HIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 20 valent (PCV20)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90677","description":"Pneumococcal conjugate vaccine_ 20 valent (PCV20)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21088","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPE0","description":"ICD-NIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1062T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1062T","description":"CPT-1062T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Integra matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4108","description":"Integra matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLF0","description":"ICD-EDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYF1","description":"ICD-KBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29010","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL43","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWF1","description":"ICD-OFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24640","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAB1","description":"ICD-JHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX03","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGA1","description":"ICD-NLGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin pedicle flap arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15572","description":"Skin pedicle flap arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARA1","description":"ICD-LARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC17","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31380","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTD0","description":"ICD-JFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX21","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of external ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69105","description":"Biopsy of external ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow mold sock suspension t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6110","description":"Elbow mold sock suspension t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPF0","description":"ICD-JAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXC1","description":"ICD-CGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILC1","description":"ICD-MILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0506","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOF0","description":"ICD-OJOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKF1","description":"ICD-JEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0655U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0655U","description":"CPT-0655U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBED0","description":"ICD-EBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct abd & pelv w/contrast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74177","description":"Ct abd & pelv w/contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRF1","description":"ICD-DCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23616","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel pad & depress for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3480","description":"Shoe heel pad & depress for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWE0","description":"ICD-KEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hf mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8551","description":"Hf mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23515","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTD0","description":"ICD-CBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML41","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJE0","description":"ICD-CBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc abd les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22903","description":"Exc abd les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PAS (Consumer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1792","description":"PAS (Consumer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tinzaparin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1655","description":"Tinzaparin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUA1","description":"ICD-GFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOA0","description":"ICD-CHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECB0","description":"ICD-IECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDE0","description":"ICD-ADDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIE0","description":"ICD-ODIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKF0","description":"ICD-KEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFC1","description":"ICD-OHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd pneum dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87487","description":"Chylmd pneum dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMC0","description":"ICD-CHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPB0","description":"ICD-FBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA236","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDD1","description":"ICD-NBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOE1","description":"ICD-HBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1_ 2_ And 3) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81194","description":"Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1_ 2_ And 3) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert pulse gen mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33221","description":"Insert pulse gen mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFC0","description":"ICD-KCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza Virus Vaccine_ Quadrivalent (Aiiv4)_ Inactivated_ Adjuvanted_ Preservative Free_ 0.5 Ml Dosage_ For Intramuscular Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90694","description":"Influenza Virus Vaccine_ Quadrivalent (Aiiv4)_ Inactivated_ Adjuvanted_ Preservative Free_ 0.5 Ml Dosage_ For Intramuscular Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBD0","description":"ICD-NJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTD1","description":"ICD-NJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAF1","description":"ICD-OCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospitalist visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0310","description":"Hospitalist visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUC0","description":"ICD-GCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILF0","description":"ICD-MILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63082","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLF0","description":"ICD-ADLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pul art balloon repr percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92998","description":"Pul art balloon repr percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA21","description":"ICD-4FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDD1","description":"ICD-BGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Each addtnl prefab post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2957","description":"Each addtnl prefab post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skn sub grft f/n/hf/g ch add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15278","description":"Skn sub grft f/n/hf/g ch add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICA0","description":"ICD-IICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive outpatient psychia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9480","description":"Intensive outpatient psychia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITA1","description":"ICD-NITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSB1","description":"ICD-LBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBE1","description":"ICD-MJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation_ upper extremity_ separate access sites of the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36837","description":"Percutaneous arteriovenous fistula creation_ upper extremity_ separate access sites of the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92326","description":"Replacement of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQE0","description":"ICD-KGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSA1","description":"ICD-OGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGC1","description":"ICD-NDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00522","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","description":"CPT-00522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1088","description":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXB0","description":"ICD-OFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11C","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGC0","description":"ICD-OFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHA1","description":"ICD-FHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20606","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUF0","description":"ICD-FCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKE1","description":"ICD-CBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0501","description":"HCPCS-C0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAD0","description":"ICD-CCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amalgam 4 or > surfaces perm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2161","description":"Amalgam 4 or > surfaces perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete cbc automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85027","description":"Complete cbc automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRD1","description":"ICD-GDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat sternum fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21820","description":"Treat sternum fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ 1000 units (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0886","description":"Injection_ epoetin alfa_ 1000 units (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMF1","description":"ICD-BIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disease progn ra good docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3476F","description":"Disease progn ra good docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKA0","description":"ICD-GFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKB0","description":"ICD-BGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1C","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy bowel pouch/biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44386","description":"Endoscopy bowel pouch/biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9610","description":"HCPCS-C9610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8C","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Belt/vest elec/combo vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0499","description":"Belt/vest elec/combo vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHC0","description":"ICD-ICHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (cervix)_ mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16_ 18_ 31_ 33_ 45_ 52_ 58)_ by real-time nu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0463U","description":"Oncology (cervix)_ mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16_ 18_ 31_ 33_ 45_ 52_ 58)_ by real-time nu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPC0","description":"ICD-CFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCME1","description":"ICD-MCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Segmental pneumatic trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0656","description":"Segmental pneumatic trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECD0","description":"ICD-NECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILA1","description":"ICD-BILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx head/neck t1-t2no prg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9109","description":"Onc dx head/neck t1-t2no prg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ each additional site (Lis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0844T","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ each additional site (Lis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70488","description":"Ct maxillofacial w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAA0","description":"ICD-MJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKE0","description":"ICD-KIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOB1","description":"ICD-PEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESF1","description":"ICD-HESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPA1","description":"ICD-JIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debridement of premalignant hyperkeratotic lesion(s) (ie_ targeted curettage_ abrasion) followed with photodynamic therapy by external application of light to destroy premalig","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96574","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie_ targeted curettage_ abrasion) followed with photodynamic therapy by external application of light to destroy premalig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients Age 66 And Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With A Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2081","description":"Patients Age 66 And Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With A Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYE1","description":"ICD-LEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ruptured uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58520","description":"Repair of ruptured uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subtalar arthro w/exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29905","description":"Subtalar arthro w/exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHA1","description":"ICD-BFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLE1","description":"ICD-ACLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSA1","description":"ICD-HBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8C","description":"Low Rehab_ ADL Index 0-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTA0","description":"ICD-BHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0019","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8H","description":"Very High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTC1","description":"ICD-EFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWD0","description":"ICD-GIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUE0","description":"ICD-IEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHA1","description":"ICD-MAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune (psoriasis)_ mRNA_ next-generation sequencing_ gene expression profiling of 50-100 genes_ skin-surface collection using adhesive patch_ algorithm reported as likeli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0258U","description":"Autoimmune (psoriasis)_ mRNA_ next-generation sequencing_ gene expression profiling of 50-100 genes_ skin-surface collection using adhesive patch_ algorithm reported as likeli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Derma-fat-fascia graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15770","description":"Derma-fat-fascia graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALE0","description":"ICD-EALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rebond/cement/repair retain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8693","description":"Rebond/cement/repair retain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glofitamab-gxbm_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9286","description":"Injection_ glofitamab-gxbm_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAB1","description":"ICD-FEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBB1","description":"ICD-KHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ and transluminal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9765","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ and transluminal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEC1","description":"ICD-NCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92631","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","description":"CPT-92631","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOC1","description":"ICD-DIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBC1","description":"ICD-GEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWF1","description":"ICD-GBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJB0","description":"ICD-FEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQF1","description":"ICD-OLQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial release of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32225","description":"Partial release of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFE1","description":"ICD-CEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXE0","description":"ICD-NFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0485T","description":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBF1","description":"ICD-GEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWA0","description":"ICD-GIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGD0","description":"ICD-OHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28X","description":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTE0","description":"ICD-OCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision graft neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35901","description":"Excision graft neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Integra flowable wound matri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4114","description":"Integra flowable wound matri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHB0","description":"ICD-BGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFF1","description":"ICD-FBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10A","description":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay)_ plasma_ algorithm reported as m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0395U","description":"Oncology (lung)_ multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay)_ plasma_ algorithm reported as m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYF0","description":"ICD-CAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLD1","description":"ICD-MDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental suture wound to 5 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7911","description":"Dental suture wound to 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cranial electrotherapy stimulation (ces) system_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0732","description":"Cranial electrotherapy stimulation (ces) system_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/o 3+ post-opnausea&vom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4557F","description":"Pt w/o 3+ post-opnausea&vom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFME0","description":"ICD-CFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo ablate renal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50541","description":"Laparo ablate renal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES156","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rx cntact lens aphakia 2 eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92316","description":"Rx cntact lens aphakia 2 eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHC0","description":"ICD-JBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteopath manj 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98926","description":"Osteopath manj 3-4 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fern test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0114","description":"Fern test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33020","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEME0","description":"ICD-OEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXF1","description":"ICD-CDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIF1","description":"ICD-AIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOE0","description":"ICD-OHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1389","description":"HCPCS-M1389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAB1","description":"ICD-MKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC16","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRF1","description":"ICD-DBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inhibin a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86336","description":"Inhibin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spacer bag/reservoir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4627","description":"Spacer bag/reservoir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us leiomyomata ablate >200","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072T","description":"Us leiomyomata ablate >200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had one or less emergency department visits in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9851","description":"Patient had one or less emergency department visits in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEF1","description":"ICD-NFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1111T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1111T","description":"CPT-1111T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Beta amyloid_ AB40 and AB42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ ratio_ plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0346U","description":"Beta amyloid_ AB40 and AB42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ ratio_ plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemophilus influenza antibdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86684","description":"Hemophilus influenza antibdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test socket knee disarticula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5622","description":"Test socket knee disarticula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prednisolone oral per 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7510","description":"Prednisolone oral per 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4B","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh_ methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22859","description":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh_ methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJE1","description":"ICD-GIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA03","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYA0","description":"ICD-LIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNA0","description":"ICD-BCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGD1","description":"ICD-NDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWF0","description":"ICD-DEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPD0","description":"ICD-CEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKF1","description":"ICD-FGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2004","description":"HCPCS-A2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXD0","description":"ICD-GGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTE0","description":"ICD-MDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCF1","description":"ICD-GFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMB1","description":"ICD-OCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc oviduct-ovary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58679","description":"Laparo proc oviduct-ovary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prior dx/active clin ascvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9662","description":"Prior dx/active clin ascvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABC0","description":"ICD-EABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWD0","description":"ICD-KAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITE0","description":"ICD-IITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0106","description":"HCPCS-B0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNE0","description":"ICD-BHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25370","description":"Revise radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRA1","description":"ICD-CFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE234","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVC0","description":"ICD-NEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0904","description":"HCPCS-A0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fabric wrapping of aneurysm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0301","description":"Fabric wrapping of aneurysm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAD0","description":"ICD-CBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDF1","description":"ICD-NGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLE0","description":"ICD-GFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of citrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82507","description":"Assay of citrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHD0","description":"ICD-BIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 anytime during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9910","description":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 anytime during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEME1","description":"ICD-NEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALD0","description":"ICD-FALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKF1","description":"ICD-CCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amp no reqd in48h ieler proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9639","description":"Amp no reqd in48h ieler proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRE0","description":"ICD-CGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prochlorperazine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0780","description":"Prochlorperazine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVC0","description":"ICD-OJVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser surgery of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52648","description":"Laser surgery of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01400","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","description":"CPT-01400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVF0","description":"ICD-BFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATD1","description":"ICD-JATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneum drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2381","description":"Pneum drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHD1","description":"ICD-OFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELA0","description":"ICD-BELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol renal-amirosy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5000","description":"Parenteral sol renal-amirosy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVF0","description":"ICD-OBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBME1","description":"ICD-GBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX34","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1054T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1054T","description":"CPT-1054T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPF1","description":"ICD-FBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enterectomy w/taper cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44127","description":"Enterectomy w/taper cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWD1","description":"ICD-DBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99191","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVA0","description":"ICD-FIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCC0","description":"ICD-IFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFME0","description":"ICD-JFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red Cell Antigen (Mns Blood Group) Genotyping (Gypa)_ Gene Analysis_ Gypa (Glycophorin A [Mns Blood Group]) Introns 1_ 5_ Exon 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1089U","description":"Red Cell Antigen (Mns Blood Group) Genotyping (Gypa)_ Gene Analysis_ Gypa (Glycophorin A [Mns Blood Group]) Introns 1_ 5_ Exon 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2102","description":"HCPCS-A2102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multi den insert direct form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5512","description":"Multi den insert direct form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carbonic anhydrase VI (CA VI)_ parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG_ IgM_ and IgA antibodies_ enzyme-linked immunosorbent assay (ELISA)_ sem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0472U","description":"Carbonic anhydrase VI (CA VI)_ parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG_ IgM_ and IgA antibodies_ enzyme-linked immunosorbent assay (ELISA)_ sem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51800","description":"Revision of bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHE1","description":"ICD-MKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSB0","description":"ICD-OFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18A","description":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANE0","description":"ICD-OANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIF1","description":"ICD-JCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEF1","description":"ICD-BCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQA1","description":"ICD-DHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mobile arm support supinator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2633","description":"Mobile arm support supinator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA136","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFB0","description":"ICD-FAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTE1","description":"ICD-KFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27052","description":"Biopsy of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRD1","description":"ICD-HFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAF1","description":"ICD-MKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/o dye_ upper extr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8935","description":"Mra_ w/o dye_ upper extr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed fixd ht w/o mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0251","description":"Hosp bed fixd ht w/o mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA31","description":"ICD-3FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo cholangiopancreatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43262","description":"Endo cholangiopancreatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRC0","description":"ICD-OGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCED1","description":"ICD-FCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPA0","description":"ICD-OCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUC0","description":"ICD-BFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNE0","description":"ICD-FGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMC0","description":"ICD-NFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transducer protect/fld bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1575","description":"Transducer protect/fld bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4427","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","description":"HCPCS-Q4427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0652U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0652U","description":"CPT-0652U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; first physician or other qualified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0820T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; first physician or other qualified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone srgry cmptr CT/MRI imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0055T","description":"Bone srgry cmptr CT/MRI imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYB0","description":"ICD-HIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","description":"HCPCS-A2034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ganciclovir sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1570","description":"Ganciclovir sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLD0","description":"ICD-IFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0948T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","description":"CPT-0948T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCD0","description":"ICD-FGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAE0","description":"ICD-OIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGA0","description":"ICD-CCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWD0","description":"ICD-OEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAD0","description":"ICD-AIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPF0","description":"ICD-OJPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXD0","description":"ICD-GBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGB0","description":"ICD-JEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neonate crit care initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99468","description":"Neonate crit care initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJA1","description":"ICD-NBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Terbutaline sulf comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7680","description":"Terbutaline sulf comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVE0","description":"ICD-OAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intestine transplant live","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44136","description":"Intestine transplant live","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJA1","description":"ICD-JAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQF1","description":"ICD-CAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; common deletions or variant (eg_ Southeast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81257","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; common deletions or variant (eg_ Southeast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC21","description":"ICD-3EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mltispectrl digital les alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0400T","description":"Mltispectrl digital les alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent treatment day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0891T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent treatment day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFA0","description":"ICD-NIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRB0","description":"ICD-HDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Abnormal Nat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93597","description":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Abnormal Nat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUC1","description":"ICD-BAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular function screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99172","description":"Ocular function screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61526","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection jaw joint x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21116","description":"Injection jaw joint x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIME0","description":"ICD-JIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEE0","description":"ICD-BHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABC1","description":"ICD-GABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ BICROS_ in the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5210","description":"Hearing aid_ BICROS_ in the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEC1","description":"ICD-JFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQB1","description":"ICD-GGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8E","description":"Low Rehab_ ADL Index 0-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVB0","description":"ICD-BBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescribed anticoagulant medication during the performance period_ history of GI bleeding_ history of intracranial bleeding_ bl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1056","description":"Prescribed anticoagulant medication during the performance period_ history of GI bleeding_ history of intracranial bleeding_ bl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMD0","description":"ICD-OAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVF1","description":"ICD-BHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKC1","description":"ICD-FBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0303T","description":"Icar ischm mntrng sys eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virus inoculation shell via","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87254","description":"Virus inoculation shell via","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0529U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","description":"CPT-0529U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPA1","description":"ICD-GEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43830","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNC0","description":"ICD-JCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYC0","description":"ICD-PAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJE1","description":"ICD-JDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPE1","description":"ICD-OEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fecal bilirubin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82252","description":"Fecal bilirubin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20C","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGME1","description":"ICD-EGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIF0","description":"ICD-EAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEA0","description":"ICD-FCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66172","description":"Incision of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICB1","description":"ICD-GICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who have a diagnosis of rhabdomyolysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9780","description":"Patients who have a diagnosis of rhabdomyolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flt3 gene analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81246","description":"Flt3 gene analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDA1","description":"ICD-EFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDE1","description":"ICD-KFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHID0","description":"ICD-BHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial angioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61630","description":"Intracranial angioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11770","description":"Remove pilonidal cyst simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHF0","description":"ICD-IHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJD0","description":"ICD-NFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUA0","description":"ICD-JHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85460","description":"Hemoglobin fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXF1","description":"ICD-CAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pressure sensor system_ includes all components (eg_ introducer sensor)_ intramuscular (imp)_ exc mobile (wireless) software app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1834","description":"Pressure sensor system_ includes all components (eg_ introducer sensor)_ intramuscular (imp)_ exc mobile (wireless) software app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Creatinine clearance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82575","description":"Creatinine clearance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gene test myo musclr dyst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3853","description":"Gene test myo musclr dyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Central dexa results docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3095F","description":"Central dexa results docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRF0","description":"ICD-PBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHE1","description":"ICD-GGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Macular pigment optical density measurement by heterochromatic flicker photometry_ unilateral or bilateral_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0506T","description":"Macular pigment optical density measurement by heterochromatic flicker photometry_ unilateral or bilateral_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUE0","description":"ICD-KBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0901","description":"HCPCS-B0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXF1","description":"ICD-JEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"New eye exam & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92018","description":"New eye exam & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCID1","description":"ICD-KCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1082","description":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61557","description":"Incise skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gel cap for trach voice pros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8512","description":"Gel cap for trach voice pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excisional biopsy of minor salivary glands","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7284","description":"Excisional biopsy of minor salivary glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES316","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEC1","description":"ICD-CAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61534","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQC1","description":"ICD-OKQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Trichomonas vaginalis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87808","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Trichomonas vaginalis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMB0","description":"ICD-OFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARA1","description":"ICD-OARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAF1","description":"ICD-JDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj tendon origin/insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20551","description":"Inj tendon origin/insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plan 2 main dr by 1 month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5050F","description":"Plan 2 main dr by 1 month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEA1","description":"ICD-JEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Co2 breathing response curve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94400","description":"Co2 breathing response curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDF1","description":"ICD-CGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRC0","description":"ICD-CIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Waiver service_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2025","description":"Waiver service_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE225","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLA1","description":"ICD-OLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No brst cncr dx min invasive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8877","description":"No brst cncr dx min invasive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automated platelet count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85049","description":"Automated platelet count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5C","description":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRD1","description":"ICD-DGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacologic mgmt w/psytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90863","description":"Pharmacologic mgmt w/psytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXA1","description":"ICD-GCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14B","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPE1","description":"ICD-KDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNE1","description":"ICD-GHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLE1","description":"ICD-MCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAB1","description":"ICD-IFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATF1","description":"ICD-JATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILC0","description":"ICD-MILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQE0","description":"ICD-LDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXE1","description":"ICD-OHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVF1","description":"ICD-BAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWA0","description":"ICD-HHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay total hydroxyproline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83505","description":"Assay total hydroxyproline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tubing used w suction pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7002","description":"Tubing used w suction pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBE0","description":"ICD-KHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKC1","description":"ICD-OEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel thomas with wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3465","description":"Shoe heel thomas with wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYF0","description":"ICD-OEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl & rplcmt dfb gen mlt ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33264","description":"Rmvl & rplcmt dfb gen mlt ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMC0","description":"ICD-MFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13A","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remov vert idrl bdy lmbr/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63307","description":"Remov vert idrl bdy lmbr/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3_ *4_ *5_ *6_ *7)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81231","description":"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3_ *4_ *5_ *6_ *7)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUE1","description":"ICD-KDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMD0","description":"ICD-JCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXD0","description":"ICD-FIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammo probably bengn docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3343F","description":"Mammo probably bengn docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWC0","description":"ICD-LFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGD0","description":"ICD-CCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainable rubber pch w fcplt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4376","description":"Drainable rubber pch w fcplt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","description":"HCPCS-M1382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPB1","description":"ICD-CGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc skin abd add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15847","description":"Exc skin abd add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety)_ genomic analysis panel_ including variant analysis of 26 genes_ buccal swab_ report including metabolizer status and risk of drug toxicit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0423U","description":"Psychiatry (eg_ depression_ anxiety)_ genomic analysis panel_ including variant analysis of 26 genes_ buccal swab_ report including metabolizer status and risk of drug toxicit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx/pro/dx inj new drug addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96375","description":"Tx/pro/dx inj new drug addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7524","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATA1","description":"ICD-GATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB150","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYB0","description":"ICD-KFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPF0","description":"ICD-FBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUB0","description":"ICD-EIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBB1","description":"ICD-JDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYF0","description":"ICD-HBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCC1","description":"ICD-JDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBD1","description":"ICD-BBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCA0","description":"ICD-ACCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ loncastuximab tesirine-lpyl_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9084","description":"Injection_ loncastuximab tesirine-lpyl_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD235","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBD0","description":"ICD-MLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of selenium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84255","description":"Assay of selenium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOE0","description":"ICD-OAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hocm>= 400mg/ml iodine_ 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9964","description":"Hocm>= 400mg/ml iodine_ 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBE1","description":"ICD-KFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo ligate spermatic vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55550","description":"Laparo ligate spermatic vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; each additional wound (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0513T","description":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; each additional wound (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWA1","description":"ICD-PCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDD0","description":"ICD-OIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49613","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGB0","description":"ICD-ODGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB101","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBC1","description":"ICD-OLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAA0","description":"ICD-KFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCB0","description":"ICD-FGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYB0","description":"ICD-DIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrin degradation quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85379","description":"Fibrin degradation quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPC0","description":"ICD-GAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIB1","description":"ICD-NGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4397","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","description":"HCPCS-Q4397","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDD0","description":"ICD-NIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93247","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEB1","description":"ICD-OEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy liver add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47001","description":"Needle biopsy liver add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWF1","description":"ICD-DDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair esophagus opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43425","description":"Repair esophagus opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAA0","description":"ICD-NKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHF1","description":"ICD-ABHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCA0","description":"ICD-OFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHA0","description":"ICD-IIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anti-inflm/anlgsc agent rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4016F","description":"Anti-inflm/anlgsc agent rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDD1","description":"ICD-MDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOA0","description":"ICD-DBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50551","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In-hospital on call service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99026","description":"In-hospital on call service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXD0","description":"ICD-BBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nutritional support offered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4551F","description":"Nutritional support offered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0407","description":"HCPCS-C0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNE0","description":"ICD-NLNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Residential Habilitation 1-3 Supp 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0101","description":"Residential Habilitation 1-3 Supp 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sho heel count plast reinfor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3430","description":"Sho heel count plast reinfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMA0","description":"ICD-MDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBF1","description":"ICD-BBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech audiometry threshold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0210T","description":"Speech audiometry threshold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ amivantamab-vmjw_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9083","description":"Injection_ amivantamab-vmjw_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1113","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antinuclear antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86038","description":"Antinuclear antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGF1","description":"ICD-OLGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB31","description":"ICD-2LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVA1","description":"ICD-GBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBA1","description":"ICD-OKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antithromb thx presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8696","description":"Antithromb thx presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGD1","description":"ICD-JGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMC1","description":"ICD-MCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1396","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","description":"HCPCS-M1396","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADC0","description":"ICD-EADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61570","description":"Remove foreign body brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21725","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHD1","description":"ICD-EDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18G","description":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUB1","description":"ICD-FBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0121A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRE1","description":"ICD-KFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXF1","description":"ICD-FCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18I","description":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIB1","description":"ICD-MEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEF0","description":"ICD-AEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASC1","description":"ICD-GASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18G","description":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHB1","description":"ICD-JGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSF0","description":"ICD-KHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home sleep test/type 2 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0398","description":"Home sleep test/type 2 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42505","description":"Repair salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECA0","description":"ICD-EECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng periton dialysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4055F","description":"Pt rcvng periton dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFF1","description":"ICD-NGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHF1","description":"ICD-JCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCD1","description":"ICD-OFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCD1","description":"ICD-BCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extrnl bleaching per arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9972","description":"Extrnl bleaching per arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJD0","description":"ICD-GIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPB1","description":"ICD-NDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITA1","description":"ICD-JITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTC1","description":"ICD-FHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of middle ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70134","description":"X-ray exam of middle ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRB0","description":"ICD-LHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antipsychotics nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80342","description":"Antipsychotics nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac event recorder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0616","description":"Cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87468","description":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP1A2 (cytochrome P450 family 1_ subfamily A_ member 2)(eg_ drug metabolism) gene analysis_ common variants (ie_ *1F_ *1K_ *6_ *7)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0031U","description":"CYP1A2 (cytochrome P450 family 1_ subfamily A_ member 2)(eg_ drug metabolism) gene analysis_ common variants (ie_ *1F_ *1K_ *6_ *7)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatic function panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80076","description":"Hepatic function panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE230","description":"Special Care Low _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTE0","description":"ICD-GCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth tubal ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85151","description":"Anesth tubal ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Weekly Bundle Not Including The Drug_ Including Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Testing If Performed (Pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2074","description":"Medication Assisted Treatment_ Weekly Bundle Not Including The Drug_ Including Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Testing If Performed (Pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lt compres band >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6450","description":"Lt compres band >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGF1","description":"ICD-OIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Standard wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0001","description":"Standard wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFED1","description":"ICD-FFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVD1","description":"ICD-NLVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFA1","description":"ICD-OBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGD1","description":"ICD-NBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fem urinary collect dev cup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4327","description":"Fem urinary collect dev cup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOA1","description":"ICD-GHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPF1","description":"ICD-JDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA11","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76498","description":"MRI procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attach bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51840","description":"Attach bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHE0","description":"ICD-MEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3272F","description":"Med risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grafix Core and GrafixPL Core_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4132","description":"Grafix Core and GrafixPL Core_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJA0","description":"ICD-FHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOB1","description":"ICD-HGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late closure of wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13160","description":"Late closure of wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmprsburngarment glove-wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6504","description":"Cmprsburngarment glove-wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHF0","description":"ICD-AEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90838","description":"Psytx pt&/fam w/e&m 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert and remove bone pin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20650","description":"Insert and remove bone pin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUF0","description":"ICD-FBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing care in home rn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9123","description":"Nursing care in home rn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKB1","description":"ICD-CGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/replace ur sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53447","description":"Remove/replace ur sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney dialysate delivry sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1510","description":"Kidney dialysate delivry sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27005","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAE1","description":"ICD-OGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBC0","description":"ICD-MHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMC0","description":"ICD-MHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE146","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIC0","description":"ICD-AAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0C","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trim nail(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0127","description":"Trim nail(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC225","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFB0","description":"ICD-KAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGE0","description":"ICD-NGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFD0","description":"ICD-BBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METE0","description":"ICD-METE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay resin 2 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2662","description":"Dental onlay resin 2 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC11","description":"ICD-4GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGB0","description":"ICD-OIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1085T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1085T","description":"CPT-1085T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPA1","description":"ICD-KFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-sterile gauze<=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6216","description":"Non-sterile gauze<=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB31","description":"Low Rehab_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPD1","description":"ICD-FGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7526","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTD0","description":"ICD-CFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gjb2 gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81253","description":"Gjb2 gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTD0","description":"ICD-MJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41116","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKF1","description":"ICD-NFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETC0","description":"ICD-AETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Large disposable underpad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4541","description":"Large disposable underpad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOB1","description":"ICD-LGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHID1","description":"ICD-JHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDC1","description":"ICD-NGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot inhibit prot c antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85302","description":"Clot inhibit prot c antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc type nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9289","description":"Doc type nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Palifermin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2425","description":"Palifermin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronch ebus samplng 1/2 node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31652","description":"Bronch ebus samplng 1/2 node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enteral stomach tube levine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4083","description":"Enteral stomach tube levine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18E","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMB1","description":"ICD-ADMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA160","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dvt prophylx recvd day 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4070F","description":"Dvt prophylx recvd day 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCD1","description":"ICD-MHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAE0","description":"ICD-MBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove in/ex hem grps & fiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46261","description":"Remove in/ex hem grps & fiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKC0","description":"ICD-NAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMC1","description":"ICD-IDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36200","description":"Place catheter in aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg_ expanded size and methylation status)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81172","description":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg_ expanded size and methylation status)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC11","description":"ICD-2FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESF0","description":"ICD-OESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUF0","description":"ICD-CGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sperm evaluation test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89329","description":"Sperm evaluation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA206","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILE0","description":"ICD-IILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILD1","description":"ICD-FILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKB0","description":"ICD-CGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1077","description":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHB0","description":"ICD-MJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Op rad mg intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9238","description":"Op rad mg intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELD1","description":"ICD-KELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home std case rate 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0270","description":"Home std case rate 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDF0","description":"ICD-BBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10B","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove collar bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23180","description":"Remove collar bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQB0","description":"ICD-GBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECD1","description":"ICD-FECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHD0","description":"ICD-MCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRE1","description":"ICD-HFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breath tube kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2326","description":"Breath tube kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ during operative procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73530","description":"Radiologic examination_ hip_ during operative procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1100","description":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKE1","description":"ICD-CDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D6280","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6280","description":"CDT-D6280","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obtaining screen pap smear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0091","description":"Obtaining screen pap smear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPC0","description":"ICD-CIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10C","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTD0","description":"ICD-ACTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA42","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63088","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of imperforated anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46742","description":"Repair of imperforated anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant auditory brain imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2235","description":"Implant auditory brain imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACE1","description":"ICD-NACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABD1","description":"ICD-BABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRD0","description":"ICD-DHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sincalide (maia) not therapeutically equivalent to j2805_ 5 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2806","description":"Injection_ sincalide (maia) not therapeutically equivalent to j2805_ 5 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWB0","description":"ICD-GCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1740","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1740","description":"HCPCS-C1740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRA0","description":"ICD-HGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj >24 hr in ed gcs <15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9532","description":"Inj >24 hr in ed gcs <15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEA0","description":"ICD-MDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBND0","description":"ICD-KBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCB0","description":"ICD-OGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUF0","description":"ICD-KGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSA1","description":"ICD-LFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair maxillofacial prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8049","description":"Repair maxillofacial prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29894","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDA1","description":"ICD-GBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete wheel lock assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2206","description":"Complete wheel lock assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSF1","description":"ICD-PHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWC1","description":"ICD-GIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACB0","description":"ICD-KACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain open abdom abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49040","description":"Drain open abdom abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGE1","description":"ICD-FGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt brain chemotx add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61517","description":"Implt brain chemotx add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRA1","description":"ICD-OKRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/drain eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67405","description":"Explore/drain eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair double ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33612","description":"Repair double ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair major blood vessel(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33322","description":"Repair major blood vessel(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKC0","description":"ICD-OBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMD1","description":"ICD-CFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8A","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB125","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSB1","description":"ICD-CCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8F","description":"Very High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUB1","description":"ICD-KGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 2999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4723","description":"Dialys sol fld vol > 2999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNE0","description":"ICD-KDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTF0","description":"ICD-IDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation cervical mucus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89330","description":"Evaluation cervical mucus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tebentafusp-tebn_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9095","description":"Injection_ tebentafusp-tebn_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bekesy audiometry screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92560","description":"Bekesy audiometry screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA255","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dil macula/fundus exam/w doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8397","description":"Dil macula/fundus exam/w doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGF1","description":"ICD-CDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASD1","description":"ICD-KASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of free testosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84402","description":"Assay of free testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIE0","description":"ICD-NBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No pt cat and  pt1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9431","description":"No pt cat and  pt1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth chest drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52451","description":"Anesth chest drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWF1","description":"ICD-OKWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBD0","description":"ICD-JIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of copper","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82525","description":"Assay of copper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14B","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change of bladder tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51705","description":"Change of bladder tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXF0","description":"ICD-CDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILD1","description":"ICD-KILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEE0","description":"ICD-FBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28570","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe lift elev heel/sole neo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3310","description":"Shoe lift elev heel/sole neo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLD0","description":"ICD-JCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYC0","description":"ICD-DIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUC0","description":"ICD-GIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRA0","description":"ICD-PIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOC1","description":"ICD-PAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITC0","description":"ICD-IITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGB1","description":"ICD-KEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFF1","description":"ICD-GCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nsg aide service up to 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1004","description":"Nsg aide service up to 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling_ ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1310","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling_ ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNC1","description":"ICD-BDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQF1","description":"ICD-CCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of androsterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82160","description":"Assay of androsterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digit nerve surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64778","description":"Digit nerve surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lipid profile not perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8728","description":"Lipid profile not perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ivf package","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4011","description":"Ivf package","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46611","description":"Anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvonorgestrl-Rls Iu Coc Sys 19.5 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9984","description":"Lvonorgestrl-Rls Iu Coc Sys 19.5 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Porfimer sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9600","description":"Porfimer sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1260","description":"Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMB0","description":"ICD-FCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJE0","description":"ICD-GEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOD1","description":"ICD-PCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plastic mod low ext pad/line","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2275","description":"Plastic mod low ext pad/line","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIF1","description":"ICD-MAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23545","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOA1","description":"ICD-PKOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTD0","description":"ICD-KFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt ed write/oral pts w/ hf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4003F","description":"Pt ed write/oral pts w/ hf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJD0","description":"ICD-GHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 7.6-12.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12015","description":"Rpr f/e/e/n/l/m 7.6-12.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0528U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","description":"CPT-0528U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kne sing axis fric shin sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5200","description":"Kne sing axis fric shin sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGID1","description":"ICD-GGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice care_ in the home_ p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9126","description":"Hospice care_ in the home_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKB0","description":"ICD-BEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWB0","description":"ICD-OFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of a peritoneal ascites pump system_ including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0874T","description":"Removal of a peritoneal ascites pump system_ including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCE1","description":"ICD-OLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Specialty care transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0434","description":"Specialty care transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA26","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKF1","description":"ICD-OJKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFA0","description":"ICD-CEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0141A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33542","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAA0","description":"ICD-JCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCA1","description":"ICD-FFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDC0","description":"ICD-KGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAD1","description":"ICD-OEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24670","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bicarbonate conc sol per gal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4706","description":"Bicarbonate conc sol per gal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX46","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBB1","description":"ICD-JHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDC0","description":"ICD-OBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debride genitalia & perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11004","description":"Debride genitalia & perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOD0","description":"ICD-OHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWA1","description":"ICD-CAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50360","description":"Transplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smokeless tobacco user","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1035F","description":"Smokeless tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair heavy duty fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1295","description":"Wheelchair heavy duty fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9944","description":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous catheter anchor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5200","description":"Percutaneous catheter anchor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIE1","description":"ICD-FHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWC0","description":"ICD-OAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFD1","description":"ICD-BFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50040","description":"Drainage of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDA1","description":"ICD-AGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUC1","description":"ICD-FIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spring-ass rot wrst w/ latch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6623","description":"Spring-ass rot wrst w/ latch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKF1","description":"ICD-CIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ankle implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27704","description":"Removal of ankle implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interprt fees/laryngeal test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92617","description":"Interprt fees/laryngeal test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep c quant rna tstng docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3220F","description":"Hep c quant rna tstng docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUB1","description":"ICD-MFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDD0","description":"ICD-JGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRD1","description":"ICD-DDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVB0","description":"ICD-ODVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCE0","description":"ICD-GHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc t-pa admin considered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4077F","description":"Doc t-pa admin considered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOC1","description":"ICD-OJOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJC0","description":"ICD-CIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHC1","description":"ICD-IIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCD1","description":"ICD-AHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJC1","description":"ICD-KAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"H pylori drug admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83014","description":"H pylori drug admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAD1","description":"ICD-ODAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1049T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1049T","description":"CPT-1049T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITF1","description":"ICD-AITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMA1","description":"ICD-FHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLE1","description":"ICD-GGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient receives hcv antibody test with nonreactive result","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1231","description":"Patient receives hcv antibody test with nonreactive result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair Of Fixed Retainer_ Includes Reattachment - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8702","description":"Repair Of Fixed Retainer_ Includes Reattachment - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arformoterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7605","description":"Arformoterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx head/neck ext unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9112","description":"Onc dx head/neck ext unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHA0","description":"ICD-MAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJF0","description":"ICD-OIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBA1","description":"ICD-NCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral speech device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92597","description":"Oral speech device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy spx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46600","description":"Diagnostic anoscopy spx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLE1","description":"ICD-JCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAD1","description":"ICD-GIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTD1","description":"ICD-MDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJB1","description":"ICD-BFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18G","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOF1","description":"ICD-HCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Homecare train pt session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5109","description":"Homecare train pt session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8X","description":"High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAA0","description":"ICD-FAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHND1","description":"ICD-BHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81249","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGA1","description":"ICD-KCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOD1","description":"ICD-HFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQA1","description":"ICD-KHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEA1","description":"ICD-MBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smoking cessation class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9453","description":"Smoking cessation class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECC0","description":"ICD-GECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLC0","description":"ICD-NBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery for vulva lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56440","description":"Surgery for vulva lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compre audiometry evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0212T","description":"Compre audiometry evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUF1","description":"ICD-NKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYC0","description":"ICD-LCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service for ages under 21 Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0312","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service for ages under 21 Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","description":"HCPCS-J0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23D","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7351","description":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKB1","description":"ICD-KGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHF0","description":"ICD-NFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYD0","description":"ICD-OAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHD1","description":"ICD-OGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELF1","description":"ICD-IELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLD1","description":"ICD-FBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFF1","description":"ICD-KEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixation of tongue_ mechanical_ other than suture (eg_ K-wire)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41500","description":"Fixation of tongue_ mechanical_ other than suture (eg_ K-wire)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27640","description":"Partial removal of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22C","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXA0","description":"ICD-CBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXF0","description":"ICD-OHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMB1","description":"ICD-EEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ single dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90480","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ single dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADE0","description":"ICD-KADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITE1","description":"ICD-AITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penile contracture device_ manual_ greater than 3 lbs traction force","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4988","description":"Penile contracture device_ manual_ greater than 3 lbs traction force","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGF0","description":"ICD-OBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJE1","description":"ICD-FFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28F","description":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92628","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","description":"CPT-92628","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27393","description":"Lengthening of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGA0","description":"ICD-FBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIA0","description":"ICD-MCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise excessive skin arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15836","description":"Excise excessive skin arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9053","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9053","description":"HCPCS-J9053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0C","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADA1","description":"ICD-AADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCE0","description":"ICD-JGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1101","description":"CDT-D1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL51","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCD0","description":"ICD-ECCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC23","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hgb not doc rns not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8974","description":"Hgb not doc rns not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDID1","description":"ICD-IDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKA0","description":"ICD-GIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11441","description":"Exc face-mm b9+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33737","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown full cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2792","description":"Crown full cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMB0","description":"ICD-AHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/M","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0394U","description":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare donor lung double","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32856","description":"Prepare donor lung double","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28E","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of skull & brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62145","description":"Repair of skull & brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKC0","description":"ICD-CDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of tendons at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25300","description":"Fusion of tendons at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGA0","description":"ICD-CFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocyte culture mixed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86821","description":"Lymphocyte culture mixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDE0","description":"ICD-NGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBF1","description":"ICD-ADBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBA0","description":"ICD-EHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAA0","description":"ICD-KAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye/attach implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65105","description":"Remove eye/attach implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluorescent antibody titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86256","description":"Fluorescent antibody titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ elotuzumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9176","description":"Injection_ elotuzumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1426","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","description":"HCPCS-M1426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2D","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHC0","description":"ICD-JAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neomatrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2021","description":"Neomatrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55821","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHD0","description":"ICD-BCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid exam both ears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92591","description":"Hearing aid exam both ears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAC1","description":"ICD-GAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNB0","description":"ICD-GBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEA0","description":"ICD-EFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXC1","description":"ICD-BIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pain management (opioid-use disorder) genotyping panel_ 16 common variants (ie_ ABCB1_ COMT_ DAT1_ DBH_ DOR_ DRD1_ DRD2_ DRD4_ GABA_ GAL_ HTR2A_ HTTLPR_ MTHFR_ MUOR_ OPRK1_ OP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0078U","description":"Pain management (opioid-use disorder) genotyping panel_ 16 common variants (ie_ ABCB1_ COMT_ DAT1_ DBH_ DOR_ DRD1_ DRD2_ DRD4_ GABA_ GAL_ HTR2A_ HTTLPR_ MTHFR_ MUOR_ OPRK1_ OP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of palm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26025","description":"Drainage of palm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insrt/redo spine n generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63685","description":"Insrt/redo spine n generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOB1","description":"ICD-PFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (cutaneous squamous cell carcinoma)_ mRNA gene expression profiling by RT-PCR of 40 genes (34 content and 6 housekeeping)_ utilizing formalin-fixed paraffin-embedded","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0315U","description":"Oncology (cutaneous squamous cell carcinoma)_ mRNA gene expression profiling by RT-PCR of 40 genes (34 content and 6 housekeeping)_ utilizing formalin-fixed paraffin-embedded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOE0","description":"ICD-LFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for tear sac x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68850","description":"Injection for tear sac x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIID0","description":"ICD-FIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABB0","description":"ICD-MABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBD1","description":"ICD-NIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA07","description":"Medium Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUA0","description":"ICD-CGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4418","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","description":"HCPCS-Q4418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amalgam two surfaces permane","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2150","description":"Amalgam two surfaces permane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy contrl bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32654","description":"Thoracoscopy contrl bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ublituximab-xiiy_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2329","description":"Injection_ ublituximab-xiiy_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIB1","description":"ICD-CBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCB0","description":"ICD-IHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBF1","description":"ICD-IGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAC1","description":"ICD-MAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neg press wnd tx </=50 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97607","description":"Neg press wnd tx </=50 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAA0","description":"ICD-JBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILD1","description":"ICD-GILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWF0","description":"ICD-DGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJC1","description":"ICD-NBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHD1","description":"ICD-KBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including target assessment_ initial motor threshold determination_ neuronavigati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0890T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including target assessment_ initial motor threshold determination_ neuronavigati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQA1","description":"ICD-ODQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXB1","description":"ICD-OHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20A","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo ablate liver cryosurg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47371","description":"Laparo ablate liver cryosurg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient progr_ neurostim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1787","description":"Patient progr_ neurostim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUE1","description":"ICD-KAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional outcome assessment documented_ care plan not documented_ documentation the patient is not eligible for a care plan at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9227","description":"Functional outcome assessment documented_ care plan not documented_ documentation the patient is not eligible for a care plan at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhc lpn/rn obs/asses ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0163","description":"Hhc lpn/rn obs/asses ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ non-coronary_ temporary_ with delivery system (propel)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1091","description":"Stent_ non-coronary_ temporary_ with delivery system (propel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSF0","description":"ICD-LFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKF1","description":"ICD-JFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUF0","description":"ICD-KIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impact tooth rem bony w/comp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7241","description":"Impact tooth rem bony w/comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQA0","description":"ICD-HCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54312","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCD1","description":"ICD-NJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCED0","description":"ICD-KCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXD0","description":"ICD-BIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIA0","description":"ICD-FEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resp suction oral interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7047","description":"Resp suction oral interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMF1","description":"ICD-KHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWA0","description":"ICD-OKWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain cavity shunt w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62201","description":"Brain cavity shunt w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWE0","description":"ICD-CBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKA0","description":"ICD-FBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC146","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOD1","description":"ICD-PKOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXA0","description":"ICD-KIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYE1","description":"ICD-OEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct elbow med ligmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24346","description":"Reconstruct elbow med ligmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRB1","description":"ICD-GDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB220","description":"Special Care Low _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc order given stop antibio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4043F","description":"Doc order given stop antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEME1","description":"ICD-IEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coroners autopsy (necropsy)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88045","description":"Coroners autopsy (necropsy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nash fibrosure(tm)_ labcorp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003M","description":"Nash fibrosure(tm)_ labcorp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55881","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","description":"CPT-55881","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin sub grft t/arm/lg child","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15273","description":"Skin sub grft t/arm/lg child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Patisiran_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0222","description":"Injection_ Patisiran_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92019","description":"Eye exam & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFC1","description":"ICD-NCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza imm status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1030F","description":"Influenza imm status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBD1","description":"ICD-CEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect mediastinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39200","description":"Resect mediastinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBE0","description":"ICD-CEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNC0","description":"ICD-KBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOB1","description":"ICD-GIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUF1","description":"ICD-KIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMD1","description":"ICD-CGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVC1","description":"ICD-FFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair lower leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27734","description":"Repair lower leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ a","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUE0","description":"ICD-GIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE121","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disease mgmt per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0317","description":"Disease mgmt per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUF1","description":"ICD-GIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOA0","description":"ICD-LHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23B","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15B","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQD0","description":"ICD-HAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1349","description":"Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARA0","description":"ICD-CARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bupropion hcl sr 60 tablets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0106","description":"Bupropion hcl sr 60 tablets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTF0","description":"ICD-NLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDC1","description":"ICD-CHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient transferred to practice after initiation of chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9826","description":"Patient transferred to practice after initiation of chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","description":"CPT-00474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known S","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0224","description":"Intravenous infusion_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE144","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonfamily hc train/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5116","description":"Nonfamily hc train/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLD1","description":"ICD-CFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal pacemaker electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33235","description":"Removal pacemaker electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10C","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28C","description":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cartilage for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20912","description":"Remove cartilage for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEA1","description":"ICD-BGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPB0","description":"ICD-NFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGC0","description":"ICD-FCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVB0","description":"ICD-BGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOB0","description":"ICD-DAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sgd accessory noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2599","description":"Sgd accessory noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCD1","description":"ICD-KCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML54","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEA0","description":"ICD-OCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No qual card diag prior12mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1461F","description":"No qual card diag prior12mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMB1","description":"ICD-NAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ver doc hear loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8565","description":"Ver doc hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pmkr_ single_ non rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2620","description":"Pmkr_ single_ non rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTE0","description":"ICD-BBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory bp analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93788","description":"Ambulatory bp analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGED0","description":"ICD-KGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ leuprolide acetate for depot suspension (fensolvi)_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1951","description":"Injection_ leuprolide acetate for depot suspension (fensolvi)_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTF0","description":"ICD-AHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMD1","description":"ICD-JBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCE1","description":"ICD-NLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA13","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTB1","description":"ICD-NGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth upper gi visualize","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74051","description":"Anesth upper gi visualize","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISD1","description":"ICD-GISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCID1","description":"ICD-FCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE224","description":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23A","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7566","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7566","description":"HCPCS-C7566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Single vitamin nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9152","description":"Single vitamin nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHD0","description":"ICD-JBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCA1","description":"ICD-FCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe molded to pt silicone s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3251","description":"Shoe molded to pt silicone s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYF1","description":"ICD-OLYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Image not std nomenclature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9319","description":"Image not std nomenclature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTA0","description":"ICD-EHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRB0","description":"ICD-HCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subretinal injection of a pharmacologic agent_ including vitrectomy and 1 or more retinotomies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0810T","description":"Subretinal injection of a pharmacologic agent_ including vitrectomy and 1 or more retinotomies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting_ isolation and preparation of harvested cells_ i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0717T","description":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting_ isolation and preparation of harvested cells_ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGC0","description":"ICD-OAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPC1","description":"ICD-CHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1A","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35331","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGD0","description":"ICD-BFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27350","description":"Removal of kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL34","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYF1","description":"ICD-HFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBD0","description":"ICD-GHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECD0","description":"ICD-OECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESD1","description":"ICD-HESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHD1","description":"ICD-IEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGE0","description":"ICD-JGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group mnt 2 or more 30 mins","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0271","description":"Group mnt 2 or more 30 mins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Predominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6086","description":"Implant Supported Crown - Predominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of kneecap tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27380","description":"Repair of kneecap tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"H2o stat docd normal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2030F","description":"H2o stat docd normal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESF0","description":"ICD-LESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAF1","description":"ICD-FIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1301","description":"HCPCS-C1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYD0","description":"ICD-GEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGD0","description":"ICD-KIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ durvalumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9492","description":"Injection_ durvalumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTA1","description":"ICD-NFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit cath care noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5497","description":"Hit cath care noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC21","description":"ICD-1GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUD1","description":"ICD-FEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC11","description":"ICD-1DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRD1","description":"ICD-KCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23466","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRE0","description":"ICD-DIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/1-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34804","description":"Endovas aaa repr w/1-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNA0","description":"ICD-OKNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEB0","description":"ICD-BIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMA0","description":"ICD-BCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNE1","description":"ICD-CCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heavy duty battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4611","description":"Heavy duty battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX31","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seg pneumatic appl full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0668","description":"Seg pneumatic appl full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","description":"HCPCS-Q4387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNA0","description":"ICD-BDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (plasma cell disorders and myeloma)_ circulating plasma cell immunologic selection_ identification_ morphological characterization_ and enumeration of plasma cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0337U","description":"Oncology (plasma cell disorders and myeloma)_ circulating plasma cell immunologic selection_ identification_ morphological characterization_ and enumeration of plasma cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCF1","description":"ICD-ECCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psori tool doc/no bnchmk met","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9651","description":"Psori tool doc/no bnchmk met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61680","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRC0","description":"ICD-GDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQB1","description":"ICD-OGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home injectable therapy_ palivizumab_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9562","description":"Home injectable therapy_ palivizumab_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inversion/eversion correction device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9285","description":"Inversion/eversion correction device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IDH1 (isocitrate dehydrogenase 1 [NADP+]_ soluble) (eg_ glioma)_ common variants (eg_ R132H_ R132C)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81120","description":"IDH1 (isocitrate dehydrogenase 1 [NADP+]_ soluble) (eg_ glioma)_ common variants (eg_ R132H_ R132C)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood pressure recorded during inpatient stays_ emergency room visits_ urgent care visits_ and patient self-reported BP_s (home and health fair BP results)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9789","description":"Blood pressure recorded during inpatient stays_ emergency room visits_ urgent care visits_ and patient self-reported BP_s (home and health fair BP results)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEE1","description":"ICD-ICEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21077","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8A","description":"Medium Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLA0","description":"ICD-BGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXF1","description":"ICD-BEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28E","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRC0","description":"ICD-PIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSF0","description":"ICD-KCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: occipital headache in children","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2195","description":"Patients with clinical indications for imaging of the head: occipital headache in children","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXD1","description":"ICD-CAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18I","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKC0","description":"ICD-NGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98012","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","description":"CPT-98012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8E","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIF1","description":"ICD-BAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOA1","description":"ICD-KDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXA0","description":"ICD-NFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJE0","description":"ICD-OIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIA0","description":"ICD-NCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine4/>vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72074","description":"X-ray exam thorac spine4/>vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m mebrofenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9537","description":"Tc99m mebrofenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9842","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repr elbow lat ligmnt w/tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24343","description":"Repr elbow lat ligmnt w/tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam roll for bandage_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6602","description":"Gradient compression bandaging supply_ high density foam roll for bandage_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL52","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAA0","description":"ICD-JHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0073A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSC1","description":"ICD-DHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES306","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sealant repair per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1353","description":"Sealant repair per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd trach dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87491","description":"Chylmd trach dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFC1","description":"ICD-CIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth skull repair/fract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21551","description":"Anesth skull repair/fract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESD1","description":"ICD-KESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBA1","description":"ICD-ECBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29889","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bladder defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51940","description":"Correction of bladder defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX44","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1451","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","description":"HCPCS-M1451","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relieve inner eye pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65820","description":"Relieve inner eye pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAND1","description":"ICD-JAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug/substance nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80375","description":"Drug/substance nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVB1","description":"ICD-GBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open tx dprsd front sinus fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21343","description":"Open tx dprsd front sinus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQC1","description":"ICD-PFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYD0","description":"ICD-KIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Internal nerve revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64727","description":"Internal nerve revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCA0","description":"ICD-JDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interferential stim 4 chan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8131","description":"Interferential stim 4 chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGC1","description":"ICD-KDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKD1","description":"ICD-OKKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQB1","description":"ICD-OBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom shape cvr knee disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5706","description":"Custom shape cvr knee disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTB1","description":"ICD-ADTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGF1","description":"ICD-JDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone harvest_auto graft proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7295","description":"Bone harvest_auto graft proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB31","description":"ICD-2IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pik3Ca (Phosphatidylinositol-4_ 5-Biphosphate 3-Kinase_ Catalytic Subunit Alpha) (Eg_ Colorectal And Breast Cancer) Gene Analysis_ Targeted Sequence Analysis (Eg_ Exons 7_ 9_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81309","description":"Pik3Ca (Phosphatidylinositol-4_ 5-Biphosphate 3-Kinase_ Catalytic Subunit Alpha) (Eg_ Colorectal And Breast Cancer) Gene Analysis_ Targeted Sequence Analysis (Eg_ Exons 7_ 9_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA15","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87471","description":"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHE1","description":"ICD-GBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCF1","description":"ICD-NCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of glucagon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82943","description":"Assay of glucagon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bh ltc res r&b_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2048","description":"Bh ltc res r&b_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrode stim brain add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95962","description":"Electrode stim brain add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pain screened as moderate to severe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1000","description":"Pain screened as moderate to severe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQC1","description":"ICD-DDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFD1","description":"ICD-NEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQF1","description":"ICD-KFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAE1","description":"ICD-BCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tube_ pneumatic caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2385","description":"Tube_ pneumatic caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5948","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5948","description":"CDT-D5948","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUD0","description":"ICD-GIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB11","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA104","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTD1","description":"ICD-GDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ondansetron 4 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0119","description":"Ondansetron 4 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC211","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTD1","description":"ICD-NCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic us exam esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43237","description":"Endoscopic us exam esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDF0","description":"ICD-FGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBC1","description":"ICD-GCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVA1","description":"ICD-KBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1025","description":"Nonpneumatic sequential compression garment_ full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLD1","description":"ICD-MCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLA1","description":"ICD-KGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin test nos antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86486","description":"Skin test nos antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNA1","description":"ICD-CDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMA1","description":"ICD-BGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB15","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEA1","description":"ICD-BDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDF0","description":"ICD-OLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect leg/ankle tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27615","description":"Resect leg/ankle tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Man w/c push-rim powr system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0986","description":"Man w/c push-rim powr system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEC1","description":"ICD-OKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPB0","description":"ICD-BDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58951","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone-material quality testing by microindentation(s) of the tibia(s)_ with results reported as a score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0547T","description":"Bone-material quality testing by microindentation(s) of the tibia(s)_ with results reported as a score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal duct glbldr calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47544","description":"Removal duct glbldr calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRD0","description":"ICD-KDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic caster tire tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2215","description":"Pneumatic caster tire tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPB1","description":"ICD-FCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable nebulizer sml vol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7004","description":"Disposable nebulizer sml vol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2002","description":"HCPCS-B2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUD1","description":"ICD-NGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of neck of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27161","description":"Incision of neck of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54336","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1477","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","description":"HCPCS-M1477","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOD1","description":"ICD-OLOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAB1","description":"ICD-NLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVC0","description":"ICD-CFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intrafraction track motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6017","description":"Intrafraction track motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2698","description":"Brachytx_ stranded_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photodynamic tx addl 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96571","description":"Photodynamic tx addl 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"guided tissue regeneration - resorbable barrier_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6106","description":"guided tissue regeneration - resorbable barrier_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reagent strip/blood glucose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82948","description":"Reagent strip/blood glucose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOF0","description":"ICD-DCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKD0","description":"ICD-GFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pralatrexate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9307","description":"Pralatrexate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore and drain kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50125","description":"Explore and drain kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker folding wheeled w/o s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0143","description":"Walker folding wheeled w/o s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOC0","description":"ICD-LFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75051","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAF1","description":"ICD-MAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1446","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","description":"HCPCS-M1446","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJA1","description":"ICD-OKJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBA1","description":"ICD-FDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26437","description":"Realignment of tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEA0","description":"ICD-AHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct elbow lat ligmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24344","description":"Reconstruct elbow lat ligmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain spinal cord cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62268","description":"Drain spinal cord cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYF1","description":"ICD-OKYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAA0","description":"ICD-EGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLE1","description":"ICD-IDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBF0","description":"ICD-CGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFE0","description":"ICD-KFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMB0","description":"ICD-OHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAA1","description":"ICD-ECAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0087","description":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pedicle e/n/e/l/ntroral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15576","description":"Pedicle e/n/e/l/ntroral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ selective-cellular enhancement technique with interpretation (eg_ liquid-based slide preparation method)_ except cer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0830T","description":"Digitization of glass microscope slides for cytopathology_ selective-cellular enhancement technique with interpretation (eg_ liquid-based slide preparation method)_ except cer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28103","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiofrequency Ablation_ Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64625","description":"Radiofrequency Ablation_ Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDE1","description":"ICD-ACDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKC0","description":"ICD-OFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA13","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xylose tolerance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84620","description":"Xylose tolerance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIF0","description":"ICD-CIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTD1","description":"ICD-IGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTE0","description":"ICD-EBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXC1","description":"ICD-KEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epifix_ inj_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4145","description":"Epifix_ inj_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRA0","description":"ICD-PCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27612","description":"Exploration of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOC0","description":"ICD-OJOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy internal hemorrhoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46930","description":"Destroy internal hemorrhoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIB0","description":"ICD-BHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFD0","description":"ICD-NLFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPF1","description":"ICD-GFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJC0","description":"ICD-FGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Beta-2 glycoprotein antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86146","description":"Beta-2 glycoprotein antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13B","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-53866","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","description":"CPT-53866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMF0","description":"ICD-KFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWF0","description":"ICD-CEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACME1","description":"ICD-ACME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Including Rib(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21601","description":"Excision Of Chest Wall Tumor Including Rib(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFB0","description":"ICD-OEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDND0","description":"ICD-JDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA211","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHD0","description":"ICD-CHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1494","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","description":"HCPCS-M1494","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair nasal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30540","description":"Repair nasal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBF1","description":"ICD-FGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYE1","description":"ICD-PLYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retinal tamp_ silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1814","description":"Retinal tamp_ silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECA1","description":"ICD-MECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATB0","description":"ICD-MATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGF1","description":"ICD-NGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOB0","description":"ICD-CFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICF0","description":"ICD-OICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14D","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKB0","description":"ICD-NFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ definitive_ utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0659","description":"Drug test(s)_ definitive_ utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERE0","description":"ICD-KERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAD1","description":"ICD-ECAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroejaculation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55870","description":"Electroejaculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace g/c tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49450","description":"Replace g/c tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKA0","description":"ICD-FGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKD0","description":"ICD-FFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis B virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9912","description":"Hepatitis B virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anti-reflective coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2750","description":"Anti-reflective coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us urine capacity measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51798","description":"Us urine capacity measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWA0","description":"ICD-DHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML44","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVA1","description":"ICD-CEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTB1","description":"ICD-FCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary pouch w ex wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4391","description":"Urinary pouch w ex wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGB1","description":"ICD-NCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKD0","description":"ICD-OFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHA1","description":"ICD-IAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLE0","description":"ICD-JGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMD1","description":"ICD-OFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood chloride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82435","description":"Assay of blood chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lenacapavir_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1961","description":"Injection_ lenacapavir_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each additional single antibody stain procedure (List separately in addi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0761T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each additional single antibody stain procedure (List separately in addi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0527U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","description":"CPT-0527U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS)_ bone-density study and fracture-risk assessment_ 1 or more sites_ hips_ pelvis_ or spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0815T","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS)_ bone-density study and fracture-risk assessment_ 1 or more sites_ hips_ pelvis_ or spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSF1","description":"ICD-LBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9292","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","description":"HCPCS-J9292","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSB0","description":"ICD-HGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAC0","description":"ICD-BGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXC0","description":"ICD-OHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCF0","description":"ICD-JDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTE0","description":"ICD-JDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo transthoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93303","description":"Echo transthoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA31","description":"Very High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33420","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolloid drg filler dry","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6241","description":"Hydrocolloid drg filler dry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQE1","description":"ICD-DBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPA1","description":"ICD-FBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMA0","description":"ICD-AAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICB1","description":"ICD-IICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOE0","description":"ICD-DCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility_ and an a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1149","description":"Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility_ and an a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBB0","description":"ICD-IBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28I","description":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx ovarian recurrence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9116","description":"Onc dx ovarian recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAF1","description":"ICD-EBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWC0","description":"ICD-CGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGC0","description":"ICD-GBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","description":"HCPCS-A2032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compres burn garment_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6512","description":"Compres burn garment_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0911T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","description":"CPT-0911T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx gastric p r1-r2noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9101","description":"Onc dx gastric p r1-r2noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD250","description":"Special Care High _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0801","description":"HCPCS-B0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEA1","description":"ICD-IIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Feces culture aerobic bact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87045","description":"Feces culture aerobic bact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVA0","description":"ICD-KHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX31","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUD1","description":"ICD-OGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27848","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sr89 strontium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9600","description":"Sr89 strontium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67299","description":"Eye surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCC1","description":"ICD-GCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0C","description":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gel-one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7326","description":"Gel-one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCA0","description":"ICD-NKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJB0","description":"ICD-OGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOA1","description":"ICD-HCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74420","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDA0","description":"ICD-AFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKC0","description":"ICD-OHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKD1","description":"ICD-FFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBC0","description":"ICD-EDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Construct vagina with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57292","description":"Construct vagina with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLD0","description":"ICD-NBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain shoulder bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23035","description":"Drain shoulder bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNE0","description":"ICD-KHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUE1","description":"ICD-AFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASE0","description":"ICD-KASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMD1","description":"ICD-OKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of thyroid (t3 or t4)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84479","description":"Assay of thyroid (t3 or t4)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPC1","description":"ICD-BBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sock fracture or equal each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3995","description":"Sock fracture or equal each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNF1","description":"ICD-NFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL50","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMC1","description":"ICD-KHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGF1","description":"ICD-NHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJA1","description":"ICD-ODJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCC0","description":"ICD-OLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pain doc pos and plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8730","description":"Pain doc pos and plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHID0","description":"ICD-GHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARC0","description":"ICD-DARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKF1","description":"ICD-FDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICD1","description":"ICD-MICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRC1","description":"ICD-GFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trluml perip athrc abd aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0236T","description":"Trluml perip athrc abd aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWB0","description":"ICD-DGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGA1","description":"ICD-FDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58940","description":"Removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trilaciclib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1448","description":"Injection_ trilaciclib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Motor speech goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9186","description":"Motor speech goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKB0","description":"ICD-FFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 15 valent (PCV15)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90671","description":"Pneumococcal conjugate vaccine_ 15 valent (PCV15)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHME0","description":"ICD-IHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQD1","description":"ICD-GAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIF1","description":"ICD-IHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC46","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk knee joints single axis p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5676","description":"Bk knee joints single axis p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venous thrombosis imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78457","description":"Venous thrombosis imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g._ inside-out technique)_ including imaging guidance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9780","description":"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g._ inside-out technique)_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGA0","description":"ICD-NIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGE1","description":"ICD-KAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ per hour of the psychologist_s or physicia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96118","description":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ per hour of the psychologist_s or physicia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAA1","description":"ICD-KFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagus endoscopy/ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43205","description":"Esophagus endoscopy/ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0803T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; Over 12 Channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77787","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; Over 12 Channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE136","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL15","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0245","description":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPC1","description":"ICD-JGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEF1","description":"ICD-MJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQB0","description":"ICD-GCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB130","description":"Clinically Complex _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNC1","description":"ICD-OLNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Positron emission tomography radiopharmaceutical_ diagnostic_ for non-tumor identification_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9598","description":"Positron emission tomography radiopharmaceutical_ diagnostic_ for non-tumor identification_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93245","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lyme disease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86617","description":"Lyme disease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAE1","description":"ICD-ECAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","description":"HCPCS-Q4375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telehealth consultation_ critical care_ subsequent_ physicians typically spend 50 minutes communicating with the patient and providers via telehealth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0509","description":"Telehealth consultation_ critical care_ subsequent_ physicians typically spend 50 minutes communicating with the patient and providers via telehealth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70558","description":"MRI brain w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSA1","description":"ICD-DGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic colonoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45378","description":"Diagnostic colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27601","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXB0","description":"ICD-OGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJB0","description":"ICD-BCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPD1","description":"ICD-JAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D7259","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D7259","description":"CDT-D7259","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTC1","description":"ICD-KHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor pancreas/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48552","description":"Prep donor pancreas/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJA0","description":"ICD-NFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINB1","description":"ICD-CINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRB1","description":"ICD-DFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQF0","description":"ICD-OFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRA1","description":"ICD-GFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group II_ all other (eg_ iron_ trichrome)_ except stain for microorganisms_ sta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0757T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group II_ all other (eg_ iron_ trichrome)_ except stain for microorganisms_ sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTC1","description":"ICD-ICTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETF0","description":"ICD-NETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYE0","description":"ICD-DAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML24","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lympho venereum antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86729","description":"Lympho venereum antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB156","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKA0","description":"ICD-FCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIE0","description":"ICD-ECIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYA0","description":"ICD-GDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOC0","description":"ICD-LBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDB1","description":"ICD-FIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"INTRAORIFICE BARRIER","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3911","description":"INTRAORIFICE BARRIER","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amantadine hcl 100mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9017","description":"Amantadine hcl 100mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDA1","description":"ICD-KBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDE1","description":"ICD-BEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBB0","description":"ICD-MJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEE0","description":"ICD-FDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81400","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEF0","description":"ICD-BEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy resect septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58560","description":"Hysteroscopy resect septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aztreonam_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0457","description":"Injection_ aztreonam_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMF0","description":"ICD-FBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXA0","description":"ICD-GHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTE1","description":"ICD-FBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKC1","description":"ICD-FHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Batt pack/cart_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1356","description":"Batt pack/cart_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetaminophen injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0131","description":"Acetaminophen injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHA1","description":"ICD-OGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNA1","description":"ICD-NKNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular imp_ aqueous drain de","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1783","description":"Ocular imp_ aqueous drain de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIC0","description":"ICD-FCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADC0","description":"ICD-BADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound breast limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76642","description":"Ultrasound breast limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug_brand name","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5001","description":"Prescription drug_brand name","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETF0","description":"ICD-IETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intraoral procedures_ including biopsy; not otherwise specif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0125U","description":"Anesthesia for intraoral procedures_ including biopsy; not otherwise specif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFND1","description":"ICD-BFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q24h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9500","description":"Hit antibiotic q24h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGD0","description":"ICD-CFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensv oral eval prob focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0160","description":"Extensv oral eval prob focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAE1","description":"ICD-BBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKF0","description":"ICD-CGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUC1","description":"ICD-GGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVA0","description":"ICD-NEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0268T","description":"Implt/rpl crtd sns dev gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj testostero enanthate 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3121","description":"Inj testostero enanthate 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYF0","description":"ICD-PGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair anomaly w/conduit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33608","description":"Repair anomaly w/conduit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXE0","description":"ICD-JBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMF1","description":"ICD-IHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRD1","description":"ICD-HDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALC0","description":"ICD-OALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEC0","description":"ICD-JGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNF1","description":"ICD-OHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBB0","description":"ICD-BHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6064","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther/proph/diag iv inf addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96366","description":"Ther/proph/diag iv inf addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rectal sensation test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91120","description":"Rectal sensation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHA1","description":"ICD-IIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9484","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB60","description":"High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0704","description":"HCPCS-A0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTA1","description":"ICD-IDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart chambers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33670","description":"Repair of heart chambers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFC0","description":"ICD-FEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFF1","description":"ICD-CHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVE1","description":"ICD-JDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWA0","description":"ICD-PGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETD1","description":"ICD-EETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthroscopy_ shoulder_ surgical; with implantation of subacromial spacer (e.g._ balloon)_ includes debridement (e.g._ limited or extensive)_ subacromial decompression_ acromio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9781","description":"Arthroscopy_ shoulder_ surgical; with implantation of subacromial spacer (e.g._ balloon)_ includes debridement (e.g._ limited or extensive)_ subacromial decompression_ acromio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family training & counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1027","description":"Family training & counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQD0","description":"ICD-DDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLA1","description":"ICD-EHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLD0","description":"ICD-EDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUC0","description":"ICD-JFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGME1","description":"ICD-NGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUB0","description":"ICD-KDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRE0","description":"ICD-CFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18D","description":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27497","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1319","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADC1","description":"ICD-KADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMD0","description":"ICD-OEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXF1","description":"ICD-GCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBME1","description":"ICD-BBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0939T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","description":"CPT-0939T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRB0","description":"ICD-GGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINE0","description":"ICD-FINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of free thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84439","description":"Assay of free thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKD0","description":"ICD-KIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHA1","description":"ICD-AEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUC1","description":"ICD-IAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERE1","description":"ICD-PERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0676","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0676","description":"HCPCS-G0676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cyclosporine oral 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7515","description":"Cyclosporine oral 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00670","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","description":"CPT-00670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMF0","description":"ICD-KHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPC0","description":"ICD-OFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0D","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJB1","description":"ICD-CFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDB1","description":"ICD-NBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQA0","description":"ICD-OAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion Of Ventricular Assist Device_ Percutaneous_ Including Radiological Supervision And Interpretation; Right Heart_ Venous Access Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33995","description":"Insertion Of Ventricular Assist Device_ Percutaneous_ Including Radiological Supervision And Interpretation; Right Heart_ Venous Access Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O shoe add instep velcro clo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3580","description":"O shoe add instep velcro clo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXA0","description":"ICD-OBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISF1","description":"ICD-LISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGA0","description":"ICD-GIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIID1","description":"ICD-MIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJB1","description":"ICD-GAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE236","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-49187","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","description":"CPT-49187","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFE0","description":"ICD-FFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Restorigin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4191","description":"Restorigin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted e&m service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99499","description":"Unlisted e&m service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMC0","description":"ICD-CIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of digoxin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80162","description":"Assay of digoxin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVF1","description":"ICD-ODVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anal pressure record","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91122","description":"Anal pressure record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36561","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1416","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","description":"HCPCS-M1416","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55842","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRC0","description":"ICD-LBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE154","description":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTC1","description":"ICD-OCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 1 visit p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90956","description":"Esrd srv 1 visit p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDE0","description":"ICD-NKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4412","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","description":"HCPCS-Q4412","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC124","description":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVE0","description":"ICD-BAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALC1","description":"ICD-BALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cycler dialysis machine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1594","description":"Cycler dialysis machine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJB0","description":"ICD-KAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLE0","description":"ICD-CGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUD0","description":"ICD-IFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tiss ex molecul study add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88388","description":"Tiss ex molecul study add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_onabotulinumtoxina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0585","description":"Injection_onabotulinumtoxina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"First Medicare Diabetes Prevention Program (MDPP) core session was attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service tha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9873","description":"First Medicare Diabetes Prevention Program (MDPP) core session was attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service tha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rehabilitation program 1/2 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2001","description":"Rehabilitation program 1/2 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hallux implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8642","description":"Hallux implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8B","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Modification of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92325","description":"Modification of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTB1","description":"ICD-ODTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBB1","description":"ICD-BDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHB0","description":"ICD-KAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDD0","description":"ICD-FHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-adjunctive_ non-implanted continuous glucose monitor or receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2103","description":"Non-adjunctive_ non-implanted continuous glucose monitor or receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA50","description":"Medium Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUF1","description":"ICD-IGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rubella virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90706","description":"Rubella virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBD0","description":"ICD-KDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGA0","description":"ICD-CEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWE0","description":"ICD-HBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Helminth antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86682","description":"Helminth antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anti-inflm/anlgsc otc assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1007F","description":"Anti-inflm/anlgsc otc assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Genicular Nerve Branches_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64454","description":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Genicular Nerve Branches_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOD1","description":"ICD-KCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFD1","description":"ICD-CGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKF0","description":"ICD-JDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYF1","description":"ICD-CEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kyphectomy 1-2 segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22818","description":"Kyphectomy 1-2 segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYC1","description":"ICD-CEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX60","description":"Low Rehab plus Extensive _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1346","description":"Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acute hepatitis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80074","description":"Acute hepatitis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTB0","description":"ICD-JGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carbamazepine; -10_11-Epoxide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80161","description":"Carbamazepine; -10_11-Epoxide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFE0","description":"ICD-OCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trans bench w/wo comm open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0247","description":"Trans bench w/wo comm open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECE0","description":"ICD-JECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYB1","description":"ICD-OIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam drg > 48 sq in w/o brdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6211","description":"Foam drg > 48 sq in w/o brdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVE1","description":"ICD-NJVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXC0","description":"ICD-NFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver and spleen imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78215","description":"Liver and spleen imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENF0","description":"ICD-OENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAB1","description":"ICD-FCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended release (brixadi)_ greater than 7 days and up to 28 days of therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0578","description":"Injection_ buprenorphine extended release (brixadi)_ greater than 7 days and up to 28 days of therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDA0","description":"ICD-JHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWF1","description":"ICD-KEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFF1","description":"ICD-JFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m maa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9540","description":"Tc99m maa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6539","description":"Gc stocking waistlngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRC1","description":"ICD-DDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBF1","description":"ICD-AGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81271","description":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28495","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC246","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No hist cd4+ cell count <350","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3493F","description":"No hist cd4+ cell count <350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0992T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","description":"CPT-0992T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAC0","description":"ICD-KGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUE1","description":"ICD-ICUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81189","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFB1","description":"ICD-BAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFC0","description":"ICD-GDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plastic mold recipro hip & c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2627","description":"Plastic mold recipro hip & c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBB0","description":"ICD-CDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection into vocal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31513","description":"Injection into vocal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASF1","description":"ICD-OASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supported housing_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0044","description":"Supported housing_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBD0","description":"ICD-OKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGE1","description":"ICD-CIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whfo w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3809","description":"Whfo w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHE1","description":"ICD-FBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01932","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","description":"CPT-01932","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0919T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","description":"CPT-0919T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECF1","description":"ICD-OECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70220","description":"X-ray exam of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXD0","description":"ICD-NLXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a suicide safety plan initiated_ reviewed_ or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1354","description":"Patients who did not have a suicide safety plan initiated_ reviewed_ or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTA1","description":"ICD-BGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 3mod sacro-scap pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0462","description":"Tlso 3mod sacro-scap pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0028","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Geriatrics Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4008","description":"Geriatrics Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMB0","description":"ICD-GEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traction stand free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0850","description":"Traction stand free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIB1","description":"ICD-IDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYC1","description":"ICD-GAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0407","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0407","description":"CDT-D0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNE1","description":"ICD-JHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMD0","description":"ICD-NGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE210","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA51","description":"Low Rehab_ ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAF0","description":"ICD-BAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75251","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNF0","description":"ICD-BFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFF1","description":"ICD-FEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Forehead flap w/vasc pedicle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15731","description":"Forehead flap w/vasc pedicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hfo nontorsion jnts pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3929","description":"Hfo nontorsion jnts pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage(s)_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7510","description":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage(s)_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Docrsn no comm comorb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9232","description":"Docrsn no comm comorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87802","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post chmbr intraocular lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2632","description":"Post chmbr intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIF0","description":"ICD-CGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"GE GNOTYP GYPC EXONS 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0188U","description":"GE GNOTYP GYPC EXONS 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATF0","description":"ICD-BATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lipoprotein_ direct measurement; small dense LDL cholesterol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83722","description":"Lipoprotein_ direct measurement; small dense LDL cholesterol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGA1","description":"ICD-OEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24530","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/2-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34802","description":"Endovas aaa repr w/2-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFD0","description":"ICD-FAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compression stocking bk18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6530","description":"Compression stocking bk18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Man w/ch acc seat w>=20in<24in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2201","description":"Man w/ch acc seat w>=20in<24in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCED0","description":"ICD-CCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as an unhealthy alcohol user received brief counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2200","description":"Patient identified as an unhealthy alcohol user received brief counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYA1","description":"ICD-KEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFD0","description":"ICD-FIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50940","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCB0","description":"ICD-BBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral con def inter plt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5958","description":"Intraoral con def inter plt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1007T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","description":"CPT-1007T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMB0","description":"ICD-JDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAD0","description":"ICD-EFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITB0","description":"ICD-CITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYF1","description":"ICD-GIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEA0","description":"ICD-BCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13133","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gene test retinoblastoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3841","description":"Gene test retinoblastoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Centruroides immune f(ab)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0716","description":"Centruroides immune f(ab)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIF1","description":"ICD-AEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEE1","description":"ICD-BBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMA0","description":"ICD-KDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing warfarin or another FDA-approved oral anticoagulant that is FDA approved for the prevention of thromboembolism (e.g._ pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8969","description":"Documentation of patient reason(s) for not prescribing warfarin or another FDA-approved oral anticoagulant that is FDA approved for the prevention of thromboembolism (e.g._ pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPB0","description":"ICD-BFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWF0","description":"ICD-PJWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEE0","description":"ICD-JEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHB1","description":"ICD-EFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35221","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFF0","description":"ICD-OCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJE0","description":"ICD-BIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug scrn quan levetiracetam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80177","description":"Drug scrn quan levetiracetam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bld inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9625","description":"Bld inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDC0","description":"ICD-KBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITF1","description":"ICD-FITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise ventricle muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33416","description":"Revise ventricle muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermal filler inj px/suppl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9800","description":"Dermal filler inj px/suppl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52224","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEB1","description":"ICD-IAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTA1","description":"ICD-CFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFD1","description":"ICD-NGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB213","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65860","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMB0","description":"ICD-MIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWE0","description":"ICD-OLWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Advancing cancer care mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0001","description":"Advancing cancer care mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAC0","description":"ICD-IDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1171","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telehealth inpt pharm mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0459","description":"Telehealth inpt pharm mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCF1","description":"ICD-ADCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDD1","description":"ICD-OFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare fecal microbiota","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44705","description":"Prepare fecal microbiota","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPC1","description":"ICD-KDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUD0","description":"ICD-MDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria lmtd endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33265","description":"Ablate atria lmtd endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLED0","description":"ICD-OLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHE1","description":"ICD-BGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1482","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","description":"HCPCS-M1482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIB0","description":"ICD-GIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADE0","description":"ICD-BADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27470","description":"Repair of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUE0","description":"ICD-BAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAED0","description":"ICD-OAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthoped ladies shoes dpth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3216","description":"Orthoped ladies shoes dpth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMD0","description":"ICD-EHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATF1","description":"ICD-EATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMD1","description":"ICD-AAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev soft tiss add imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10036","description":"Perq dev soft tiss add imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQC0","description":"ICD-GBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTA1","description":"ICD-JBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKA0","description":"ICD-GAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB21","description":"ICD-2CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCC1","description":"ICD-GBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVB1","description":"ICD-CAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (vivimusta)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9056","description":"Injection_ bendamustine hydrochloride (vivimusta)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elder maltreatment screen documented as positive_ follow-up plan not documented_ documentation the patient is not eligible for follow-up plan at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8941","description":"Elder maltreatment screen documented as positive_ follow-up plan not documented_ documentation the patient is not eligible for follow-up plan at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWA0","description":"ICD-GFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQC1","description":"ICD-PKQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLE1","description":"ICD-OHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWB0","description":"ICD-OLWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHF0","description":"ICD-CFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPC1","description":"ICD-OIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel dressing >48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6233","description":"Hydrogel dressing >48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPF0","description":"ICD-CGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing care not possible because the patient self-discharged early (e.g._ financial or insurance reasons_ transportation problems_ or reason unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1148","description":"Ongoing care not possible because the patient self-discharged early (e.g._ financial or insurance reasons_ transportation problems_ or reason unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reposition vad diff session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33993","description":"Reposition vad diff session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEE0","description":"ICD-ECEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8X","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromatogram assay sugars","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84375","description":"Chromatogram assay sugars","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28X","description":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBF0","description":"ICD-KHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manipulation of spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22505","description":"Manipulation of spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells_ per day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0537T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells_ per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27181","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of chest tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32551","description":"Insertion of chest tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pacemaker monitr audible/vis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0610","description":"Pacemaker monitr audible/vis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replantation thumb complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20827","description":"Replantation thumb complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red blood cells unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9021","description":"Red blood cells unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETB1","description":"ICD-NETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFB1","description":"ICD-GCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1018","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pten gene dup/delet variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81323","description":"Pten gene dup/delet variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNB1","description":"ICD-JHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKB0","description":"ICD-CFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAED1","description":"ICD-MAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonemergency transport taxi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0100","description":"Nonemergency transport taxi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFD1","description":"ICD-BEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC126","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft subclav-subclav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35511","description":"Art byp grft subclav-subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIF0","description":"ICD-FCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHND0","description":"ICD-FHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTD0","description":"ICD-NKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped home apnea rec report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94777","description":"Ped home apnea rec report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRB0","description":"ICD-PLRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagomyotomy thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43331","description":"Esophagomyotomy thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle w/suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67334","description":"Revise eye muscle w/suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inlay composite/resin two su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2651","description":"Inlay composite/resin two su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore wound neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20100","description":"Explore wound neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair penis and bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54390","description":"Repair penis and bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of carnitine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82379","description":"Assay of carnitine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQF0","description":"ICD-HAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA05","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocytotoxicity assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86806","description":"Lymphocytotoxicity assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEB0","description":"ICD-FGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3C","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUB0","description":"ICD-AAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEF1","description":"ICD-BGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAD1","description":"ICD-KHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63268","description":"Excise intrspinl lesion scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phys blood bank serv reactj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86078","description":"Phys blood bank serv reactj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEF0","description":"ICD-FBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB41","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLC0","description":"ICD-GGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIC0","description":"ICD-GGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rectal catheter for use with the manual pump-operated enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4453","description":"Rectal catheter for use with the manual pump-operated enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB31","description":"ICD-1FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWC1","description":"ICD-PLWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit resp therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99503","description":"Home visit resp therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVB0","description":"ICD-BFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQB0","description":"ICD-OFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visual field assmnt rev/rprt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0378T","description":"Visual field assmnt rev/rprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUE0","description":"ICD-IHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPA1","description":"ICD-CGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFB0","description":"ICD-BBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7562","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7562","description":"HCPCS-C7562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No filt remov w/in 3mos plcm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9544","description":"No filt remov w/in 3mos plcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gauze <= 16 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6219","description":"Gauze <= 16 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMC0","description":"ICD-NAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLD1","description":"ICD-AHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise urethra stage 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53405","description":"Revise urethra stage 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ADENOVIRUS ENTERIC TYP 40/41","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87301","description":"IAAD IA ADENOVIRUS ENTERIC TYP 40/41","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Integrated filter & holder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7507","description":"Integrated filter & holder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Soft interface above knee se","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2830","description":"Soft interface above knee se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBE0","description":"ICD-KIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat sesamoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28531","description":"Treat sesamoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTB1","description":"ICD-KDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUB1","description":"ICD-OKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITE1","description":"ICD-OITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Init pm e/m new pat 65+ yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99387","description":"Init pm e/m new pat 65+ yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0857","description":"Pwc gp3 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPF0","description":"ICD-FIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTC0","description":"ICD-MCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFF0","description":"ICD-CEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDA0","description":"ICD-BEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOC1","description":"ICD-DCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAID0","description":"ICD-MAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of uterus lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58100","description":"Biopsy of uterus lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATA1","description":"ICD-JATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11B","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28B","description":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52235","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgraft tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4263","description":"Surgraft tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRD1","description":"ICD-PDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAD0","description":"ICD-BGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-sterile gauze > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6218","description":"Non-sterile gauze > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWE1","description":"ICD-PDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal hemoglobin chemical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83030","description":"Fetal hemoglobin chemical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fluphenazine hcl_ 1.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2679","description":"Injection_ fluphenazine hcl_ 1.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCE0","description":"ICD-CGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACB1","description":"ICD-FACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen drsg>16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6022","description":"Collagen drsg>16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJA1","description":"ICD-BHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECE0","description":"ICD-AECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1958","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1958","description":"HCPCS-J1958","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWD0","description":"ICD-LGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Co57 cyano","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9559","description":"Co57 cyano","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWE0","description":"ICD-PKWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBF1","description":"ICD-NCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99377","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interventional Radiology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4012","description":"Interventional Radiology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXC0","description":"ICD-OFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drop lock knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2182","description":"Drop lock knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIA1","description":"ICD-KCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEA0","description":"ICD-JGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBA0","description":"ICD-GCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp axillary-axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35650","description":"Art byp axillary-axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQA1","description":"ICD-GGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ctr mount pwr elev leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1012","description":"Ctr mount pwr elev leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX54","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNB0","description":"ICD-JBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIE0","description":"ICD-GFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFE0","description":"ICD-GDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy w/us needle bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43232","description":"Esophagoscopy w/us needle bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOF0","description":"ICD-OAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIA1","description":"ICD-AEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of skull with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62146","description":"Repair of skull with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMA0","description":"ICD-ICMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKB1","description":"ICD-BHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67500","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transparent film >16<=48 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6258","description":"Transparent film >16<=48 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUA1","description":"ICD-BFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of blood pku","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84030","description":"Assay of blood pku","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57135","description":"Remove vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Holotranscobalamin_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0103T","description":"Holotranscobalamin_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61151","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLB1","description":"ICD-FGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBB1","description":"ICD-GBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTC0","description":"ICD-MHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHC0","description":"ICD-MJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove pituit tumor w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62165","description":"Remove pituit tumor w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Palliative Care Services Given To Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0031","description":"Palliative Care Services Given To Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral surgery procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7999","description":"Oral surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIE1","description":"ICD-JIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVC0","description":"ICD-NJVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECA0","description":"ICD-BECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63001","description":"Remove spine lamina 1/2 crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Legg perthes orth newington","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1710","description":"Legg perthes orth newington","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXE0","description":"ICD-OEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc limited","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9068","description":"Onc dx sclc/nsclc limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMD1","description":"ICD-NEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOD0","description":"ICD-PAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6065","description":"Implant supported crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHA0","description":"ICD-MHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACB0","description":"ICD-AACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD231","description":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 2.1-3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11603","description":"Exc tr-ext mal+marg 2.1-3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGME1","description":"ICD-IGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient not receiving a first course of anti-tnf therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8871","description":"Patient not receiving a first course of anti-tnf therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYA1","description":"ICD-OCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDA0","description":"ICD-KGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01610","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","description":"CPT-01610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Trivisc_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7329","description":"Hyaluronan or derivative_ Trivisc_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAID0","description":"ICD-EAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE245","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEC1","description":"ICD-CBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhc pt assistant ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0157","description":"Hhc pt assistant ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEA0","description":"ICD-IIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dipyridamole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1245","description":"Dipyridamole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCC0","description":"ICD-JHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJC1","description":"ICD-KFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chiropractic manj 5 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98942","description":"Chiropractic manj 5 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLB0","description":"ICD-MJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pentazocine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3070","description":"Pentazocine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISC1","description":"ICD-LISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0557U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","description":"CPT-0557U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMB1","description":"ICD-KAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALC1","description":"ICD-KALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thorac cont lat support upri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2680","description":"Thorac cont lat support upri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-81558","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","description":"CPT-81558","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl of subq defibrillator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33272","description":"Rmvl of subq defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCE0","description":"ICD-OKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDB0","description":"ICD-ODDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of gdh enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82965","description":"Assay of gdh enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ SC_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5137","description":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ SC_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUB0","description":"ICD-NFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQE0","description":"ICD-DGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ROTAVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87425","description":"IAAD IA ROTAVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKF1","description":"ICD-GEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt ed re ft care inspct rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4305F","description":"Pt ed re ft care inspct rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43632","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lang express goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9163","description":"Lang express goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVA0","description":"ICD-KEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAF1","description":"ICD-KCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64901","description":"Nerve graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACB0","description":"ICD-FACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAC0","description":"ICD-OIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGA1","description":"ICD-OHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alginate dressing <=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6196","description":"Alginate dressing <=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLC1","description":"ICD-ECLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC121","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNA1","description":"ICD-FFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHF0","description":"ICD-IIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJB0","description":"ICD-CHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMA0","description":"ICD-MIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental case management - motivational interviewing","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9993","description":"Dental case management - motivational interviewing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA54","description":"Very High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYF0","description":"ICD-KBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98011","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","description":"CPT-98011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXD1","description":"ICD-GHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEC1","description":"ICD-GIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enema tube_ with or without adapter_ any type_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4457","description":"Enema tube_ with or without adapter_ any type_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35013","description":"Repair artery rupture arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCF1","description":"ICD-EHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special joystick handle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2323","description":"Special joystick handle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBF1","description":"ICD-KIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMF1","description":"ICD-ACMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2005","description":"HCPCS-B2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77620","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug-Induced Sleep Endoscopy_ With Dynamic Evaluation Of Velum_ Pharynx_ Tongue Base_ And Larynx For Evaluation Of Sleep-Disordered Breathing_ Flexible_ Diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42975","description":"Drug-Induced Sleep Endoscopy_ With Dynamic Evaluation Of Velum_ Pharynx_ Tongue Base_ And Larynx For Evaluation Of Sleep-Disordered Breathing_ Flexible_ Diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray special views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71035","description":"Chest x-ray special views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone cutting ramus closed","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7941","description":"Bone cutting ramus closed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Curette/treat cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65436","description":"Curette/treat cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMF0","description":"ICD-FGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAE1","description":"ICD-AFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES360","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain pancreatic pseudocyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48510","description":"Drain pancreatic pseudocyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1051","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFD1","description":"ICD-JAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62269","description":"Needle biopsy spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVC0","description":"ICD-BAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD134","description":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWC1","description":"ICD-DCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCD1","description":"ICD-FHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmi calc_ pt no f/u plan elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8938","description":"Bmi calc_ pt no f/u plan elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA31","description":"ICD-2BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Waterjet prostate abltj cmpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0421T","description":"Waterjet prostate abltj cmpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlorambucil 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0172","description":"Chlorambucil 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVA1","description":"ICD-BBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit longterm infusion diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9347","description":"Hit longterm infusion diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAF1","description":"ICD-NLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96935","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATF1","description":"ICD-KATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVF0","description":"ICD-KDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEC1","description":"ICD-MBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart-vein defect(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33730","description":"Repair heart-vein defect(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEF0","description":"ICD-ADEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETF0","description":"ICD-JETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfusion service fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36460","description":"Transfusion service fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVA0","description":"ICD-OLVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repr of anal fistula w/glue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46706","description":"Repr of anal fistula w/glue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIC1","description":"ICD-JFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL55","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDB1","description":"ICD-BFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENA1","description":"ICD-GENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGA0","description":"ICD-OKGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ non-cor_ tem w/del sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2625","description":"Stent_ non-cor_ tem w/del sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTE0","description":"ICD-BHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67966","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of intranasal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30117","description":"Removal of intranasal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRB1","description":"ICD-GCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDB0","description":"ICD-NHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIA1","description":"ICD-FBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trichogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96902","description":"Trichogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRD0","description":"ICD-GDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days_ including at least weekly downloads of pulmonary artery pressure recordings_ interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93264","description":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days_ including at least weekly downloads of pulmonary artery pressure recordings_ interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBME1","description":"ICD-EBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTE0","description":"ICD-AHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9773","description":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 125","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86304","description":"Immunoassay tumor ca 125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-81195","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","description":"CPT-81195","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1009T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","description":"CPT-1009T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXC1","description":"ICD-JIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99153","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0694U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694U","description":"CPT-0694U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"General health panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80050","description":"General health panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILE0","description":"ICD-CILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBF1","description":"ICD-GBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of bone cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20615","description":"Treatment of bone cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUC0","description":"ICD-FHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGE0","description":"ICD-FIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alteplase recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2997","description":"Alteplase recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVD0","description":"ICD-BAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1469","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","description":"HCPCS-M1469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOE1","description":"ICD-KBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKF0","description":"ICD-KHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27846","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKC0","description":"ICD-OAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of foot bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28288","description":"Partial removal of foot bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc neck tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21556","description":"Exc neck tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55110","description":"Explore scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0515T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart septum defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33647","description":"Repair heart septum defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visual evoked potential_ testing for glaucoma_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0464T","description":"Visual evoked potential_ testing for glaucoma_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIA1","description":"ICD-BFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATA0","description":"ICD-BATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA111","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spiro no perf or doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8926","description":"Spiro no perf or doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct abdomen w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74150","description":"Ct abdomen w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCB1","description":"ICD-GGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPA1","description":"ICD-FHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of impacted wax md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0268","description":"Removal of impacted wax md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13D","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFD1","description":"ICD-FIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99222","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETB0","description":"ICD-GETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1946","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1946","description":"HCPCS-J1946","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Euglobulin lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85360","description":"Euglobulin lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAD0","description":"ICD-NFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral place of fix dev","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7998","description":"Intraoral place of fix dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYA0","description":"ICD-KCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calcium infusion test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82331","description":"Calcium infusion test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYC1","description":"ICD-CIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Above knee flex cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5964","description":"Above knee flex cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENE1","description":"ICD-FENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAF1","description":"ICD-FFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20B","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUB0","description":"ICD-MIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASD0","description":"ICD-LASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gr27 non-sealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2372","description":"Gr27 non-sealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep b surface antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86706","description":"Hep b surface antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEA0","description":"ICD-OEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAE0","description":"ICD-MFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFED1","description":"ICD-KFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHF0","description":"ICD-EFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28B","description":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAB1","description":"ICD-OKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKC1","description":"ICD-GAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMD1","description":"ICD-FBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77049","description":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIA0","description":"ICD-OBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNE0","description":"ICD-NHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAE0","description":"ICD-NDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA140","description":"Reduced Physical Function _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXE0","description":"ICD-KDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45346","description":"Sigmoidoscopy w/ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAF0","description":"ICD-NBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALC0","description":"ICD-AALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8D","description":"Medium Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC14","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8X","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dis site  tele svcs RHC/FQHC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2025","description":"Dis site  tele svcs RHC/FQHC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHA1","description":"ICD-FFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCB1","description":"ICD-CGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIB1","description":"ICD-OFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27558","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of ureter & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50810","description":"Fusion of ureter & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRF1","description":"ICD-PDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy & decompress","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45337","description":"Sigmoidoscopy & decompress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXD0","description":"ICD-CHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35471","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of upper nose/throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42804","description":"Biopsy of upper nose/throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICA1","description":"ICD-KICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g._ patient with adverse effect_ alle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9781","description":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g._ patient with adverse effect_ alle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect inferior turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30140","description":"Resect inferior turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUD0","description":"ICD-AAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tail bone ulcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15920","description":"Removal of tail bone ulcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEC0","description":"ICD-IFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_eptinezumab-jjmr_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9063","description":"Injection_eptinezumab-jjmr_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSC0","description":"ICD-OCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELA1","description":"ICD-AELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen tent excl croup/ped t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0455","description":"Oxygen tent excl croup/ped t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trimethobenzamide hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3250","description":"Trimethobenzamide hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUD0","description":"ICD-GFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol/substance abuse skil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1012","description":"Alcohol/substance abuse skil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amphetamine or methamphetamine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6042","description":"Amphetamine or methamphetamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair elevating leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0990","description":"Wheelchair elevating leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICF1","description":"ICD-MICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal endoscop po debrid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2342","description":"Nasal endoscop po debrid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUA0","description":"ICD-EEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of intraosseous basivertebral nerve_ first two vertebral bodies_ including imaging guidance (e.g._ fluoroscopy)_ lu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9752","description":"Destruction of intraosseous basivertebral nerve_ first two vertebral bodies_ including imaging guidance (e.g._ fluoroscopy)_ lu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ adalimumab-aacf (idacio)_ biosimilar_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5131","description":"Injection_ adalimumab-aacf (idacio)_ biosimilar_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPD1","description":"ICD-OGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAE0","description":"ICD-EIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGB0","description":"ICD-BDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVE1","description":"ICD-OHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB225","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMF1","description":"ICD-MAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Motion analysis video/3d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96000","description":"Motion analysis video/3d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply surf ldr radionuclide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77789","description":"Apply surf ldr radionuclide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8A","description":"Very High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins device for rt guide open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49412","description":"Ins device for rt guide open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N-et; patient attend/escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2001","description":"N-et; patient attend/escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPB1","description":"ICD-KCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCF1","description":"ICD-OBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0676U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676U","description":"CPT-0676U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWA0","description":"ICD-PLWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc w burn prior to d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8908","description":"Pt doc w burn prior to d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWB1","description":"ICD-CHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEF0","description":"ICD-NLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACF0","description":"ICD-AACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC53","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYB1","description":"ICD-CDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARE0","description":"ICD-PARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVB0","description":"ICD-FBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPC0","description":"ICD-KFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alefacept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0215","description":"Alefacept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMA1","description":"ICD-JAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETC0","description":"ICD-BETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVB1","description":"ICD-NJVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corticotropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0800","description":"Corticotropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVB1","description":"ICD-BIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1303","description":"HCPCS-A1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheo-esophagoplasty cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43314","description":"Tracheo-esophagoplasty cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; paper_ 1-dimensional_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82487","description":"Chromatography_ qualitative; paper_ 1-dimensional_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dyspnea scrnd no-mild dysp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3450F","description":"Dyspnea scrnd no-mild dysp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lecanemab-irmb_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0174","description":"Injection_ lecanemab-irmb_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alloskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4123","description":"Alloskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXD1","description":"ICD-OJXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTB0","description":"ICD-NKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ multiple analytes_ quantitative_ single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82544","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ multiple analytes_ quantitative_ single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCF0","description":"ICD-GHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXD0","description":"ICD-JBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDB1","description":"ICD-FGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g._ history of gastrointestinal bleed_ intra-cranial bleed_ idiopathic thrombocytopenic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9794","description":"Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g._ history of gastrointestinal bleed_ intra-cranial bleed_ idiopathic thrombocytopenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice or home hlth in home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5001","description":"Hospice or home hlth in home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDF0","description":"ICD-CFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES213","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDB0","description":"ICD-CGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBE1","description":"ICD-EIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adhesive remover_ wipes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4456","description":"Adhesive remover_ wipes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIB0","description":"ICD-JDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy ring each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4404","description":"Ostomy ring each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscp guide wire dilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43196","description":"Esophagoscp guide wire dilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing 1 locus lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81373","description":"Hla i typing 1 locus lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB254","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmi documented outside normal parameters_ no follow-up plan documented_ no reason given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1276","description":"Bmi documented outside normal parameters_ no follow-up plan documented_ no reason given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00126","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","description":"CPT-00126","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy_ single or multiple_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7542","description":"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy_ single or multiple_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWC1","description":"ICD-KHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB155","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sgd digitized pre-rec <=8min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2500","description":"Sgd digitized pre-rec <=8min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx spine process fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22305","description":"Closed tx spine process fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMD1","description":"ICD-IAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI angio chest w or w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71555","description":"MRI angio chest w or w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHE0","description":"ICD-GDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKD0","description":"ICD-JCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECE0","description":"ICD-KECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Measure ureter pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50686","description":"Measure ureter pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLD0","description":"ICD-MCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneum full leg splnt pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4370","description":"Pneum full leg splnt pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEB0","description":"ICD-CIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohols biomarkers 1or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80321","description":"Alcohols biomarkers 1or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGID1","description":"ICD-IGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLB1","description":"ICD-EBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo-vag hyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58553","description":"Laparo-vag hyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove coronoid process","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21070","description":"Remove coronoid process","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENF0","description":"ICD-KENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBA0","description":"ICD-JDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETB0","description":"ICD-OETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBB0","description":"ICD-ADBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of cleft lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10251","description":"Anesth repair of cleft lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQC0","description":"ICD-OCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTE0","description":"ICD-FGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac cond noadd by guide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9061","description":"Onc prac cond noadd by guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHA0","description":"ICD-FGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPD1","description":"ICD-OEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHB0","description":"ICD-NDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Salivary gland function exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78232","description":"Salivary gland function exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC11","description":"ICD-1FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53450","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCB1","description":"ICD-MGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNA0","description":"ICD-JCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of horseshoe kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50540","description":"Revision of horseshoe kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coping","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2975","description":"Coping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vc lesion scope/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31546","description":"Remove vc lesion scope/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove penis & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54135","description":"Remove penis & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand_ finger_ single or double upright(s)_ includes microp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8702","description":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand_ finger_ single or double upright(s)_ includes microp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECD1","description":"ICD-GECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61540","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAF0","description":"ICD-CIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37290","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","description":"CPT-37290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj occipital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64405","description":"N block inj occipital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES313","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peroneal straps pair pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0980","description":"Peroneal straps pair pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration_ with single automated_ standardized instrument via electronic platform_ with automated result only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96146","description":"Psychological or neuropsychological test administration_ with single automated_ standardized instrument via electronic platform_ with automated result only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGF0","description":"ICD-BBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAA1","description":"ICD-KAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99347","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIB1","description":"ICD-MHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penile vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93981","description":"Penile vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43216","description":"Esophagoscopy lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3933","description":"Fo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD221","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMA1","description":"ICD-CEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clin sig dep sym by dep tool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3354F","description":"Clin sig dep sym by dep tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILA1","description":"ICD-OILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCA1","description":"ICD-JBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (multiple myeloma)_ LC-MS/MS_ peptide ion quantification_ serum_ results compared with baseline to determine monoclonal paraprotein abundance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0451U","description":"Oncology (multiple myeloma)_ LC-MS/MS_ peptide ion quantification_ serum_ results compared with baseline to determine monoclonal paraprotein abundance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJED1","description":"ICD-NJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv rna vrl ld <lmts quantif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3502F","description":"Hiv rna vrl ld <lmts quantif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj arthroscopy disc reposit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7874","description":"Tmj arthroscopy disc reposit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multi-durometer symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5661","description":"Multi-durometer symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye glass case","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2756","description":"Eye glass case","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLD0","description":"ICD-BFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB01","description":"High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intens cardiac rehab w/exerc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0422","description":"Intens cardiac rehab w/exerc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAED0","description":"ICD-BAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHF0","description":"ICD-NLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supportive care for neurodegenerative conditions mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0004","description":"Supportive care for neurodegenerative conditions mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Safety concerns screening not provided_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9925","description":"Safety concerns screening not provided_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUB0","description":"ICD-JCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9949","description":"Leg pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIB0","description":"ICD-ADIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERF1","description":"ICD-LERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arsenic trioxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9017","description":"Arsenic trioxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKF1","description":"ICD-ODKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBE1","description":"ICD-KDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace blood leak detector","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1560","description":"Replace blood leak detector","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQD1","description":"ICD-CGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCB1","description":"ICD-EGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHD1","description":"ICD-EFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAE1","description":"ICD-MEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWB0","description":"ICD-KCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYB0","description":"ICD-PLYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIF1","description":"ICD-CAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4023","description":"Cast sup sht arm splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVD0","description":"ICD-NIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQA1","description":"ICD-PDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection ferric pyrophosphate citrate solution 0.1 mg iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9976","description":"Injection ferric pyrophosphate citrate solution 0.1 mg iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iron sucrose injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1756","description":"Iron sucrose injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUB1","description":"ICD-GAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Analysis_ Review And Report By A Physician Or Othe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0576T","description":"Interrogation Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Analysis_ Review And Report By A Physician Or Othe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXF1","description":"ICD-BFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32663","description":"Thoracoscopy w/lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC30","description":"Ultra High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNB1","description":"ICD-FBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXA1","description":"ICD-NFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28D","description":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNC0","description":"ICD-CCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr pck base combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0489","description":"Pwr pck base combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAD0","description":"ICD-FGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapy exercise joint rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4018F","description":"Therapy exercise joint rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWD0","description":"ICD-CCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I131 iodide sol_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9530","description":"I131 iodide sol_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHD1","description":"ICD-JHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc shoulder tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23076","description":"Exc shoulder tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC115","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1436","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","description":"HCPCS-M1436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIID0","description":"ICD-MIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Miglustat_ oral_ 65 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1202","description":"Miglustat_ oral_ 65 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPE1","description":"ICD-CGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCC1","description":"ICD-GHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"implant/abutment supported interim fixed denture for edentulous arch – maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6119","description":"implant/abutment supported interim fixed denture for edentulous arch – maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOC0","description":"ICD-KBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETA0","description":"ICD-IETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asp therp used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8598","description":"Asp therp used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKC0","description":"ICD-FFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Palate/uvula surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42299","description":"Palate/uvula surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fit aphakia spectcl monofocl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92352","description":"Fit aphakia spectcl monofocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC60","description":"Ultra High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAB1","description":"ICD-JCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure dev_ vasc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1760","description":"Closure dev_ vasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDC1","description":"ICD-FGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Appl desensitizing resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9911","description":"Appl desensitizing resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ampicillin 500 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0290","description":"Ampicillin 500 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB31","description":"ICD-3KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped home apnea rec downld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94776","description":"Ped home apnea rec downld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analysis of clinical data stored in computers (eg_ ECGs_ blood pressures_ hematologic data)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99090","description":"Analysis of clinical data stored in computers (eg_ ECGs_ blood pressures_ hematologic data)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJA0","description":"ICD-FDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUA1","description":"ICD-NJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUC1","description":"ICD-OJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOB1","description":"ICD-DAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No bld inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9627","description":"No bld inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHB1","description":"ICD-IAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAE1","description":"ICD-MLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKA0","description":"ICD-BIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEF0","description":"ICD-FFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB35","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBA1","description":"ICD-KDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9341","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","description":"HCPCS-J9341","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL22","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAB0","description":"ICD-IIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ palonosetron HCl (Avyxa)_ not therapeutically equivalent to J2469_ 25 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2468","description":"Injection_ palonosetron HCl (Avyxa)_ not therapeutically equivalent to J2469_ 25 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNC1","description":"ICD-CHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFC1","description":"ICD-GCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAF0","description":"ICD-KCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJD1","description":"ICD-FBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALD0","description":"ICD-MALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ipratropium bromide non-comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7644","description":"Ipratropium bromide non-comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Admin hepatitis b vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0010","description":"Admin hepatitis b vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES356","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPB0","description":"ICD-BHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trach-esoph voice pros pt in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8507","description":"Trach-esoph voice pros pt in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGC0","description":"ICD-BAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper gi endoscopy performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3130F","description":"Upper gi endoscopy performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA20","description":"Low Rehab_ ADL Index 0-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYC0","description":"ICD-KIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERD0","description":"ICD-GERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rad exp time w/fluor doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9500","description":"Rad exp time w/fluor doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSD0","description":"ICD-HHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHF1","description":"ICD-ICHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB115","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harvest auto stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38206","description":"Harvest auto stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDA1","description":"ICD-MLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4544","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","description":"HCPCS-A4544","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64620","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","description":"HCPCS-M1386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6075","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRF1","description":"ICD-GFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc new diag 1st/addl mdd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3093F","description":"Doc new diag 1st/addl mdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERA1","description":"ICD-KERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01744","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","description":"CPT-01744","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIC0","description":"ICD-ICIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFD1","description":"ICD-BDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal biophys profile w/nst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76818","description":"Fetal biophys profile w/nst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYE1","description":"ICD-KEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFD0","description":"ICD-BEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve repair w/allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64910","description":"Nerve repair w/allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCD0","description":"ICD-BHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUF1","description":"ICD-KDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBB0","description":"ICD-ECBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUA1","description":"ICD-IBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXB1","description":"ICD-ODXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCF1","description":"ICD-CGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB25","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ortho dvc repair per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4205","description":"Ortho dvc repair per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIA1","description":"ICD-BEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28116","description":"Revision of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWB0","description":"ICD-DBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVA1","description":"ICD-NGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGE1","description":"ICD-JFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAA1","description":"ICD-KEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test for g6pd enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82960","description":"Test for g6pd enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEC0","description":"ICD-KGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBD1","description":"ICD-BHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pressure pneum appl full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0672","description":"Pressure pneum appl full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure of nephrovisceral fistula (eg_ renocolic)_ including visceral repair; thoracic approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50526","description":"Closure of nephrovisceral fistula (eg_ renocolic)_ including visceral repair; thoracic approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEC0","description":"ICD-KBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with noninvasive interface (e.g._ mask)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0461","description":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with noninvasive interface (e.g._ mask)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA15","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFE1","description":"ICD-OBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQB0","description":"ICD-OKQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ intra echocardiography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1759","description":"Cath_ intra echocardiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plan caremng angnl symptdocd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0557F","description":"Plan caremng angnl symptdocd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOC0","description":"ICD-OIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALD1","description":"ICD-BALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bath/shower chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0240","description":"Bath/shower chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0892","description":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFF1","description":"ICD-FFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVC1","description":"ICD-JGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETE0","description":"ICD-CETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45112","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Veritas collagen matrix_ cm2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9354","description":"Veritas collagen matrix_ cm2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHA0","description":"ICD-OBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26060","description":"Incision of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGA1","description":"ICD-NHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLE1","description":"ICD-FHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUD1","description":"ICD-MCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87811","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERC1","description":"ICD-DERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDF1","description":"ICD-NBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - bitewing radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0388","description":"intraoral tomosynthesis - bitewing radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMC0","description":"ICD-IEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc disc tx choices","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9399","description":"Doc disc tx choices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0304T","description":"Icar ischm mntrng sys device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCF0","description":"ICD-NDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBD0","description":"ICD-GEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDD1","description":"ICD-OBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE230","description":"Reduced Physical Function _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Improving care for lower extremity joint repair mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0058","description":"Improving care for lower extremity joint repair mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE120","description":"Reduced Physical Function _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clin tx mdd comm to tx clin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8959","description":"Clin tx mdd comm to tx clin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62223","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEF1","description":"ICD-BBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUA0","description":"ICD-CBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0476U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","description":"CPT-0476U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3B","description":"Default_ /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKE1","description":"ICD-KDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDA1","description":"ICD-OBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgraft xt_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4269","description":"Surgraft xt_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9771","description":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk waist belt padded and lin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5690","description":"Bk waist belt padded and lin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroscopy_ physician or other qualified health care professional time more than 1 hour_ assisting a nonradiologic physician or other qualified health care professional (eg_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76001","description":"Fluoroscopy_ physician or other qualified health care professional time more than 1 hour_ assisting a nonradiologic physician or other qualified health care professional (eg_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Guided tissue regeneration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3432","description":"Guided tissue regeneration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray bile duct endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74328","description":"X-ray bile duct endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOD1","description":"ICD-KIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","description":"HCPCS-M1428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECD0","description":"ICD-MECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv/aids measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8491","description":"Hiv/aids measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSB1","description":"ICD-LCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reprogram cochlear implt 7/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92604","description":"Reprogram cochlear implt 7/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TPMT (thiopurine S-methyltransferase) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81335","description":"TPMT (thiopurine S-methyltransferase) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physical medicine procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97139","description":"Physical medicine procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKF1","description":"ICD-OFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth biopsy of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16451","description":"Anesth biopsy of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGD0","description":"ICD-FDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQD0","description":"ICD-LCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1361","description":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWC1","description":"ICD-DBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pelvic fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57020","description":"Drainage of pelvic fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA23","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVF0","description":"ICD-GHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVE1","description":"ICD-NLVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q2057","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","description":"HCPCS-Q2057","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHE0","description":"ICD-MGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33238","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis treatment performed exactly three times per week for > 90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8714","description":"Hemodialysis treatment performed exactly three times per week for > 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of a subcutaneous peritoneal ascites pump_ including reconnection between pump and indwelling bladder and peritoneal catheters_ including initial programming and i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0871T","description":"Replacement of a subcutaneous peritoneal ascites pump_ including reconnection between pump and indwelling bladder and peritoneal catheters_ including initial programming and i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6533","description":"Gc stocking thighlngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prehensile actuator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7040","description":"Prehensile actuator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Celera Dual Layer or Celera Dual Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4259","description":"Celera Dual Layer or Celera Dual Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ntiol category 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q1004","description":"Ntiol category 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAE1","description":"ICD-BAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray guide gi dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74360","description":"X-ray guide gi dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of sternum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21740","description":"Reconstruction of sternum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVF1","description":"ICD-BEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEC0","description":"ICD-EFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB41","description":"Medium Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9894","description":"Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mlh1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81288","description":"Mlh1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC111","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSE0","description":"ICD-GFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHB0","description":"ICD-NIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQC0","description":"ICD-DIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic eye other type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2629","description":"Prosthetic eye other type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27218","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA113","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJA0","description":"ICD-GGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXE1","description":"ICD-JAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQE1","description":"ICD-PKQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSB0","description":"ICD-GDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA31","description":"ICD-2GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXB0","description":"ICD-OCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHD1","description":"ICD-IGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJA1","description":"ICD-CGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJE1","description":"ICD-OCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28435","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0559T","description":"Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4D","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Who cock-up nonmolde pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3908","description":"Who cock-up nonmolde pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX22","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tympanometry & reflex thresh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92550","description":"Tympanometry & reflex thresh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGB0","description":"ICD-GEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asthma impairment assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2015F","description":"Asthma impairment assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITB1","description":"ICD-IITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interro eval cardiac modulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0418T","description":"Interro eval cardiac modulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogate crtd sns w/pgrmg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0273T","description":"Interrogate crtd sns w/pgrmg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAD0","description":"ICD-OAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12B","description":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQF0","description":"ICD-GEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-3/> piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21143","description":"Lefort i-3/> piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIC0","description":"ICD-BFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine ost pouch w bltinconv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4429","description":"Urine ost pouch w bltinconv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC117","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"removal of fixed orthodontic appliances for reasons other than completion of treatm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8695","description":"removal of fixed orthodontic appliances for reasons other than completion of treatm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exoskeletal bk ultralt mater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5785","description":"Exoskeletal bk ultralt mater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTB1","description":"ICD-CBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPE0","description":"ICD-KBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0521","description":"Management of new patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWA1","description":"ICD-KIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATB0","description":"ICD-FATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cesarean birth class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9438","description":"Cesarean birth class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Counseling_ individual_ by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9002","description":"Counseling_ individual_ by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCA0","description":"ICD-JBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFD1","description":"ICD-KGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMB1","description":"ICD-FEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQF0","description":"ICD-PAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTD0","description":"ICD-GHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Devise bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44316","description":"Devise bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSA1","description":"ICD-PLSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5140","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","description":"HCPCS-Q5140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICC1","description":"ICD-IICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18I","description":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drnble ostomy pouch w/o barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5062","description":"Drnble ostomy pouch w/o barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJB0","description":"ICD-NDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXC1","description":"ICD-OIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59400","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFE1","description":"ICD-GIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0835","description":"Pwc gp2 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRA1","description":"ICD-CCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score shdl >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8663","description":"Fun stat score shdl >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable corrugated tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7010","description":"Disposable corrugated tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lt compres band >=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6449","description":"Lt compres band >=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCC1","description":"ICD-JFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIC0","description":"ICD-MKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGC0","description":"ICD-CAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINC0","description":"ICD-BINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiography head w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70544","description":"Mr angiography head w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2031","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","description":"HCPCS-A2031","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXB0","description":"ICD-GCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Buprenorphine oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0571","description":"Buprenorphine oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVA0","description":"ICD-NKVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYE0","description":"ICD-KGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33957","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6066","description":"Implant supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor xi pta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85270","description":"Clot factor xi pta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPA1","description":"ICD-NHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLF1","description":"ICD-EGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVB0","description":"ICD-OBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair tcat mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33419","description":"Repair tcat mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEA1","description":"ICD-MCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Regadenoson injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2785","description":"Regadenoson injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Legg perthes orthosis trilat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1720","description":"Legg perthes orthosis trilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd varices ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43244","description":"Egd varices ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOB0","description":"ICD-HEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Routine ophthalmological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0620","description":"Routine ophthalmological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWF0","description":"ICD-CFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert heyman uteri capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58346","description":"Insert heyman uteri capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPA0","description":"ICD-GFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJD1","description":"ICD-BGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55150","description":"Removal of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3d predictive model generation for pre-planning of a cardiac procedure_ using data from cardiac computed tomographic angiography with report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9793","description":"3d predictive model generation for pre-planning of a cardiac procedure_ using data from cardiac computed tomographic angiography with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOD1","description":"ICD-OHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth kidney stone destruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87351","description":"Anesth kidney stone destruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPB0","description":"ICD-NAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC20","description":"High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28G","description":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hinge extension/flex wrist/f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3900","description":"Hinge extension/flex wrist/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLE1","description":"ICD-IHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENF0","description":"ICD-FENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFC0","description":"ICD-NEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRE0","description":"ICD-GDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGC1","description":"ICD-OJGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurosurgical Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4016","description":"Neurosurgical Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61510","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle_ myocutaneous_ or fasciocutaneous flap; head and neck with named vascular pedicle (ie_ buccinators_ genioglossus_ temporalis_ masseter_ sternocleidomastoid_ levator sca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15733","description":"Muscle_ myocutaneous_ or fasciocutaneous flap; head and neck with named vascular pedicle (ie_ buccinators_ genioglossus_ temporalis_ masseter_ sternocleidomastoid_ levator sca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXF1","description":"ICD-OLXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIC1","description":"ICD-OAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Canalith repositioning proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95992","description":"Canalith repositioning proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYD1","description":"ICD-OFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/o hemodyn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75887","description":"Vein x-ray liver w/o hemodyn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADED0","description":"ICD-ADED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hd trapeze bar attach to bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0911","description":"Hd trapeze bar attach to bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAB0","description":"ICD-ICAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4A","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMD1","description":"ICD-GBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intra-vaginal motion sensor system_ provides biofeedback for pelvic floor muscle rehabilitation device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9002","description":"Intra-vaginal motion sensor system_ provides biofeedback for pelvic floor muscle rehabilitation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ (sinuva)_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7402","description":"Mometasone furoate sinus implant_ (sinuva)_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nesiritide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2325","description":"Nesiritide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5B","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHB1","description":"ICD-BDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAA1","description":"ICD-FCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJB0","description":"ICD-CAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIC1","description":"ICD-CBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"alloPLY_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4323","description":"alloPLY_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01112","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","description":"CPT-01112","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUE1","description":"ICD-JFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOF1","description":"ICD-GAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB241","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB23","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No sig dep symp by dep tool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3352F","description":"No sig dep symp by dep tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0261U","description":"Oncology (colorectal cancer)_ image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGA0","description":"ICD-GCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repeat control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30906","description":"Repeat control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADD1","description":"ICD-FADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of eyelid fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67715","description":"Incision of eyelid fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dysphag test done b/4 eating","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6010F","description":"Dysphag test done b/4 eating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess hghlymalig doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3345F","description":"Mammo assess hghlymalig doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01486","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","description":"CPT-01486","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOD0","description":"ICD-LIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0614","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","description":"HCPCS-J0614","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIC1","description":"ICD-AFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCE1","description":"ICD-AHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33475","description":"Replacement pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonvascular shunt x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75809","description":"Nonvascular shunt x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXA1","description":"ICD-JCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic prop tire tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2212","description":"Pneumatic prop tire tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCB0","description":"ICD-ABCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISA1","description":"ICD-KISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of calf tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27687","description":"Revision of calf tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01760","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","description":"CPT-01760","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJE0","description":"ICD-NHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrical bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20974","description":"Electrical bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug screenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0002","description":"Alcohol and/or drug screenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGA1","description":"ICD-OIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYF0","description":"ICD-HFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGD1","description":"ICD-OJGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRF1","description":"ICD-ODRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMC1","description":"ICD-KGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDB0","description":"ICD-KFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc stroke after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9258","description":"Doc stroke after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDA0","description":"ICD-FGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWE0","description":"ICD-CFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep c screen high risk/other","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0472","description":"Hep c screen high risk/other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc foot/toe tum sc 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28039","description":"Exc foot/toe tum sc 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ear cartilage graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21235","description":"Ear cartilage graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQC1","description":"ICD-GAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLB0","description":"ICD-BBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00868","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","description":"CPT-00868","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDA0","description":"ICD-BCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVD0","description":"ICD-BEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remv&replc pm gen dual lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33228","description":"Remv&replc pm gen dual lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWF0","description":"ICD-DAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2083","description":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC02","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBA0","description":"ICD-GDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject spine cerv/thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62310","description":"Inject spine cerv/thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEC1","description":"ICD-ABEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sympathectomy supfc palmar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64823","description":"Sympathectomy supfc palmar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apheresis adsorp/reinfuse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36515","description":"Apheresis adsorp/reinfuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUD1","description":"ICD-IDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAA1","description":"ICD-AHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cyp2d6 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81226","description":"Cyp2d6 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0104","description":"HCPCS-A0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In111 capromab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9507","description":"In111 capromab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABC1","description":"ICD-NABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Term dev_ passive hand mitt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6703","description":"Term dev_ passive hand mitt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cyanide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82600","description":"Assay of cyanide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC43","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRC0","description":"ICD-GCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKC1","description":"ICD-OLKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKD1","description":"ICD-GBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIA0","description":"ICD-KGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fabrication and delivery of oral appliance therapy (OAT) morning repositioning device","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9954","description":"Fabrication and delivery of oral appliance therapy (OAT) morning repositioning device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHF1","description":"ICD-MBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92653","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGF0","description":"ICD-FDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulpal regeneration complete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3357","description":"Pulpal regeneration complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr epigastric hern blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49572","description":"Rpr epigastric hern blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relocation pocket pacemaker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33222","description":"Relocation pocket pacemaker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLE1","description":"ICD-KGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLE0","description":"ICD-GHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX36","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQC0","description":"ICD-GAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJD1","description":"ICD-KCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHB1","description":"ICD-CDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEB0","description":"ICD-FDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABC0","description":"ICD-MABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0941T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","description":"CPT-0941T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ elranatamab-bcmm_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1323","description":"Injection_ elranatamab-bcmm_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54520","description":"Removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPE1","description":"ICD-BFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXD1","description":"ICD-FBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTA0","description":"ICD-EGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No ahi or rdi initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8844","description":"No ahi or rdi initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHB1","description":"ICD-KIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1701","description":"HCPCS-B1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mh clubhouse svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2030","description":"Mh clubhouse svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; Each Add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0628T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; Each Add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tonsils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42825","description":"Removal of tonsils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABF1","description":"ICD-NABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7567","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7567","description":"HCPCS-C7567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL54","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVE0","description":"ICD-OFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTB1","description":"ICD-OFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRF1","description":"ICD-OLRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33010","description":"Drainage of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECF1","description":"ICD-GECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYC1","description":"ICD-GDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0403","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0403","description":"CDT-D0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPF1","description":"ICD-FGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial custom socket insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5683","description":"Initial custom socket insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81184","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXF0","description":"ICD-NJXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXF0","description":"ICD-JHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE211","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral aprepitant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8501","description":"Oral aprepitant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound(s) care non-selective","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97602","description":"Wound(s) care non-selective","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWD0","description":"ICD-LIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTE1","description":"ICD-EHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Herpes simplex 2 ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87273","description":"Herpes simplex 2 ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monitoring feature/devicenoc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9279","description":"Monitoring feature/devicenoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo removal donor kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50547","description":"Laparo removal donor kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMA1","description":"ICD-IFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place cecostomy tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49442","description":"Place cecostomy tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEF0","description":"ICD-FEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24C","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBF0","description":"ICD-EGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1464","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","description":"HCPCS-M1464","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEF0","description":"ICD-JHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 std mult pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0885","description":"Pwc gp4 std mult pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPD0","description":"ICD-OBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove epididymis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54830","description":"Remove epididymis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63267","description":"Excise intrspinl lesion lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii recomb obizur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7188","description":"Factor viii recomb obizur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB246","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNA0","description":"ICD-KCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHE1","description":"ICD-GIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVE0","description":"ICD-KCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism ehealthline clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1021","description":"Clinical decision support mechanism ehealthline clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2B","description":"Ultra High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJC0","description":"ICD-KIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFE1","description":"ICD-NJFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFC0","description":"ICD-BGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOD1","description":"ICD-CIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVA0","description":"ICD-CEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETC0","description":"ICD-NETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colon motility 6 hr study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91117","description":"Colon motility 6 hr study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calculated 10-year ascvd risk score of  = 20 percent during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1364","description":"Calculated 10-year ascvd risk score of  = 20 percent during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rotavirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86759","description":"Rotavirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOE1","description":"ICD-LAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj phrenic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64410","description":"N block inj phrenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQF0","description":"ICD-DDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIC0","description":"ICD-FEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUD0","description":"ICD-ACUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHD1","description":"ICD-MJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCID0","description":"ICD-MCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXE0","description":"ICD-KIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABE0","description":"ICD-KABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytarabine liposome inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9098","description":"Cytarabine liposome inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTF0","description":"ICD-GHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted px extraocular musc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67399","description":"Unlisted px extraocular musc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJA0","description":"ICD-BEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6120","description":"Implant Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHE1","description":"ICD-JFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEC0","description":"ICD-CCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTE0","description":"ICD-KFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEC0","description":"ICD-GBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat larynx fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31584","description":"Treat larynx fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull (press relief)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61343","description":"Incise skull (press relief)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHD1","description":"ICD-JAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVC1","description":"ICD-JHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Midfacial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8041","description":"Midfacial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCF1","description":"ICD-ODCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nos quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0110T","description":"Nos quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPB1","description":"ICD-GEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29835","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ovary/tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58720","description":"Removal of ovary/tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKA0","description":"ICD-NBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFD1","description":"ICD-NDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYE0","description":"ICD-KEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temporary tear duct plug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4262","description":"Temporary tear duct plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27607","description":"Treat lower leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML21","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genotype dna/rna hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87902","description":"Genotype dna/rna hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCD0","description":"ICD-KGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osa mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8759","description":"Osa mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASD0","description":"ICD-CASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTE1","description":"ICD-MHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDA1","description":"ICD-CDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Each Additional 30 Minutes Of Counseling In A Week Of Medication Assisted Treatment_ (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2080","description":"Each Additional 30 Minutes Of Counseling In A Week Of Medication Assisted Treatment_ (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOD1","description":"ICD-CCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albuterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7613","description":"Albuterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSE1","description":"ICD-CCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30435","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBA1","description":"ICD-EDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spirom fev/fvc <70% w/copd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3025F","description":"Spirom fev/fvc <70% w/copd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUA1","description":"ICD-GIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompressive craniotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61322","description":"Decompressive craniotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNE1","description":"ICD-KCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision/removal of kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27424","description":"Revision/removal of kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKB1","description":"ICD-KDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release palm/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26440","description":"Release palm/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHC0","description":"ICD-NKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYA1","description":"ICD-KFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLND0","description":"ICD-OLND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDME1","description":"ICD-JDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAED1","description":"ICD-IAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heel leather reinforced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3440","description":"Heel leather reinforced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monitor_ Cardiac_ Including Intracardiac Lead And All System Components (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1833","description":"Monitor_ Cardiac_ Including Intracardiac Lead And All System Components (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; UNILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53452","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; UNILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDE1","description":"ICD-KHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUD1","description":"ICD-ACUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy hand joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26100","description":"Biopsy hand joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTB0","description":"ICD-AHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99418","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTF0","description":"ICD-GBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUA0","description":"ICD-GHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx periorbital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21386","description":"Opn tx orbit fx periorbital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0505","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0505","description":"CDT-D0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHC0","description":"ICD-KDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 9 PFAS compounds by LC-MS/MS_ plasma or serum_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0457U","description":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 9 PFAS compounds by LC-MS/MS_ plasma or serum_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenervation anal musc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46505","description":"Chemodenervation anal musc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYE1","description":"ICD-KIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEA0","description":"ICD-EGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUF1","description":"ICD-FCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUB0","description":"ICD-BGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc pretreatment serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86978","description":"Rbc pretreatment serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRF0","description":"ICD-CDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped complete intact nut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4158","description":"Ef ped complete intact nut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJF0","description":"ICD-NBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPB1","description":"ICD-NEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot arch supp longitud/meta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3060","description":"Foot arch supp longitud/meta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPC0","description":"ICD-GHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFB0","description":"ICD-JIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No surg site infection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9311","description":"No surg site infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCB0","description":"ICD-MFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBF0","description":"ICD-BDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAF0","description":"ICD-KDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mitochondrial gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81440","description":"Mitochondrial gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRF1","description":"ICD-CGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMC1","description":"ICD-NBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHF1","description":"ICD-IFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUD0","description":"ICD-GBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAA1","description":"ICD-NKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXC0","description":"ICD-BGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-bvzr_ biosimilar_ (Zirabev)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5118","description":"Injection_ bevacizumab-bvzr_ biosimilar_ (Zirabev)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Moderately Complex Clinical Problem_ With Review Of Patient_S History And Medical Records And Moderate Level Of Medical Decision Making","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80504","description":"Pathology Clinical Consultation; For A Moderately Complex Clinical Problem_ With Review Of Patient_S History And Medical Records And Moderate Level Of Medical Decision Making","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67840","description":"Remove eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6610","description":"Gradient compression stocking_ below knee_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFC0","description":"ICD-KHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETA1","description":"ICD-NETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWC0","description":"ICD-DBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOB0","description":"ICD-GGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFC1","description":"ICD-BCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSA0","description":"ICD-CBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp5 ped sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0890","description":"Pwc gp5 ped sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo by both infusion and o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0085","description":"Chemo by both infusion and o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00904","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","description":"CPT-00904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo sing solid stirrup calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1980","description":"Afo sing solid stirrup calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unpln rup post cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9389","description":"Unpln rup post cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thawing cryopresrved embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89352","description":"Thawing cryopresrved embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBF1","description":"ICD-OJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAB1","description":"ICD-CCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA246","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27040","description":"Biopsy of soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydration status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2018F","description":"Hydration status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Battery for hearing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5266","description":"Battery for hearing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imaging coil_ mr_ insertable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1770","description":"Imaging coil_ mr_ insertable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4339","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","description":"HCPCS-Q4339","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay toxin or antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87230","description":"Assay toxin or antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0D","description":"Default_ /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC03","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIB1","description":"ICD-KBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOF0","description":"ICD-DGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE217","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTB1","description":"ICD-OBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed fixed ht w/ mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0250","description":"Hosp bed fixed ht w/ mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIE0","description":"ICD-KGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9901","description":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXF1","description":"ICD-NKXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hexa gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81255","description":"Hexa gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33692","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGE1","description":"ICD-CBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIID0","description":"ICD-EIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nvr cndj tst 1-2 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95907","description":"Nvr cndj tst 1-2 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMB1","description":"ICD-OEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES216","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX02","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29860","description":"Hip arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla x-math non-cytotoxic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86825","description":"Hla x-math non-cytotoxic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vancomycin hcl (xellia) not therapeutically equivalent to j3370_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3372","description":"Injection_ vancomycin hcl (xellia) not therapeutically equivalent to j3370_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9999","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9999","description":"HCPCS-A9999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of unstable kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27422","description":"Revision of unstable kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUD1","description":"ICD-NJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCD1","description":"ICD-MGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93284","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation at shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23920","description":"Amputation at shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy flexible brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43200","description":"Esophagoscopy flexible brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinogen test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85370","description":"Fibrinogen test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alpha-1-antitrypsin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82103","description":"Alpha-1-antitrypsin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRF1","description":"ICD-OBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUE1","description":"ICD-FFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXD0","description":"ICD-CAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI lwr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73720","description":"MRI lwr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart pacing mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93631","description":"Heart pacing mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQC0","description":"ICD-CIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCF1","description":"ICD-JFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0108U","description":"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive care for joint replacement model_ home visit for patient assemssment performed by clinical staff for an individual not considered homebound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9490","description":"Comprehensive care for joint replacement model_ home visit for patient assemssment performed by clinical staff for an individual not considered homebound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXA0","description":"ICD-JAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev resin rest_ perm tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1352","description":"Prev resin rest_ perm tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSD0","description":"ICD-CGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKD0","description":"ICD-BHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICB0","description":"ICD-KICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQF0","description":"ICD-CBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sinus caus bac inx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9364","description":"Sinus caus bac inx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHB1","description":"ICD-CBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD117","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMC0","description":"ICD-BFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dispos cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0500","description":"Dispos cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAD1","description":"ICD-JCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect apical lung tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32503","description":"Resect apical lung tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flotufolastat F-18_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9156","description":"Flotufolastat F-18_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOE1","description":"ICD-CEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMD0","description":"ICD-AIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAF1","description":"ICD-KHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASA0","description":"ICD-OASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMA0","description":"ICD-EGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCA1","description":"ICD-OKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection of contrast for knee arthrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27370","description":"Injection of contrast for knee arthrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUA0","description":"ICD-NEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCC0","description":"ICD-FHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Injection Of Cellular Implant Into Knee Joint Including Ultrasound Gu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0566T","description":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Injection Of Cellular Implant Into Knee Joint Including Ultrasound Gu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGA0","description":"ICD-OLGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj magnesium sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3475","description":"Inj magnesium sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB205","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWD1","description":"ICD-GHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMD1","description":"ICD-NGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain thyroid/tongue cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60000","description":"Drain thyroid/tongue cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSD0","description":"ICD-PHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sperm duct(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55250","description":"Removal of sperm duct(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97035","description":"Ultrasound therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSA0","description":"ICD-LGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYB0","description":"ICD-PGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLA0","description":"ICD-FBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVE1","description":"ICD-JHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1009","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC41","description":"Medium Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEC0","description":"ICD-JCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKE0","description":"ICD-NAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid dispensing fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5090","description":"Hearing aid dispensing fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0204","description":"HCPCS-B0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYD0","description":"ICD-GDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUE1","description":"ICD-FEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 3)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1708","description":"Pfizer-BioNTech Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC22","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAF0","description":"ICD-JFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHE0","description":"ICD-AGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Measles and rubella virus vaccine_ live_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90708","description":"Measles and rubella virus vaccine_ live_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOC0","description":"ICD-PKOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96381","description":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RARE DS GEN DNA ALYS EA COMP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0213U","description":"RARE DS GEN DNA ALYS EA COMP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVF0","description":"ICD-CHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMB0","description":"ICD-EDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOD0","description":"ICD-PDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTC1","description":"ICD-NGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVD1","description":"ICD-KBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASE1","description":"ICD-OASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES311","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kerecis Omega3_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4158","description":"Kerecis Omega3_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41100","description":"Biopsy of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46760","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol 52-73 gm prot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4193","description":"Parenteral sol 52-73 gm prot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGE0","description":"ICD-OEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ bupivacaine liposome","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9290","description":"Inj_ bupivacaine liposome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFA0","description":"ICD-FGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHED1","description":"ICD-KHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla class i/ii antibody qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86829","description":"Hla class i/ii antibody qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDD0","description":"ICD-JEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIF1","description":"ICD-KAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUE1","description":"ICD-BFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnioexcel or biodexcel_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4137","description":"Amnioexcel or biodexcel_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHC1","description":"ICD-GAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29530","description":"Strapping of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKE0","description":"ICD-GIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0C","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","description":"HCPCS-Q4407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Out-of-hosp on call service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99027","description":"Out-of-hosp on call service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEME1","description":"ICD-KEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0743","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","description":"HCPCS-E0743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venous sampling by catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75893","description":"Venous sampling by catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOC1","description":"ICD-OKOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pmp22 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81326","description":"Pmp22 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Perfusion Echo Ischm/Viability Assmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0439T","description":"Myocardial Perfusion Echo Ischm/Viability Assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVE1","description":"ICD-CEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUC0","description":"ICD-KDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLB1","description":"ICD-GBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBB0","description":"ICD-MFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYC0","description":"ICD-DBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYC1","description":"ICD-KFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRF0","description":"ICD-ODRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAA1","description":"ICD-GIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHD0","description":"ICD-EHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIE0","description":"ICD-EHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKD1","description":"ICD-NJKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 xtra hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0829","description":"Pwc gp 2 xtra hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKC0","description":"ICD-OJKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43338","description":"Esoph lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFID1","description":"ICD-JFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKC1","description":"ICD-GEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYF0","description":"ICD-KGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67825","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERE0","description":"ICD-OERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIED1","description":"ICD-FIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not rcvng epo thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4095F","description":"Pt not rcvng epo thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63650","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx atrial fib pulm vein isol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93656","description":"Tx atrial fib pulm vein isol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECE1","description":"ICD-CECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"P32 na phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9563","description":"P32 na phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIE1","description":"ICD-IGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo fem fx cast thermoplas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2126","description":"Kafo fem fx cast thermoplas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fx distal radial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25606","description":"Treat fx distal radial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixed adjust armrest pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0020","description":"Fixed adjust armrest pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33697","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27818","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKID1","description":"ICD-OKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTE1","description":"ICD-NHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHE0","description":"ICD-MCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUB0","description":"ICD-NHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","description":"CPT-98015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Candida dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87480","description":"Candida dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26205","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect scapula tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23210","description":"Resect scapula tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNA0","description":"ICD-GHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0721","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0721","description":"HCPCS-E0721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOE1","description":"ICD-DFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht inj growth horm diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9558","description":"Ht inj growth horm diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0898","description":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00147","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","description":"CPT-00147","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEB1","description":"ICD-BFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNA1","description":"ICD-KHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc perm/cont/parox atr fib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1060F","description":"Doc perm/cont/parox atr fib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit cont chem diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9330","description":"Hit cont chem diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC145","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJD1","description":"ICD-JBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARC1","description":"ICD-HARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Oritavancin_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9444","description":"Injection_ Oritavancin_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33963","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQB0","description":"ICD-LAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0303","description":"HCPCS-B0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOD1","description":"ICD-LFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13A","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSA1","description":"ICD-OJSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMC1","description":"ICD-BBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75962","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo drain lymphocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49323","description":"Laparo drain lymphocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0966T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","description":"CPT-0966T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of finger jnt add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26861","description":"Fusion of finger jnt add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENC1","description":"ICD-BENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAB0","description":"ICD-FFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDB1","description":"ICD-IBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place breast rad tube/caths","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19298","description":"Place breast rad tube/caths","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOE0","description":"ICD-HHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEA1","description":"ICD-GGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25525","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSA0","description":"ICD-ODSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLD1","description":"ICD-KBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open thrombect av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36831","description":"Open thrombect av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBE1","description":"ICD-GFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE217","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHB0","description":"ICD-FEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0608","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","description":"HCPCS-J0608","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl alkaline battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8622","description":"Repl alkaline battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27485","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDD0","description":"ICD-IBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pharyngeal walls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42892","description":"Revision of pharyngeal walls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIC0","description":"ICD-ACIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLF1","description":"ICD-FGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLD0","description":"ICD-IHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMD0","description":"ICD-FDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCED0","description":"ICD-NCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQE1","description":"ICD-PEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44020","description":"Explore small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63102","description":"Remove vert body dcmprn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQA1","description":"ICD-HFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVE0","description":"ICD-KAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25260","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family homecare train/sessio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5111","description":"Family homecare train/sessio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aud brainstem implt programg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92640","description":"Aud brainstem implt programg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mltispectrl digital les alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0401T","description":"Mltispectrl digital les alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise lesion skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61615","description":"Resect/excise lesion skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHF0","description":"ICD-MFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aqueous shunt prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8612","description":"Aqueous shunt prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGED0","description":"ICD-BGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Who nontorsion jnts pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3915","description":"Who nontorsion jnts pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMF0","description":"ICD-AGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERF1","description":"ICD-OERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mpsv4 vaccine subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90733","description":"Mpsv4 vaccine subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBE0","description":"ICD-MCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKF0","description":"ICD-CEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune (systemic lupus erythematosus)_ IgG and IgM analysis of 80 biomarkers_ utilizing serum_ algorithm reported with a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0062U","description":"Autoimmune (systemic lupus erythematosus)_ IgG and IgM analysis of 80 biomarkers_ utilizing serum_ algorithm reported with a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUA1","description":"ICD-BHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0070","description":"Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUB1","description":"ICD-KDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC21","description":"ICD-2BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSA1","description":"ICD-PDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mogamulizumab-kpkc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9038","description":"Injection_ mogamulizumab-kpkc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHF0","description":"ICD-GCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIF1","description":"ICD-NBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYD0","description":"ICD-PCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2351","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","description":"HCPCS-J2351","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKD0","description":"ICD-OBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc xdrl/idrl lsn any lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63290","description":"Bx/exc xdrl/idrl lsn any lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1421","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","description":"HCPCS-M1421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Varicella zoster ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87290","description":"Varicella zoster ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB254","description":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUE0","description":"ICD-EFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWB1","description":"ICD-KBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXD0","description":"ICD-GIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lengthen radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25391","description":"Lengthen radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDF1","description":"ICD-MIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBE1","description":"ICD-AIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecallantide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1290","description":"Ecallantide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRA0","description":"ICD-OHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVA1","description":"ICD-NCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair paravag defect vag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57285","description":"Repair paravag defect vag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional electric stim nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0770","description":"Functional electric stim nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYA1","description":"ICD-DGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTF1","description":"ICD-OHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cult skin grft f/n/hfg add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15156","description":"Cult skin grft f/n/hfg add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANC1","description":"ICD-KANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit mech ventilator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99504","description":"Home visit mech ventilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC31","description":"ICD-3CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reposition l ventric lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33226","description":"Reposition l ventric lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUF0","description":"ICD-MKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult size brief/diaper lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4523","description":"Adult size brief/diaper lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXF1","description":"ICD-JBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Western blot test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84181","description":"Western blot test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12C","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEC1","description":"ICD-MEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gemtuzumab ozogamicin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9300","description":"Gemtuzumab ozogamicin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preorthodontic tx visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8660","description":"Preorthodontic tx visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee heavy dut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1195","description":"Wheelchair amputee heavy dut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWF0","description":"ICD-HEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETC0","description":"ICD-GETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of forearm cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29075","description":"Application of forearm cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPA1","description":"ICD-OBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61581","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78266","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSE1","description":"ICD-CDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHB0","description":"ICD-OKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRC1","description":"ICD-OBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spkt/v less than 1. 2 (single-pool clearance of urea [kt] / volume [v])_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8717","description":"Spkt/v less than 1. 2 (single-pool clearance of urea [kt] / volume [v])_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQF1","description":"ICD-DBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEE1","description":"ICD-ECEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJE1","description":"ICD-OEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thigh/wght bear lacer molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2540","description":"Thigh/wght bear lacer molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No reason for no hep c rna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9204","description":"No reason for no hep c rna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ferumoxytol_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0139","description":"Ferumoxytol_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhcp-serv of pt_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0151","description":"Hhcp-serv of pt_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB131","description":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUE1","description":"ICD-OJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWA0","description":"ICD-LCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"F emb trns canc case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4018","description":"F emb trns canc case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIE0","description":"ICD-NIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAE1","description":"ICD-NDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ any specimen source)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9803","description":"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ any specimen source)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVD1","description":"ICD-GHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0604","description":"HCPCS-C0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXA1","description":"ICD-FGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVF0","description":"ICD-ODVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDC0","description":"ICD-JFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWC1","description":"ICD-OJWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUF1","description":"ICD-GAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subs eval for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1121F","description":"Subs eval for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hfo nontorsion jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3930","description":"Hfo nontorsion jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEB0","description":"ICD-NBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDF0","description":"ICD-AEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fo pip dip jnt/sprng pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3925","description":"Fo pip dip jnt/sprng pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opiates 1 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80361","description":"Opiates 1 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYD1","description":"ICD-OJYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xray place dist ext thor ao","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75959","description":"Xray place dist ext thor ao","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELD0","description":"ICD-JELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1013T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","description":"CPT-1013T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMA0","description":"ICD-BBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pancreatic stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48020","description":"Removal of pancreatic stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHA0","description":"ICD-EFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBID0","description":"ICD-EBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDF1","description":"ICD-NLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCF1","description":"ICD-IGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXE1","description":"ICD-OCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEE1","description":"ICD-AGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20D","description":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUF1","description":"ICD-FIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGB0","description":"ICD-BGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUF1","description":"ICD-KEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABC0","description":"ICD-IABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSD1","description":"ICD-CDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTD1","description":"ICD-BCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC31","description":"ICD-2DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACE0","description":"ICD-JACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98970","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject pulm art hrt cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93568","description":"Inject pulm art hrt cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIC1","description":"ICD-CIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHD0","description":"ICD-ECHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74470","description":"X-ray exam of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWB1","description":"ICD-KGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFA0","description":"ICD-JGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder/vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51900","description":"Repair bladder/vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office visit after hours","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9440","description":"Office visit after hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLF1","description":"ICD-AGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens hydrophilic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2520","description":"Contact lens hydrophilic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spirom doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3023F","description":"Spirom doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERF1","description":"ICD-KERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFED0","description":"ICD-BFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYC0","description":"ICD-LGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDC0","description":"ICD-EHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 6","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA46","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOF1","description":"ICD-DGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin splt grft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15101","description":"Skin splt grft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol (ethanol); any specimen except breath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6040","description":"Alcohol (ethanol); any specimen except breath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBF0","description":"ICD-AGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALA0","description":"ICD-AALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRF1","description":"ICD-OJRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLE0","description":"ICD-JBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biliary duct stone extraction_ percutaneous via t-tube tract_ basket_ o snare (eg_ burhenne technique)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47630","description":"Biliary duct stone extraction_ percutaneous via t-tube tract_ basket_ o snare (eg_ burhenne technique)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo guidance radiotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76965","description":"Echo guidance radiotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTC0","description":"ICD-BFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METB0","description":"ICD-METB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27510","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/4.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2313","description":"Lens sphc trifo 7.25-12/4.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAD0","description":"ICD-OFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1042","description":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22C","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGA1","description":"ICD-BEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDD0","description":"ICD-FBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATA1","description":"ICD-KATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place device impacted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7283","description":"Place device impacted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suspension of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54640","description":"Suspension of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBC0","description":"ICD-MGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJB0","description":"ICD-GIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEB0","description":"ICD-ICEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEB0","description":"ICD-BAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of manganese","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83785","description":"Assay of manganese","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens spher bifoc plano 4.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2200","description":"Lens spher bifoc plano 4.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close mastoid fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69700","description":"Close mastoid fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITC0","description":"ICD-MITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVC0","description":"ICD-FHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70140","description":"X-ray exam of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit periorbt w/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21395","description":"Opn tx orbit periorbt w/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVC1","description":"ICD-BCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWA1","description":"ICD-HFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWF0","description":"ICD-CIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBE0","description":"ICD-AIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD106","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12D","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCE0","description":"ICD-FBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPF1","description":"ICD-CDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTD0","description":"ICD-JGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18D","description":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vagotomy & pylorus repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43640","description":"Vagotomy & pylorus repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWB1","description":"ICD-CGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETC0","description":"ICD-OETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELF1","description":"ICD-EELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPC0","description":"ICD-NAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC125","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Odontoplasty 1-2 teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9971","description":"Odontoplasty 1-2 teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB17","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDA0","description":"ICD-NDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlamydia culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87110","description":"Chlamydia culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implnt/abut remov dent mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6111","description":"Implnt/abut remov dent mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21080","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEE1","description":"ICD-BGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDE0","description":"ICD-OIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism InveniQA semantic answers in medicine _ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1014","description":"Clinical decision support mechanism InveniQA semantic answers in medicine _ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUC1","description":"ICD-GFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYC1","description":"ICD-HGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABF0","description":"ICD-BABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture belly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35122","description":"Repair artery rupture belly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQC1","description":"ICD-DFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+ cell >=15% (hiv)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3498F","description":"Cd4+ cell >=15% (hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRA1","description":"ICD-OLRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCA0","description":"ICD-MKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWB0","description":"ICD-OKWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOD1","description":"ICD-ODOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low back disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63030","description":"Low back disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31370","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEB0","description":"ICD-FCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBID1","description":"ICD-KBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetate conc sol per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4708","description":"Acetate conc sol per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVB1","description":"ICD-KGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8977","description":"Oncology measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBF0","description":"ICD-IEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERC1","description":"ICD-LERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulp cap direct","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3110","description":"Pulp cap direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAC0","description":"ICD-JEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73120","description":"X-ray exam of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNA1","description":"ICD-JGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKE0","description":"ICD-JCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Finger tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26498","description":"Finger tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUB0","description":"ICD-MCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWD1","description":"ICD-HCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Food thickener oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4100","description":"Food thickener oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28A","description":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUF0","description":"ICD-EGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTD0","description":"ICD-OJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replc sockt above elbow disa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6884","description":"Replc sockt above elbow disa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPB0","description":"ICD-FFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES206","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA11","description":"ICD-1IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self care mngment training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97535","description":"Self care mngment training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital bed var ht w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0256","description":"Hospital bed var ht w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0049","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18H","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA31","description":"ICD-4GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMC1","description":"ICD-FFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft carotid-brchial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35510","description":"Art byp grft carotid-brchial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl icar ischm mntrng dvce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0307T","description":"Rmvl icar ischm mntrng dvce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elect stim wound care not pd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0282","description":"Elect stim wound care not pd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTD1","description":"ICD-JGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUC0","description":"ICD-NIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group therapeutic procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97150","description":"Group therapeutic procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFC0","description":"ICD-FHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dil macular/fundus not perfo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8398","description":"Dil macular/fundus not perfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8011","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8011","description":"HCPCS-C8011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pland chemo docd b/4 txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0519F","description":"Pland chemo docd b/4 txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDA0","description":"ICD-OCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJB1","description":"ICD-FGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUD0","description":"ICD-OBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair lead pace-defib dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33220","description":"Repair lead pace-defib dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pantoprazole sodium_ 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2470","description":"Injection_ pantoprazole sodium_ 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHA0","description":"ICD-IAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPA0","description":"ICD-CEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGA0","description":"ICD-FCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Frozen Entree","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1760","description":"Home Delivered Meals-Frozen Entree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microprcsr cu combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0482","description":"Microprcsr cu combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Placental lactogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83632","description":"Placental lactogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSB1","description":"ICD-HDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNC0","description":"ICD-FCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac Output Measurement(S)_ Thermodilution Or Other Indicator Dilution Method_ Performed During Cardiac Catheterization For The Evaluation Of Congenital Heart Defects (List","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93598","description":"Cardiac Output Measurement(S)_ Thermodilution Or Other Indicator Dilution Method_ Performed During Cardiac Catheterization For The Evaluation Of Congenital Heart Defects (List","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Water circ cold pad w pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0218","description":"Water circ cold pad w pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEA0","description":"ICD-OIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lungcx bx rpt docs class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9418","description":"Lungcx bx rpt docs class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHA0","description":"ICD-NIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGB1","description":"ICD-FEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRC1","description":"ICD-LCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27599","description":"Leg surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDD0","description":"ICD-EFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC113","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0995T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","description":"CPT-0995T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAC0","description":"ICD-AEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB112","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost s/d ultlite mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7402","description":"Add ue prost s/d ultlite mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPD1","description":"ICD-FDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLA0","description":"ICD-OFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4419","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","description":"HCPCS-Q4419","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ace/arb not rxd; doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8474","description":"Ace/arb not rxd; doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4368","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","description":"HCPCS-Q4368","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBB1","description":"ICD-ABBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; biopsy(ies)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38221","description":"Diagnostic bone marrow; biopsy(ies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAF1","description":"ICD-BBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1447","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","description":"HCPCS-M1447","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMC0","description":"ICD-OBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dolasetron 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0174","description":"Dolasetron 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFC1","description":"ICD-ODFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHB0","description":"ICD-NCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fev<60% pred & copd sym","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8924","description":"Fev<60% pred & copd sym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDD0","description":"ICD-CBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIE0","description":"ICD-OGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEC0","description":"ICD-MDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCC1","description":"ICD-GDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA11","description":"ICD-4GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKC0","description":"ICD-BIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath w/drainage 2-way silcne","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4315","description":"Cath w/drainage 2-way silcne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCED1","description":"ICD-MCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERA0","description":"ICD-CERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAE0","description":"ICD-KFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Long-acting inhaled bronchodilator prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9695","description":"Long-acting inhaled bronchodilator prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD231","description":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTC1","description":"ICD-NBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUA1","description":"ICD-KBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES315","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Polarization_ any lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2762","description":"Polarization_ any lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhs/hospice of lpn ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0300","description":"Hhs/hospice of lpn ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJB1","description":"ICD-GEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAD1","description":"ICD-FBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLD1","description":"ICD-AFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36010","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPA0","description":"ICD-FAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doxorubicin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9000","description":"Doxorubicin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56740","description":"Remove vagina gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra_ w/o&w/dye_ upper extr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8936","description":"Mra_ w/o&w/dye_ upper extr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ non-small cell lung neoplasia_ DN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0136U","description":"Targeted genomic sequence analysis panel_ non-small cell lung neoplasia_ DN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENE0","description":"ICD-OENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPF1","description":"ICD-GCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEB1","description":"ICD-MKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDE1","description":"ICD-OJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXE1","description":"ICD-NEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-linked intellectual dblt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81470","description":"X-linked intellectual dblt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHF1","description":"ICD-BFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXE1","description":"ICD-NAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTD0","description":"ICD-AFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28193","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPF0","description":"ICD-OHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA20","description":"Default_ /14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTB0","description":"ICD-BCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB01","description":"Very High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m tetrofosmin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9502","description":"Tc99m tetrofosmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGC0","description":"ICD-CEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUC0","description":"ICD-IBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise spin&cord 2 stgs crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63198","description":"Incise spin&cord 2 stgs crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJD1","description":"ICD-NEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSE0","description":"ICD-LGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0551U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0551U","description":"CPT-0551U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Review/report bp recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93790","description":"Review/report bp recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impact tooth remov comp bony","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7240","description":"Impact tooth remov comp bony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ortho shoe add march bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3595","description":"Ortho shoe add march bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWE1","description":"ICD-OGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain canal shunt procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61070","description":"Brain canal shunt procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDC0","description":"ICD-GCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA55","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht irrigation diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9590","description":"Ht irrigation diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXC1","description":"ICD-NGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj trigger point 1/2 muscl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20552","description":"Inj trigger point 1/2 muscl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEB0","description":"ICD-EFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAD0","description":"ICD-KHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJD1","description":"ICD-JFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Signs of melanoma absent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8749","description":"Signs of melanoma absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic passive restor comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6360","description":"Thoracic passive restor comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22632","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD220","description":"Special Care High _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4A","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCE1","description":"ICD-ODCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGF1","description":"ICD-ODGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of pyruvate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84210","description":"Assay of pyruvate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23A","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (Cutaquig)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1551","description":"Injection_ immune globulin (Cutaquig)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNA0","description":"ICD-BHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt has no resp insufficiency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1505F","description":"Pt has no resp insufficiency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0084","description":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDE1","description":"ICD-GBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5C","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIE0","description":"ICD-MEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHF1","description":"ICD-MHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWA1","description":"ICD-CGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUD0","description":"ICD-CDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKF1","description":"ICD-BBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPD0","description":"ICD-FEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24361","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWD0","description":"ICD-KCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYB0","description":"ICD-GAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPF1","description":"ICD-GEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TBP (TATA box binding protein) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81344","description":"TBP (TATA box binding protein) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood transfusion service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36430","description":"Blood transfusion service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVF0","description":"ICD-NIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKF0","description":"ICD-GIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj sciatic sng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64445","description":"N block inj sciatic sng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUB0","description":"ICD-EAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No hepc rna after med docrsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9210","description":"No hepc rna after med docrsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35261","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWA0","description":"ICD-GAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKB0","description":"ICD-BBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Install spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63740","description":"Install spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVF1","description":"ICD-KBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMF1","description":"ICD-OFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC11","description":"ICD-3DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHF1","description":"ICD-NFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQC0","description":"ICD-PHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artificial cornea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8609","description":"Artificial cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB11","description":"ICD-4KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0406","description":"HCPCS-A0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laminotomy single lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63042","description":"Laminotomy single lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rabies vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90675","description":"Rabies vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCC1","description":"ICD-BBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert pacing lead & connect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33224","description":"Insert pacing lead & connect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services for patient provided any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1067","description":"Hospice services for patient provided any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMA0","description":"ICD-IIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00921","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","description":"CPT-00921","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq card angio/athrect addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92925","description":"Prq card angio/athrect addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFE1","description":"ICD-JHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rad w/o backup non-inv intfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0470","description":"Rad w/o backup non-inv intfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHE0","description":"ICD-MKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCE1","description":"ICD-BHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0649T","description":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis auto w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81001","description":"Urinalysis auto w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEA1","description":"ICD-IHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFE0","description":"ICD-GAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCB0","description":"ICD-FBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22846","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA11","description":"ICD-3HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNA0","description":"ICD-GCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00104","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","description":"CPT-00104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77065","description":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1330","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1330","description":"HCPCS-L1330","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24A","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYB0","description":"ICD-OFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGC0","description":"ICD-GIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intake Activities_ Including Initial Medical Examination That Is A Complete_ Fully Documented Physical Evaluation And Initial Assessment By A Program Physician Or A Primary Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2076","description":"Intake Activities_ Including Initial Medical Examination That Is A Complete_ Fully Documented Physical Evaluation And Initial Assessment By A Program Physician Or A Primary Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMD1","description":"ICD-MKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sps elbow device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1801","description":"Sps elbow device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAE0","description":"ICD-IAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKF0","description":"ICD-NAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUD0","description":"ICD-BCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAF1","description":"ICD-GIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVF0","description":"ICD-CEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin fluid swg/sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5828","description":"Endo knee-shin fluid swg/sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALE1","description":"ICD-OALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58952","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMF1","description":"ICD-NHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sys bp less 140","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8752","description":"Sys bp less 140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARC0","description":"ICD-LARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPC1","description":"ICD-JEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFB0","description":"ICD-NJFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLC0","description":"ICD-BCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAC0","description":"ICD-CBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGC0","description":"ICD-FHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0650U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0650U","description":"CPT-0650U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dias bp less 90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8754","description":"Dias bp less 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE215","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAF1","description":"ICD-MHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relieve bladder contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52640","description":"Relieve bladder contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nipple Prosthesis_ Custom Fabricated_ Reusable_ Any Material_ Any Type_ Each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8033","description":"Nipple Prosthesis_ Custom Fabricated_ Reusable_ Any Material_ Any Type_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDA0","description":"ICD-BFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQB1","description":"ICD-OCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWC1","description":"ICD-PHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNB1","description":"ICD-NHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOD1","description":"ICD-PEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA22","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25676","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE155","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA145","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection into spinal artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62294","description":"Injection into spinal artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Weight mgmt class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9449","description":"Weight mgmt class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX41","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLC1","description":"ICD-JGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMB1","description":"ICD-ABMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thiethylperazine maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3280","description":"Thiethylperazine maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATD1","description":"ICD-BATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko w/0 joint rigid molded to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1834","description":"Ko w/0 joint rigid molded to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARE1","description":"ICD-LARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9859","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGB0","description":"ICD-NEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLC0","description":"ICD-MLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLB1","description":"ICD-IBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELB1","description":"ICD-BELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc of dsm-iv init eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9212","description":"Doc of dsm-iv init eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of thigh muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27430","description":"Revision of thigh muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8C","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB35","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADF0","description":"ICD-MADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99157","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic casts","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0470","description":"Diagnostic casts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUE1","description":"ICD-OGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICE0","description":"ICD-EICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray upper gi delay w/o kub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74240","description":"X-ray upper gi delay w/o kub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKF1","description":"ICD-GIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHD0","description":"ICD-FAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRF0","description":"ICD-HGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAB1","description":"ICD-MGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLC0","description":"ICD-MCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8692","description":"Replacement retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","description":"HCPCS-M1379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCE1","description":"ICD-JHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA INFLUENZA A/B EACH","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87400","description":"IAAD IA INFLUENZA A/B EACH","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acute pvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1337","description":"Acute pvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUB1","description":"ICD-FIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKC0","description":"ICD-NLKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAF1","description":"ICD-NIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLE1","description":"ICD-CFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACD0","description":"ICD-AACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot_ adductus positioning device_ adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3161","description":"Foot_ adductus positioning device_ adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pancreatic)_ DNA_ whole genome sequencing with 5-hydroxymethylcytosine enrichment_ whole blood or plasma_ algorithm reported as cancer detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0410U","description":"Oncology (pancreatic)_ DNA_ whole genome sequencing with 5-hydroxymethylcytosine enrichment_ whole blood or plasma_ algorithm reported as cancer detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient Respite Care - A flat per diem rate before area wage adjustment paid for each day on which the patient is in an inpatient facility and is receiving respite care.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0604","description":"Inpatient Respite Care - A flat per diem rate before area wage adjustment paid for each day on which the patient is in an inpatient facility and is receiving respite care.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCB1","description":"ICD-KHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 600 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0240","description":"Injection_ casirivimab and imdevimab_ 600 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTD1","description":"ICD-ICTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No asp therp used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8599","description":"No asp therp used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rimantadine hcl 100mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9020","description":"Rimantadine hcl 100mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSE1","description":"ICD-LGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Development of cognitive skills to improve attention_ memory_ problem solving (includes compensatory training)_ direct (one-on-one) patient contact_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0515","description":"Development of cognitive skills to improve attention_ memory_ problem solving (includes compensatory training)_ direct (one-on-one) patient contact_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA21","description":"ICD-1LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Idet 1 or more levels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22527","description":"Idet 1 or more levels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clearance of tear duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68530","description":"Clearance of tear duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy fimbrioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58672","description":"Laparoscopy fimbrioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Up ext fx orthos humeral nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3980","description":"Up ext fx orthos humeral nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEA1","description":"ICD-CDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray guide gu dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74485","description":"X-ray guide gu dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney & ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50236","description":"Removal of kidney & ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genetic test spec analysis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0423","description":"Genetic test spec analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVD1","description":"ICD-GBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGE0","description":"ICD-OBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0503U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","description":"CPT-0503U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGID0","description":"ICD-JGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Standing frame sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0638","description":"Standing frame sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQC0","description":"ICD-HAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation Supply; Sleeve_ Disposable_ Per Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4437","description":"Irrigation Supply; Sleeve_ Disposable_ Per Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDA1","description":"ICD-EBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMA1","description":"ICD-ACMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAD1","description":"ICD-BIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professiona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95250","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOD0","description":"ICD-LGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUF0","description":"ICD-BDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHC1","description":"ICD-BAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53260","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","description":"HCPCS-A2038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMC0","description":"ICD-GAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28E","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intermittent urinary cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4353","description":"Intermittent urinary cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy orchiectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54690","description":"Laparoscopy orchiectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGC0","description":"ICD-NEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00756","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","description":"CPT-00756","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCD1","description":"ICD-EFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTD0","description":"ICD-FCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB141","description":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAA0","description":"ICD-BBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure of split wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12021","description":"Closure of split wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0804","description":"HCPCS-A0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIC1","description":"ICD-JBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPF0","description":"ICD-FFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRA0","description":"ICD-DBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUC0","description":"ICD-JAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43108","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFID0","description":"ICD-KFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQD0","description":"ICD-ODQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE140","description":"Reduced Physical Function _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASD0","description":"ICD-DASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX12","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICC0","description":"ICD-BICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXB0","description":"ICD-FCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEF1","description":"ICD-JBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVC1","description":"ICD-BHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEE1","description":"ICD-KHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suspension sleeve lower ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2397","description":"Suspension sleeve lower ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALC1","description":"ICD-FALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQE1","description":"ICD-KIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQC0","description":"ICD-OAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRB1","description":"ICD-CHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVD0","description":"ICD-OKVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMD0","description":"ICD-AEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENE0","description":"ICD-CENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01234","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","description":"CPT-01234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO foot or ankle intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9731","description":"Patient unable to complete the FOTO foot or ankle intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1577","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1577","description":"HCPCS-J1577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct neck spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72127","description":"Ct neck spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCD1","description":"ICD-KFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMC1","description":"ICD-GDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKB0","description":"ICD-FDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFB0","description":"ICD-JBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMA1","description":"ICD-KGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phakic iol refractive error","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0596","description":"Phakic iol refractive error","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of collarbone joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23106","description":"Incision of collarbone joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tmp manipulation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7820","description":"Closed tmp manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Init ak ischal plstr direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5505","description":"Init ak ischal plstr direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCD0","description":"ICD-MFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr rem hernia init reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49550","description":"Rpr rem hernia init reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1010","description":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7520","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE113","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEC0","description":"ICD-KDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIF1","description":"ICD-EBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep a/hep b vacc adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90636","description":"Hep a/hep b vacc adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1402","description":"HCPCS-C1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBF1","description":"ICD-ACBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m apcitide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9504","description":"Tc99m apcitide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUC1","description":"ICD-KFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDC1","description":"ICD-IIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seat upholstery_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0981","description":"Seat upholstery_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPD1","description":"ICD-NKPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHC0","description":"ICD-NFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPE1","description":"ICD-OGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implant from hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26320","description":"Removal of implant from hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Color vision examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92283","description":"Color vision examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSA1","description":"ICD-KGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20703","description":"Removal Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove intestinal allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44137","description":"Remove intestinal allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ padded textile_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6606","description":"Gradient compression bandaging supply_ padded textile_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQE1","description":"ICD-HFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWC0","description":"ICD-CBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWA1","description":"ICD-CDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYE0","description":"ICD-PKYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ complete joint (ie_ joint space and peri-articular soft tissue structures) real-time with image documentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76881","description":"Ultrasound_ complete joint (ie_ joint space and peri-articular soft tissue structures) real-time with image documentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHF1","description":"ICD-IHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clsd reduct compd maxilla fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7720","description":"Clsd reduct compd maxilla fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam knee 4 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73564","description":"X-ray exam knee 4 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63700","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB53","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHA0","description":"ICD-MKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOB0","description":"ICD-HFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/3-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34803","description":"Endovas aaa repr w/3-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUA0","description":"ICD-IIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g. virtual check-in_ by a physician or other qualified health care professional who can report evaluation and management servic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2252","description":"Brief communication technology-based service_ e.g. virtual check-in_ by a physician or other qualified health care professional who can report evaluation and management servic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGC0","description":"ICD-FFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abd paracentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49082","description":"Abd paracentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAA1","description":"ICD-MDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apexification/recalc interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3352","description":"Apexification/recalc interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine hydrochloride (biorphen)_ 20 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2372","description":"Injection_ phenylephrine hydrochloride (biorphen)_ 20 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLB0","description":"ICD-OGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92230","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr pack base elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0488","description":"Pwr pack base elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIA0","description":"ICD-IAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0795T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/abn lvef b-bloc no rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8452","description":"Pt w/abn lvef b-bloc no rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCF1","description":"ICD-MLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lipopro bld electrophoretic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83700","description":"Lipopro bld electrophoretic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIA1","description":"ICD-BGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDB0","description":"ICD-MIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA116","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTF1","description":"ICD-CDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic incision larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31320","description":"Diagnostic incision larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5144","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","description":"HCPCS-Q5144","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37246","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBB1","description":"ICD-GGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTE1","description":"ICD-NDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBE0","description":"ICD-JHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9260","description":"Methotrexate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46940","description":"Treatment of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMB1","description":"ICD-JBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTC0","description":"ICD-GDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILE0","description":"ICD-NILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDB0","description":"ICD-GBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1096","description":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear rx intra-arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79445","description":"Nuclear rx intra-arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSF1","description":"ICD-CDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKE1","description":"ICD-OLKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aor ane >=6.0 cm max diam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9599","description":"Aor ane >=6.0 cm max diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNE0","description":"ICD-CFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHC0","description":"ICD-NAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOE0","description":"ICD-LEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27557","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOE0","description":"ICD-PDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTB1","description":"ICD-ECTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBE1","description":"ICD-OKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levonorgestrel implant sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7306","description":"Levonorgestrel implant sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAID0","description":"ICD-GAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHF1","description":"ICD-FEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 xhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0854","description":"Pwc gp 3 xhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Braf gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81210","description":"Braf gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tactile breast img uni/bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0422T","description":"Tactile breast img uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA204","description":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28112","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision graft extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35903","description":"Excision graft extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRE1","description":"ICD-OBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEF0","description":"ICD-FCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair corporeal tear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54437","description":"Repair corporeal tear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAC1","description":"ICD-CDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKB0","description":"ICD-CHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81364","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXF1","description":"ICD-FBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRE0","description":"ICD-HDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHD1","description":"ICD-NCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUB0","description":"ICD-KGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMF1","description":"ICD-CHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGE1","description":"ICD-JBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Topical anesthetic_ per gram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4736","description":"Topical anesthetic_ per gram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANE1","description":"ICD-FANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66500","description":"Incision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral occlusal film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0240","description":"Intraoral occlusal film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWA0","description":"ICD-DFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUE1","description":"ICD-JBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBB1","description":"ICD-JGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; BILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53451","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; BILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUC0","description":"ICD-AGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AmnioBind_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4225","description":"AmnioBind_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJC1","description":"ICD-BGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUF0","description":"ICD-EAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQA1","description":"ICD-HIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYB1","description":"ICD-LBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVA1","description":"ICD-OAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add to spinal orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0999","description":"Add to spinal orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAE0","description":"ICD-CDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQA1","description":"ICD-CBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFD1","description":"ICD-NIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBC0","description":"ICD-EEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTD1","description":"ICD-MBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLD0","description":"ICD-KGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Appropos mthd offloading rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4269F","description":"Appropos mthd offloading rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKF1","description":"ICD-BIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27332","description":"Removal of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21C","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE140","description":"Clinically Complex _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gi/renal risk assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1008F","description":"Gi/renal risk assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBF1","description":"ICD-MJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOD0","description":"ICD-PJOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCC1","description":"ICD-FCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rad resect hand tumor 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26118","description":"Rad resect hand tumor 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise excessive skin thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15832","description":"Excise excessive skin thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj pembrolizumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9271","description":"Inj pembrolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCA1","description":"ICD-OGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHA0","description":"ICD-JBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic exenteration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45126","description":"Pelvic exenteration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pharm ther osteo rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8633","description":"Pharm ther osteo rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC52","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYA1","description":"ICD-GAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC121","description":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLE1","description":"ICD-IFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow harvest allogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38230","description":"Bone marrow harvest allogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA21","description":"ICD-4EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJED0","description":"ICD-MJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cva lumen obstruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75902","description":"Remove cva lumen obstruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCA1","description":"ICD-MBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMC1","description":"ICD-NIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychoed svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2027","description":"Psychoed svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXE0","description":"ICD-BAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PIGF Preeclampsia Screen_ PerkinElmer Genetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0243U","description":"PIGF Preeclampsia Screen_ PerkinElmer Genetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXB0","description":"ICD-OKXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRD0","description":"ICD-HHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sleeve_ inter limb comp dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4600","description":"Sleeve_ inter limb comp dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRE1","description":"ICD-KHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMD1","description":"ICD-MBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"S bowel endoscope w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44379","description":"S bowel endoscope w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0143","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXB0","description":"ICD-CEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syphilis test_ non-treponemal antibody_ immunoassay_ qualitative (RPR)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0065U","description":"Syphilis test_ non-treponemal antibody_ immunoassay_ qualitative (RPR)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27033","description":"Exploration of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDD1","description":"ICD-FGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQC1","description":"ICD-KDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13A","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBD1","description":"ICD-OEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1089T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1089T","description":"CPT-1089T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peripheral nerve block (PNB)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9770","description":"Peripheral nerve block (PNB)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILF0","description":"ICD-NILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fomepizole_ 15 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1451","description":"Fomepizole_ 15 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue homogenization cultr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87176","description":"Tissue homogenization cultr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene minor bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81207","description":"Bcr/abl1 gene minor bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12A","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEE0","description":"ICD-KDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABA0","description":"ICD-OABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Security Deposit)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7334","description":"Community Transition Svcs (Security Deposit)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9258","description":"Injection_ paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10B","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis c revrs trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87522","description":"Hepatitis c revrs trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHD1","description":"ICD-GHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOC0","description":"ICD-GAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJB0","description":"ICD-NIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGA1","description":"ICD-NFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVB0","description":"ICD-JEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOF0","description":"ICD-OGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1703","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1703","description":"CDT-D1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phenothiazine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6057","description":"Phenothiazine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADD0","description":"ICD-IADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPB0","description":"ICD-NEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGB1","description":"ICD-GIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMA0","description":"ICD-JDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nepuitant 300 mg and palonosetron 0.5 mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9978","description":"Nepuitant 300 mg and palonosetron 0.5 mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42830","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPA0","description":"ICD-JIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC124","description":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ot re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97004","description":"Ot re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin rapid 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5550","description":"Insulin rapid 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHA1","description":"ICD-GFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup body cast fiberglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4002","description":"Cast sup body cast fiberglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJF0","description":"ICD-FFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC135","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25A","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close mult vsd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33675","description":"Close mult vsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHF1","description":"ICD-FGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pituitary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61548","description":"Removal of pituitary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine_ thoracolumbar_ standing (scoliosis)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72069","description":"Radiologic examination_ spine_ thoracolumbar_ standing (scoliosis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLF1","description":"ICD-ECLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMB1","description":"ICD-IHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2050","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2050","description":"HCPCS-A2050","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84702","description":"Chorionic gonadotropin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLF0","description":"ICD-IHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fancc gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81242","description":"Fancc gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHE0","description":"ICD-NJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMB0","description":"ICD-JHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHF1","description":"ICD-NKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye/revise socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65112","description":"Remove eye/revise socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMC1","description":"ICD-JHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited dental tx transition","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8020","description":"Limited dental tx transition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYF1","description":"ICD-CDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37291","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","description":"CPT-37291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDF0","description":"ICD-IFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSE0","description":"ICD-OLSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBB1","description":"ICD-ODBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYB1","description":"ICD-PDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18F","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXA0","description":"ICD-OIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alloderm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4116","description":"Alloderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0684","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","description":"HCPCS-G0684","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10008","description":"Fine needle aspiration biopsy_ including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHB0","description":"ICD-AHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conform band s w <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6445","description":"Conform band s w <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQD1","description":"ICD-HBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Jaw arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29800","description":"Jaw arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95146","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44314","description":"Revision of ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEB0","description":"ICD-KIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDF1","description":"ICD-OJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQF1","description":"ICD-LBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB06","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSE1","description":"ICD-OBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ granisetron_ extended-release_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1627","description":"Injection_ granisetron_ extended-release_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1041T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1041T","description":"CPT-1041T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tot contact ak/knee disart s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5650","description":"Tot contact ak/knee disart s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88365","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNA0","description":"ICD-KGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67805","description":"Remove eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWB1","description":"ICD-GEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCF0","description":"ICD-CBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-93145","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","description":"CPT-93145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1003T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","description":"CPT-1003T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay carboxyhb quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82375","description":"Assay carboxyhb quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99152","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIB1","description":"ICD-OIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical opening esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43352","description":"Surgical opening esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIC1","description":"ICD-CDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWE0","description":"ICD-OKWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert/place heart catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93503","description":"Insert/place heart catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O shoe add felt w leath insl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3520","description":"O shoe add felt w leath insl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01260","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","description":"CPT-01260","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15B","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rhythm ecg tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93041","description":"Rhythm ecg tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O2 contents gas cubic ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8120","description":"O2 contents gas cubic ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Malaria antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86750","description":"Malaria antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAB1","description":"ICD-BHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compatibility test incubate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86921","description":"Compatibility test incubate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0435","description":"Oral hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEA0","description":"ICD-MKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct upper jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21206","description":"Reconstruct upper jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAE1","description":"ICD-EHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFED1","description":"ICD-AFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspirate pleura w/o imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32554","description":"Aspirate pleura w/o imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHID1","description":"ICD-EHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33305","description":"Repair of heart wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQC0","description":"ICD-CCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27158","description":"Revision of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPE1","description":"ICD-NIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBE0","description":"ICD-ICBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXA1","description":"ICD-CCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain open retroperi abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49060","description":"Drain open retroperi abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUC0","description":"ICD-EEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt disch home day #2 evar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8826","description":"Pt disch home day #2 evar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post-coital mucous exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0115","description":"Post-coital mucous exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCC0","description":"ICD-MCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1064T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1064T","description":"CPT-1064T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQA0","description":"ICD-PCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENE0","description":"ICD-FENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBF1","description":"ICD-CGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOF0","description":"ICD-GGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report_ unilateral or bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95919","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report_ unilateral or bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOA1","description":"ICD-HAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endometrial cryoablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58356","description":"Endometrial cryoablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC31","description":"ICD-1FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"U2Af1 (U2 Small Nuclear Rna Auxiliary Factor 1) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ S34F_ S34Y_ Q157R_ Q157P)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81357","description":"U2Af1 (U2 Small Nuclear Rna Auxiliary Factor 1) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ S34F_ S34Y_ Q157R_ Q157P)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61566","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration/repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45562","description":"Exploration/repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLD0","description":"ICD-MKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove knee cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27347","description":"Remove knee cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Residual limb support system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1020","description":"Residual limb support system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens bifocal add over 3.25d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2220","description":"Lens bifocal add over 3.25d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4D","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens hydrophil extend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2523","description":"Cntct lens hydrophil extend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFB0","description":"ICD-KBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGE0","description":"ICD-KEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dna/rna direct probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87149","description":"Dna/rna direct probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68810","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28005","description":"Treat foot bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not rcvng warf thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4301F","description":"Pt not rcvng warf thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVA0","description":"ICD-NJVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA215","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAE1","description":"ICD-EFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUD1","description":"ICD-ABUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41826","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC21","description":"ICD-1KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg arterial single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33533","description":"Cabg arterial single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPF0","description":"ICD-ODPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2D","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinician documented that patient had medical reason for not performing lower extremity neurological exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2179","description":"Clinician documented that patient had medical reason for not performing lower extremity neurological exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPC0","description":"ICD-JHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx septal&nose fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21337","description":"Closed tx septal&nose fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fev <40% predicted value","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3040F","description":"Fev <40% predicted value","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUD1","description":"ICD-NIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGC0","description":"ICD-CFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"InnovaBurn or InnovaMatrix XL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2022","description":"InnovaBurn or InnovaMatrix XL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No reason for no hep c geno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9208","description":"No reason for no hep c geno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Beta blckr admin w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4115F","description":"Beta blckr admin w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXB1","description":"ICD-NEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC21","description":"ICD-3DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWC1","description":"ICD-DFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implnt/abut fixed dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6114","description":"Implnt/abut fixed dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMA1","description":"ICD-NGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB204","description":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQA0","description":"ICD-CGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAC1","description":"ICD-EFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSE1","description":"ICD-CHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHC1","description":"ICD-FFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUB1","description":"ICD-IFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14D","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHA1","description":"ICD-BIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFD0","description":"ICD-JCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEB0","description":"ICD-JIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laps rmvl nstim array vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0313T","description":"Laps rmvl nstim array vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJC1","description":"ICD-OJJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECC0","description":"ICD-JECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1044","description":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rubella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86762","description":"Rubella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUD1","description":"ICD-ECUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUD0","description":"ICD-OIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDC1","description":"ICD-GHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPD0","description":"ICD-GGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Powered pressure reducing underlay/pad_ alternating_ with pump_ inc heavy duty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0183","description":"Powered pressure reducing underlay/pad_ alternating_ with pump_ inc heavy duty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1818","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1818","description":"HCPCS-J1818","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5C","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLC1","description":"ICD-FBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc_ frz/deg/wsh_ l/r_ irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9057","description":"Rbc_ frz/deg/wsh_ l/r_ irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fecal microbiota prep instil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0455","description":"Fecal microbiota prep instil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology breast mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81519","description":"Oncology breast mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJC1","description":"ICD-GIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-52443","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","description":"CPT-52443","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Igh vari regional mutation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81263","description":"Igh vari regional mutation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHF0","description":"ICD-BBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPA1","description":"ICD-FEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVC1","description":"ICD-CIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBD1","description":"ICD-MJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech volume modulation system_ any type_ including all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E3000","description":"Speech volume modulation system_ any type_ including all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJC1","description":"ICD-FDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMA1","description":"ICD-CIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHB0","description":"ICD-IGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker seat attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0156","description":"Walker seat attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJA0","description":"ICD-KAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cholinesterase challenge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95857","description":"Cholinesterase challenge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJE0","description":"ICD-CIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep a vac series prev recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4155F","description":"Hep a vac series prev recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUE0","description":"ICD-MHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTC0","description":"ICD-MGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEE0","description":"ICD-MIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTD1","description":"ICD-FGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mycobacteric identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87118","description":"Mycobacteric identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKD1","description":"ICD-CFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDF0","description":"ICD-GGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBC1","description":"ICD-BCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAE1","description":"ICD-MHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB31","description":"ICD-3BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Frozen Tissue_ Blood_ Or Bone Marrow_ Comparative Structural Vari","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0299U","description":"Oncology (Pan Tumor)_ Whole Genome Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Frozen Tissue_ Blood_ Or Bone Marrow_ Comparative Structural Vari","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDB1","description":"ICD-AIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRC0","description":"ICD-OCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATC0","description":"ICD-CATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEC0","description":"ICD-OIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDE0","description":"ICD-CCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXB1","description":"ICD-CEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQA1","description":"ICD-HBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection Fluocinolone Acetonide Intravitreal Implant_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9450","description":"Injection Fluocinolone Acetonide Intravitreal Implant_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUB0","description":"ICD-FEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJC1","description":"ICD-OFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVD1","description":"ICD-BHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Guide nerv destr needle emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95874","description":"Guide nerv destr needle emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v auto in fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88174","description":"Cytopath c/v auto in fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA31","description":"ICD-1FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio hrt w/3d image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75574","description":"Ct angio hrt w/3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEC0","description":"ICD-GFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2107","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISC0","description":"ICD-OISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneum walk boot pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4386","description":"Non-pneum walk boot pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Astigmatism-correct function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2787","description":"Astigmatism-correct function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Instillation_ ciprofloxacin otic suspension_ 6 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7342","description":"Instillation_ ciprofloxacin otic suspension_ 6 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADE0","description":"ICD-JADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFC0","description":"ICD-FIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERB0","description":"ICD-CERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYF1","description":"ICD-OHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJE0","description":"ICD-GFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nitroglycerin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2305","description":"Injection_ nitroglycerin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5250","description":"Hearing aid_ prog_ bin_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whchr s-recl fxd arm leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1100","description":"Whchr s-recl fxd arm leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antepartum management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1001","description":"Antepartum management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"New episode for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1127F","description":"New episode for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABD0","description":"ICD-IABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meas lung vol thru 2 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94013","description":"Meas lung vol thru 2 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72133","description":"Ct lumbar spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ motixafortide_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2277","description":"Injection_ motixafortide_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTB1","description":"ICD-FBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPA1","description":"ICD-GFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBC0","description":"ICD-BGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUC0","description":"ICD-MHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ (aristada initio)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1943","description":"Injection_ aripiprazole lauroxil_ (aristada initio)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIB0","description":"ICD-AAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cltx thigh fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27267","description":"Cltx thigh fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOC0","description":"ICD-GDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJC0","description":"ICD-NEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27884","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB11","description":"ICD-4IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB21","description":"ICD-3HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQB0","description":"ICD-OCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNC0","description":"ICD-JDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCB1","description":"ICD-FCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Encephaltis east eqne anbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86652","description":"Encephaltis east eqne anbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo iv push sngl drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96409","description":"Chemo iv push sngl drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAA0","description":"ICD-GBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIE1","description":"ICD-NGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1433","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","description":"HCPCS-M1433","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLF1","description":"ICD-ODLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Warfarin or another FDA-approved oral anticoagulant is prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8967","description":"Warfarin or another FDA-approved oral anticoagulant is prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFA0","description":"ICD-NFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gross exam prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0472","description":"Gross exam prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAD0","description":"ICD-NCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEC0","description":"ICD-AAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXE1","description":"ICD-NJXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27620","description":"Explore/treat ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0170","description":"Commode chair electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev care mg qual act perfrm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8496","description":"Prev care mg qual act perfrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8I","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair hand joint with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26541","description":"Repair hand joint with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIE1","description":"ICD-JCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ho post-op hip abduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1686","description":"Ho post-op hip abduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLE1","description":"ICD-EGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g._ allergy_ intolerance_ infectious etiology_ pancrea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1184","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g._ allergy_ intolerance_ infectious etiology_ pancrea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcath closure of asd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93580","description":"Transcath closure of asd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVE1","description":"ICD-GBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57288","description":"Repair bladder defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFC1","description":"ICD-BAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYA1","description":"ICD-DHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMD0","description":"ICD-IDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSD0","description":"ICD-GDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCC0","description":"ICD-FBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC134","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOE0","description":"ICD-GGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD144","description":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pad band w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6441","description":"Pad band w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX45","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lab pathology consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80500","description":"Lab pathology consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB116","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy into cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96450","description":"Chemotherapy into cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"One-way allow prorated miles","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9603","description":"One-way allow prorated miles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise hip/thigh nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64763","description":"Incise hip/thigh nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8920","description":"Mra w/o fol w/cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOD1","description":"ICD-LEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18D","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGE1","description":"ICD-KBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRF1","description":"ICD-GDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHB0","description":"ICD-NHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal allograft pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48556","description":"Removal allograft pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc back tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21932","description":"Exc back tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26040","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDD1","description":"ICD-GCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic sigmoidoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45330","description":"Diagnostic sigmoidoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFED0","description":"ICD-JFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; subdural taps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0131U","description":"Anesthesia for intracranial procedures; subdural taps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary pouch on barr w/flng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5073","description":"Urinary pouch on barr w/flng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain shoulder bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23031","description":"Drain shoulder bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin barrier powder per oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4371","description":"Skin barrier powder per oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTA0","description":"ICD-KDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore sinus remove polyps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31032","description":"Explore sinus remove polyps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRC0","description":"ICD-DDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFF0","description":"ICD-GAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24516","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRC1","description":"ICD-KIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA11","description":"ICD-2HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOC1","description":"ICD-OFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art pancreas inv disp sensor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1035","description":"Art pancreas inv disp sensor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNF1","description":"ICD-GBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRC0","description":"ICD-PJRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mt bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20957","description":"Mt bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy or excision of lymph node(s); open_ inguinofemoral node(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38531","description":"Biopsy or excision of lymph node(s); open_ inguinofemoral node(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWE1","description":"ICD-LIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Safety concerns screening positive screen is without provision of mitigation recommendations_ including but not limited to referral to other resources","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9926","description":"Safety concerns screening positive screen is without provision of mitigation recommendations_ including but not limited to referral to other resources","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMB1","description":"ICD-BAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whole body photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96904","description":"Whole body photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSF0","description":"ICD-LBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysterectomy/bladder repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51925","description":"Hysterectomy/bladder repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGC0","description":"ICD-JHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXC0","description":"ICD-JGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA21","description":"ICD-2BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECD1","description":"ICD-MECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vaccinia (smallpox) virus vaccine_ live_ lyophilized_ 0.3 mL dosage_ for percutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90622","description":"Vaccinia (smallpox) virus vaccine_ live_ lyophilized_ 0.3 mL dosage_ for percutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUF0","description":"ICD-MBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mrs disc pain acquisj data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0609T","description":"Mrs disc pain acquisj data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELD0","description":"ICD-MELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAA1","description":"ICD-BAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ing hern premie blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49492","description":"Rpr ing hern premie blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRE0","description":"ICD-DDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDD0","description":"ICD-KEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFD1","description":"ICD-OGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUF0","description":"ICD-FAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEE0","description":"ICD-NEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANA0","description":"ICD-JANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RegeneLink Amniotic Membrane Allograft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4315","description":"RegeneLink Amniotic Membrane Allograft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77332","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No strk cabg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8574","description":"No strk cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28E","description":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0807T","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA53","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHE1","description":"ICD-CIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVA1","description":"ICD-JEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJA0","description":"ICD-OEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGF0","description":"ICD-CGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDB1","description":"ICD-KBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01969","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","description":"CPT-01969","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJD1","description":"ICD-FIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vutrisiran_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0225","description":"Injection_ vutrisiran_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIND1","description":"ICD-NIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5213","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSC0","description":"ICD-GFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt tk tams hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9503","description":"Pt tk tams hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodener muscle larynx emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64617","description":"Chemodener muscle larynx emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDE1","description":"ICD-ICDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUF1","description":"ICD-ECUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31577","description":"Remove foreign body larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVA1","description":"ICD-OGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ moxetumomab pasudotox-tdfk_ 0.01 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9313","description":"Injection_ moxetumomab pasudotox-tdfk_ 0.01 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBD1","description":"ICD-GEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18F","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXF1","description":"ICD-OGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFB1","description":"ICD-FAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMA1","description":"ICD-KHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELE1","description":"ICD-EELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXB0","description":"ICD-CFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9305","description":"HCPCS-C9305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVD1","description":"ICD-JGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDC1","description":"ICD-IBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor liver 3-segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47144","description":"Prep donor liver 3-segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFE0","description":"ICD-CGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Approp oral rehyd recommd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4056F","description":"Approp oral rehyd recommd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnio-Maxx or Amnio Maxx Lite_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4239","description":"Amnio-Maxx or Amnio Maxx Lite_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPE0","description":"ICD-NCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9313","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9313","description":"HCPCS-C9313","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMA1","description":"ICD-CCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVA0","description":"ICD-NIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp4 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0877","description":"Pwc gp4 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIF0","description":"ICD-KHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELA1","description":"ICD-EELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGD0","description":"ICD-NBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDC1","description":"ICD-BIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIB1","description":"ICD-OBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIC0","description":"ICD-KIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4417","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","description":"HCPCS-Q4417","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj follitropin alfa 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0126","description":"Inj follitropin alfa 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oscillating tracking test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92545","description":"Oscillating tracking test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVE1","description":"ICD-FCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAA0","description":"ICD-BAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair pulmonary atresia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33920","description":"Repair pulmonary atresia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC31","description":"ICD-1CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening tramadol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80373","description":"Drug screening tramadol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEC1","description":"ICD-ODEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHC1","description":"ICD-BHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKB1","description":"ICD-BEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair hvy duty detach a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1290","description":"Wheelchair hvy duty detach a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXE1","description":"ICD-CFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB15","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25125","description":"Remove/graft forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mandibular part denture flex","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5226","description":"Mandibular part denture flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTE1","description":"ICD-FFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMC1","description":"ICD-ICMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBC0","description":"ICD-KDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay carbamazepine total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80156","description":"Assay carbamazepine total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDF0","description":"ICD-OCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMF0","description":"ICD-CHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRB1","description":"ICD-PCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood gases o2 sat only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82810","description":"Blood gases o2 sat only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMA1","description":"ICD-MJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8B","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng epo thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4090F","description":"Pt rcvng epo thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vaginal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57415","description":"Remove vaginal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSF0","description":"ICD-KGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTF1","description":"ICD-ADTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOF1","description":"ICD-CEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOB0","description":"ICD-PJOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cognitive test by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96125","description":"Cognitive test by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of tsi globulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84445","description":"Assay of tsi globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal or debulking of intracardiac mass (eg_ vegetations_ thrombus) via suction (eg_ vacuum_ aspiration) device_ percutaneous approach_ w/ intraoperative reinf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0644T","description":"Transcatheter removal or debulking of intracardiac mass (eg_ vegetations_ thrombus) via suction (eg_ vacuum_ aspiration) device_ percutaneous approach_ w/ intraoperative reinf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPA0","description":"ICD-KBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB32","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir and rilpivirine_ 2mg/3mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9077","description":"Injection_ cabotegravir and rilpivirine_ 2mg/3mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cygnus Matrix_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4199","description":"Cygnus Matrix_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes (Versiti™ Red Cell Genotyping Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0282U","description":"Red blood cell antigen typing_ DNA_ genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes (Versiti™ Red Cell Genotyping Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral function therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92526","description":"Oral function therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IFNL3 (interferon_ lambda 3) (eg_ drug response)_ gene analysis_ rs12979860 variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81283","description":"IFNL3 (interferon_ lambda 3) (eg_ drug response)_ gene analysis_ rs12979860 variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent leadless pacemaker_ right ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33275","description":"Transcatheter removal of permanent leadless pacemaker_ right ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Follow-up surgery of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66250","description":"Follow-up surgery of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr angio upr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73225","description":"Mr angio upr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical stent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5982","description":"Surgical stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plerixafor injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2562","description":"Plerixafor injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQD0","description":"ICD-OJQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI joint upr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73223","description":"MRI joint upr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOC0","description":"ICD-GFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHC1","description":"ICD-OGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhcp-svs of aide_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0156","description":"Hhcp-svs of aide_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTF0","description":"ICD-NHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0981T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","description":"CPT-0981T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYD1","description":"ICD-PLYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWC1","description":"ICD-LEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYC1","description":"ICD-OAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBF0","description":"ICD-MKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28299","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPD0","description":"ICD-JHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18H","description":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCA1","description":"ICD-KHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJA0","description":"ICD-OCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBE1","description":"ICD-ECBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIF0","description":"ICD-IHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21139","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bia whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0358T","description":"Bia whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBB1","description":"ICD-CEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAE1","description":"ICD-KGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFC1","description":"ICD-NEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBF0","description":"ICD-AHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB33","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDD1","description":"ICD-MEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSB0","description":"ICD-LCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGB1","description":"ICD-NEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFE0","description":"ICD-JEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42415","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAD1","description":"ICD-JBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKE0","description":"ICD-NHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGA1","description":"ICD-JIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPB1","description":"ICD-CCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc serum pretx incubj drugs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86975","description":"Rbc serum pretx incubj drugs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUD0","description":"ICD-BHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXF0","description":"ICD-KCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert w lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5673","description":"Socket insert w lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp animat ret imag series","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0380T","description":"Comp animat ret imag series","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHA1","description":"ICD-NGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0691U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691U","description":"CPT-0691U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93650","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISF1","description":"ICD-PISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIND0","description":"ICD-FIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin a1c level is missing_ or was not performed during the measurement period (12 months)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1212","description":"Hemoglobin a1c level is missing_ or was not performed during the measurement period (12 months)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cdifficile testing performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3520F","description":"Cdifficile testing performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPB1","description":"ICD-BFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise intraspinl lesion crv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63265","description":"Excise intraspinl lesion crv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDF1","description":"ICD-BHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPD1","description":"ICD-CFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFE1","description":"ICD-FFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0404","description":"HCPCS-C0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYB1","description":"ICD-GCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFF1","description":"ICD-GGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19120","description":"Removal of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pessary_ disposable_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4564","description":"Pessary_ disposable_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBA1","description":"ICD-OCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIA0","description":"ICD-FAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEE1","description":"ICD-JCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYA0","description":"ICD-KIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLA1","description":"ICD-BBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA02","description":"Low Rehab_ ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNE1","description":"ICD-JBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove lower leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27635","description":"Remove lower leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1466","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","description":"HCPCS-M1466","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVE1","description":"ICD-OCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX55","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx gastric unresectable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9102","description":"Onc dx gastric unresectable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGB0","description":"ICD-NJGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMC0","description":"ICD-MGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stem cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86367","description":"Stem cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJB1","description":"ICD-BGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGC0","description":"ICD-GDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown-titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2794","description":"Crown-titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXD1","description":"ICD-OCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTF1","description":"ICD-EHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERC0","description":"ICD-DERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trabeculotomy by laser_ including optical coherence tomography (OCT) guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0730T","description":"Trabeculotomy by laser_ including optical coherence tomography (OCT) guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB01","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35226","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-RUC01","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"RUC01","description":"ICD-RUC01","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22214","description":"Incis 1 vertebral seg lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOE0","description":"ICD-PEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUF1","description":"ICD-FFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL11","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10B","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFE0","description":"ICD-CBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64408","description":"N block inj vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCA1","description":"ICD-GDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic defect closure within the entire gastrointestinal tract_ including upper endoscopy (including diagnostic_ if performed) or colonoscopy (including diagnostic_ if per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9901","description":"Endoscopic defect closure within the entire gastrointestinal tract_ including upper endoscopy (including diagnostic_ if performed) or colonoscopy (including diagnostic_ if per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18F","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Max MRI image capture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0385","description":"Max MRI image capture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABB0","description":"ICD-JABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYD1","description":"ICD-DDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKC0","description":"ICD-FCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTB0","description":"ICD-MCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0541","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","description":"HCPCS-G0541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL17","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYE0","description":"ICD-LDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA231","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo fem fx cast molded to p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2128","description":"Kafo fem fx cast molded to p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDA1","description":"ICD-BFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB20","description":"Ultra High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57105","description":"Biopsy of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQE1","description":"ICD-DDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAF0","description":"ICD-CFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trach/laryn tube plug/stop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7527","description":"Trach/laryn tube plug/stop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with iliac and/or femoral artery angiograph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7517","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with iliac and/or femoral artery angiograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOC1","description":"ICD-PFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement interface spsd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1821","description":"Replacement interface spsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunfix e-phorsis/urine/csf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86335","description":"Immunfix e-phorsis/urine/csf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ immunohistochemistry_ protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1]_ carcinoembryonic antigen-related cell","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0067U","description":"Oncology (breast)_ immunohistochemistry_ protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1]_ carcinoembryonic antigen-related cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHE1","description":"ICD-AGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSA1","description":"ICD-OHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Soft tissue graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4278","description":"Soft tissue graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35450","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open Implantation Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64582","description":"Open Implantation Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPD0","description":"ICD-NKPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9982","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXF1","description":"ICD-KBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision graft thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35905","description":"Excision graft thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HER2-targeted therapies not administered during the initial course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9827","description":"HER2-targeted therapies not administered during the initial course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGB0","description":"ICD-BHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMF0","description":"ICD-CFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_  casirivimab and imdevimab_ 2400 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0243","description":"Injection_  casirivimab and imdevimab_ 2400 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imm admin by intramusc injection of  (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 2nd dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0022A","description":"Imm admin by intramusc injection of  (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 2nd dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLD0","description":"ICD-OFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB42","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMB0","description":"ICD-EFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWD1","description":"ICD-PBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYC1","description":"ICD-GFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEC0","description":"ICD-CAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3C","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport mini-bus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0120","description":"Noner transport mini-bus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0987T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","description":"CPT-0987T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDA1","description":"ICD-BHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSA1","description":"ICD-GGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8E","description":"Low Rehab_ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kit gene targeted seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81272","description":"Kit gene targeted seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNC1","description":"ICD-OHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKD1","description":"ICD-JCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC145","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBE1","description":"ICD-BIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maxillofacial fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21100","description":"Maxillofacial fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEC1","description":"ICD-OCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEB0","description":"ICD-FBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILF1","description":"ICD-KILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATF1","description":"ICD-BATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFF1","description":"ICD-CCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone imaging multiple areas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78305","description":"Bone imaging multiple areas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Precision attachment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5862","description":"Precision attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLD1","description":"ICD-BBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQC0","description":"ICD-GGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid sup/access/dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5267","description":"Hearing aid sup/access/dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23140","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBB0","description":"ICD-ACBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8E","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKF1","description":"ICD-NCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45900","description":"Reduction of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transportation costs to and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9992","description":"Transportation costs to and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWE1","description":"ICD-PHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGD0","description":"ICD-FFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLF1","description":"ICD-MFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther/prop/diag inj/inf proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96379","description":"Ther/prop/diag inj/inf proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ftrst upper hanger bracket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0044","description":"Ftrst upper hanger bracket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHF0","description":"ICD-NGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDB0","description":"ICD-ICDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMF0","description":"ICD-EGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"S&i stent/chest vert art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0076T","description":"S&i stent/chest vert art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFA0","description":"ICD-FHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHA1","description":"ICD-MEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place cath xtrnl carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36227","description":"Place cath xtrnl carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMF1","description":"ICD-JAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBA0","description":"ICD-EFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50976","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15B","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISB1","description":"ICD-OISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter intraoperative blood vessel microinfusion(s) (e.g._ intraluminal_ vascular wall and/or perivascular) ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9759","description":"Transcatheter intraoperative blood vessel microinfusion(s) (e.g._ intraluminal_ vascular wall and/or perivascular) ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGE0","description":"ICD-OAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES240","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSD1","description":"ICD-DFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21C","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5B","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNC1","description":"ICD-NLNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATF0","description":"ICD-AATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla i & ii type verify lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81371","description":"Hla i & ii type verify lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attempted vbac delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59620","description":"Attempted vbac delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gene test alpha-thalassemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3845","description":"Gene test alpha-thalassemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRF1","description":"ICD-CBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQF1","description":"ICD-DDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATD0","description":"ICD-JATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee cap medial or lateral p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2800","description":"Knee cap medial or lateral p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quant results activity &symp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3115F","description":"Quant results activity &symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYC1","description":"ICD-OJYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53235","description":"Removal of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWF0","description":"ICD-CCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALD0","description":"ICD-KALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRD1","description":"ICD-OCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald unspecified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5274","description":"Ald unspecified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFF1","description":"ICD-NFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Idecabtagene Vicleucel_ Up To 460 Million Autologous B-Cell Maturation Antigen (Bcma) Directed Car-Positive T Cells_ Including Leukapheresis And Dose Preparation Procedures_ P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2055","description":"Idecabtagene Vicleucel_ Up To 460 Million Autologous B-Cell Maturation Antigen (Bcma) Directed Car-Positive T Cells_ Including Leukapheresis And Dose Preparation Procedures_ P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHD1","description":"ICD-JIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess inc xray docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3340F","description":"Mammo assess inc xray docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); blocking antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86042","description":"Acetylcholine receptor (AChR); blocking antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ONC MRNA 5 genes ur alg rish urothelial cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012M","description":"ONC MRNA 5 genes ur alg rish urothelial cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCA1","description":"ICD-JGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRC0","description":"ICD-DGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Had History Of At Least One Of The Following Contraindications Any Time During Or Before The Measurement Period: Anaphylaxis Due To Tdap Vaccine_ Anaphylaxis Due To Td","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2155","description":"Patient Had History Of At Least One Of The Following Contraindications Any Time During Or Before The Measurement Period: Anaphylaxis Due To Tdap Vaccine_ Anaphylaxis Due To Td","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJD0","description":"ICD-KFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPD0","description":"ICD-BCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRE0","description":"ICD-OKRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHE1","description":"ICD-EAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMC0","description":"ICD-ODMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWD0","description":"ICD-OBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6524","description":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNA1","description":"ICD-OCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUB1","description":"ICD-IGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Charger and base station for intraurethral activation device_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1012","description":"Charger and base station for intraurethral activation device_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed var ht w/o rail w/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0292","description":"Hosp bed var ht w/o rail w/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20C","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47490","description":"Incision of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlmyd/gonrh tsts docd done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3511F","description":"Chlmyd/gonrh tsts docd done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (hospira)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9049","description":"Injection_ bortezomib (hospira)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deionizer h2o puri system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1615","description":"Deionizer h2o puri system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMC0","description":"ICD-IGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enlargemnt of eye prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2625","description":"Enlargemnt of eye prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78320","description":"Bone imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIF0","description":"ICD-KGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41251","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCF0","description":"ICD-OKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGF1","description":"ICD-GCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0926T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","description":"CPT-0926T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYF1","description":"ICD-LFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATE1","description":"ICD-BATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCF1","description":"ICD-GCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIA1","description":"ICD-OEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ eflapegrastim-xnst_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1449","description":"Injection_ eflapegrastim-xnst_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGB1","description":"ICD-CIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYB0","description":"ICD-GEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16074","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16074","description":"CPT-16074","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYC1","description":"ICD-LDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKC1","description":"ICD-BAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNE0","description":"ICD-BGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27041","description":"Biopsy of soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRB0","description":"ICD-PKRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDC0","description":"ICD-ECDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knuckle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26516","description":"Fusion of knuckle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBA0","description":"ICD-AIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1002","description":"HCPCS-C1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTB1","description":"ICD-CFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLME1","description":"ICD-OLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHD0","description":"ICD-IBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit intermit chemo diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9331","description":"Hit intermit chemo diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSC1","description":"ICD-GHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWA0","description":"ICD-KGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMD0","description":"ICD-KHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01965","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","description":"CPT-01965","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFE0","description":"ICD-GGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCD0","description":"ICD-MDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOB0","description":"ICD-LGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 50 mcg/0.5 mL dosage_ for int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91309","description":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 50 mcg/0.5 mL dosage_ for int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQF0","description":"ICD-CIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduce bowel obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44050","description":"Reduce bowel obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95165","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retrograde filling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3430","description":"Retrograde filling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPC1","description":"ICD-BGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Truskin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4167","description":"Truskin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICA0","description":"ICD-BICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corneal smear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65430","description":"Corneal smear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITC0","description":"ICD-AITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGF1","description":"ICD-FBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61692","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Percutaneous Right Heart Ventricular Assist Device_ Venous Cannula_ At Separate And Distinct Session From Insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33997","description":"Removal Of Percutaneous Right Heart Ventricular Assist Device_ Venous Cannula_ At Separate And Distinct Session From Insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 6/> vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72084","description":"X-ray exam entire spi 6/> vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXC1","description":"ICD-JCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rig ped wc tltnspc w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1233","description":"Rig ped wc tltnspc w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASE0","description":"ICD-LASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHA1","description":"ICD-JEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBB0","description":"ICD-MGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9802","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGC1","description":"ICD-NEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20A","description":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monovisc inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7327","description":"Monovisc inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJE1","description":"ICD-OLJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of skull with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62147","description":"Repair of skull with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98005","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","description":"CPT-98005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXE1","description":"ICD-GFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrodiag polyneuro 6 mn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3751F","description":"Electrodiag polyneuro 6 mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg_patients with malignant)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9346","description":"Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg_patients with malignant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPE0","description":"ICD-NHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEB0","description":"ICD-ADEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUA0","description":"ICD-MKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYC1","description":"ICD-HDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cntct toric prism ballast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2511","description":"Cntct toric prism ballast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen crosslinks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82523","description":"Collagen crosslinks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51550","description":"Partial removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Msh2 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81297","description":"Msh2 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWE0","description":"ICD-CHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28445","description":"Treat ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKE1","description":"ICD-JFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDA0","description":"ICD-FCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ercp sphincter pressure meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43263","description":"Ercp sphincter pressure meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMA0","description":"ICD-MEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 hd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0862","description":"Pwc gp3 hd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1059T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1059T","description":"CPT-1059T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERF0","description":"ICD-GERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVB0","description":"ICD-FEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0679U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679U","description":"CPT-0679U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEE0","description":"ICD-EAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00528","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","description":"CPT-00528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDE0","description":"ICD-CEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB236","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or both","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1193","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or both","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 30-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0516","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 30-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUE0","description":"ICD-GHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/cont_ f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8922","description":"Tte w or w/o fol w/cont_ f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBC0","description":"ICD-OEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ C-1 esterase inhibitor (human)_ (Haegarda)_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0599","description":"Injection_ C-1 esterase inhibitor (human)_ (Haegarda)_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQA0","description":"ICD-PKQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIA0","description":"ICD-IGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVD0","description":"ICD-FEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHC1","description":"ICD-AFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEA0","description":"ICD-GCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cpk in blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82552","description":"Assay of cpk in blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84703","description":"Chorionic gonadotropin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEC1","description":"ICD-IBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96167","description":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy trisom risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81507","description":"Fetal aneuploidy trisom risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDA1","description":"ICD-MGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNC0","description":"ICD-BCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0661","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","description":"HCPCS-G0661","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND E","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX14","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND E","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYD1","description":"ICD-CEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTB1","description":"ICD-MKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLF0","description":"ICD-GDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVF0","description":"ICD-CAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Motor &/ sens nrve cndj test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95905","description":"Motor &/ sens nrve cndj test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHE1","description":"ICD-OJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODME1","description":"ICD-ODME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOB1","description":"ICD-OJOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOE1","description":"ICD-KIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC21","description":"High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automated rbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85041","description":"Automated rbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWD0","description":"ICD-GCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYB1","description":"ICD-DBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXB0","description":"ICD-NLXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Protector heel or elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0191","description":"Protector heel or elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us leiomyomata ablate <200","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071T","description":"Us leiomyomata ablate <200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay activated protein c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85307","description":"Assay activated protein c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEC1","description":"ICD-JDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIC0","description":"ICD-CGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUA1","description":"ICD-GBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHB0","description":"ICD-EAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLA0","description":"ICD-IHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFE1","description":"ICD-JCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUB1","description":"ICD-OLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trac stand free stand extrem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0880","description":"Trac stand free stand extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISE1","description":"ICD-KISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKF1","description":"ICD-NAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Thorax_ Low Dose For Lung Cancer Screening_ Without Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71271","description":"Computed Tomography_ Thorax_ Low Dose For Lung Cancer Screening_ Without Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28430","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of gland abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56420","description":"Drainage of gland abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAD0","description":"ICD-OEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBE1","description":"ICD-OHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX11","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEF1","description":"ICD-OJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKE0","description":"ICD-CGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGD1","description":"ICD-NFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pvb thoracic single inj site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64461","description":"Pvb thoracic single inj site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHF1","description":"ICD-NEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLA1","description":"ICD-MGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDD1","description":"ICD-KDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20B","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ca screen;flexi sigmoidscope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0104","description":"Ca screen;flexi sigmoidscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPB1","description":"ICD-OGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair spec sz spec ht a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1227","description":"Wheelchair spec sz spec ht a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIB1","description":"ICD-GCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENB0","description":"ICD-KENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished w/in a bene home)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0083","description":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished w/in a bene home)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQB1","description":"ICD-DIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCF1","description":"ICD-JHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microvolt t-wave assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93025","description":"Microvolt t-wave assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit pain mgmt per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9325","description":"Hit pain mgmt per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; First 2 Vertebral Bodies_ Lumbar Or Sacral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64628","description":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; First 2 Vertebral Bodies_ Lumbar Or Sacral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Init nb em per day hosp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99460","description":"Init nb em per day hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8618","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAB1","description":"ICD-OJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEB0","description":"ICD-EBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Locm 300-399mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9967","description":"Locm 300-399mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVC1","description":"ICD-GAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Did Not Receive At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2162","description":"Patient Did Not Receive At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHD0","description":"ICD-CAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ethchlorvynol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6050","description":"Ethchlorvynol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antibiot rxd/given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4120F","description":"Antibiot rxd/given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTE1","description":"ICD-NBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUA0","description":"ICD-KHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial and fungal)_ organism identification_ blood culture_ using rRNA FISH_ 6 or more organism targets_ reported as positive or negative with phenotypi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0086U","description":"Infectious disease (bacterial and fungal)_ organism identification_ blood culture_ using rRNA FISH_ 6 or more organism targets_ reported as positive or negative with phenotypi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv vaccine pandemic im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90668","description":"Iiv vaccine pandemic im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"B-12 binding capacity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82608","description":"B-12 binding capacity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMB0","description":"ICD-CCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complex body section x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76101","description":"Complex body section x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD241","description":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iv pole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0776","description":"Iv pole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQD0","description":"ICD-LAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood_ l/r_ irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9056","description":"Blood_ l/r_ irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastime-bmez_ biosimilar_ (ziextenzo) 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9058","description":"Injection_ pegfilgrastime-bmez_ biosimilar_ (ziextenzo) 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSE1","description":"ICD-KBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88027","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUB0","description":"ICD-CAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left ventricular pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0518T","description":"Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left ventricular pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24B","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIC0","description":"ICD-OFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autonomic nrv syst funj test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95923","description":"Autonomic nrv syst funj test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIF0","description":"ICD-GBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSE0","description":"ICD-PLSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1832","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","description":"HCPCS-E1832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS BE ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87350","description":"IAAD IA HEPATITIS BE ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine culture/colony count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87086","description":"Urine culture/colony count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWD1","description":"ICD-CFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILF1","description":"ICD-AILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNC0","description":"ICD-FDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach_ including transseptal puncture_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0483T","description":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach_ including transseptal puncture_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supp for self-adm injections","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4211","description":"Supp for self-adm injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGE1","description":"ICD-NBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ reslizumab_ 1 mg (Cinqair)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9481","description":"Injection_ reslizumab_ 1 mg (Cinqair)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDD1","description":"ICD-IEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMA1","description":"ICD-JDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAF1","description":"ICD-FEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB126","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHB1","description":"ICD-JIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTB1","description":"ICD-NLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Toc tool incl key elem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9655","description":"Toc tool incl key elem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert vad artery access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33990","description":"Insert vad artery access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRB0","description":"ICD-DFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFA0","description":"ICD-NKFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNB0","description":"ICD-KDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILD0","description":"ICD-MILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKA1","description":"ICD-CCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLD0","description":"ICD-NFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAE1","description":"ICD-ABAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 100 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0148U","description":"Drug assay_ definitive_ 100 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHED0","description":"ICD-KHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ interphalangeal joints_ with or without internal fixation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7506","description":"Arthrodesis_ interphalangeal joints_ with or without internal fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQD0","description":"ICD-OFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs)_ urine and buccal DNA_ for specimen identity verification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0079U","description":"Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs)_ urine and buccal DNA_ for specimen identity verification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUB1","description":"ICD-NJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","description":"HCPCS-M1391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNC1","description":"ICD-NGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33300","description":"Repair of heart wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX40","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening tests dm done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3754F","description":"Screening tests dm done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAD0","description":"ICD-BAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complement total (ch50)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86162","description":"Complement total (ch50)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLB1","description":"ICD-KHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27786","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXC0","description":"ICD-FHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLE1","description":"ICD-FGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTA0","description":"ICD-OCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30905","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venous m-thrombectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37188","description":"Venous m-thrombectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0985T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","description":"CPT-0985T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24341","description":"Repair arm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neg scrn dep symp by deptool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3351F","description":"Neg scrn dep symp by deptool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHF0","description":"ICD-CCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27703","description":"Reconstruction ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1327","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHB1","description":"ICD-MIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg artery-vein two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33518","description":"Cabg artery-vein two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJA0","description":"ICD-OIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQB1","description":"ICD-HFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFD0","description":"ICD-OCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAB0","description":"ICD-OHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBB1","description":"ICD-KCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove intra-aortic balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33974","description":"Remove intra-aortic balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMA1","description":"ICD-EFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aud rehab pre-ling hear loss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92630","description":"Aud rehab pre-ling hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bowel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44605","description":"Repair of bowel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ total hysterectomy for resection of malignancy (tumor debulking)_ with omentectomy including salpingo-oophorectomy_ unilateral or bilateral_ when perfor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58575","description":"Laparoscopy_ surgical_ total hysterectomy for resection of malignancy (tumor debulking)_ with omentectomy including salpingo-oophorectomy_ unilateral or bilateral_ when perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97129","description":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA31","description":"ICD-2AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd pneum dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87486","description":"Chylmd pneum dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKD0","description":"ICD-FIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE141","description":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEF0","description":"ICD-NJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (fresenius kabi) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0134","description":"Injection_ acetaminophen (fresenius kabi) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38510","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair narrowing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0969","description":"Wheelchair narrowing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-t9 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0455","description":"Tlso flex trnk sj-t9 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITB1","description":"ICD-BITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"H pylori (c-13) breath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83013","description":"H pylori (c-13) breath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMB1","description":"ICD-BFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of hemoglobin heat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83065","description":"Assay of hemoglobin heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATC1","description":"ICD-MATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBB0","description":"ICD-GBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFED1","description":"ICD-JFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJND1","description":"ICD-OJND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Water pressure pad for mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0198","description":"Water pressure pad for mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Facial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5919","description":"Facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth one lung ventilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54151","description":"Anesth one lung ventilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE245","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Butorphanol tartrate_ nasal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0012","description":"Butorphanol tartrate_ nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSD1","description":"ICD-KBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1C","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27050","description":"Biopsy of sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILF0","description":"ICD-BILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEED0","description":"ICD-AEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33917","description":"Repair pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Full length surg stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4510","description":"Full length surg stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHC1","description":"ICD-MAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALA0","description":"ICD-JALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Addition of walker to cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29440","description":"Addition of walker to cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Taking statin or recd order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9664","description":"Taking statin or recd order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/dxa no results doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8400","description":"Pt w/dxa no results doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEB1","description":"ICD-BGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQE0","description":"ICD-KHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement blood pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1620","description":"Replacement blood pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGED1","description":"ICD-IGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXB0","description":"ICD-OJXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0668","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","description":"HCPCS-G0668","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPA0","description":"ICD-GAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetazolamid sodium injectio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1120","description":"Acetazolamid sodium injectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28124","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITD1","description":"ICD-IITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0B","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TYMS (thymidylate synthetase) (eg_ 5-fluorouracil/5-FU drug metabolism)_ gene analysis_ common variant(s) (eg_ tandem repeat variant)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81346","description":"TYMS (thymidylate synthetase) (eg_ 5-fluorouracil/5-FU drug metabolism)_ gene analysis_ common variant(s) (eg_ tandem repeat variant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; subcutaneous electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0458T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; subcutaneous electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0658","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","description":"HCPCS-E0658","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC21","description":"Medium Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA31","description":"ICD-4AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUF1","description":"ICD-CGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUB1","description":"ICD-CFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMA0","description":"ICD-MFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHF0","description":"ICD-FBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"History aids-defining cond","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3490F","description":"History aids-defining cond","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB11","description":"ICD-4HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0967T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","description":"CPT-0967T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC32","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTB1","description":"ICD-MFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEC0","description":"ICD-EBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endodontic endosseous implan","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3460","description":"Endodontic endosseous implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDE1","description":"ICD-GDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19368","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinogen test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85366","description":"Fibrinogen test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relieve pressure on nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64722","description":"Relieve pressure on nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLD0","description":"ICD-FHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1705","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1705","description":"HCPCS-A1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no statin med disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8817","description":"Doc reas no statin med disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37263","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","description":"CPT-37263","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Male sling procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53440","description":"Male sling procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1026","description":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYE1","description":"ICD-GGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15D","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_ automated sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0147","description":"Scr c/v cyto_ automated sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISB1","description":"ICD-KISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50070","description":"Incision of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPC1","description":"ICD-FAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISD0","description":"ICD-LISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA31","description":"ICD-1AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUE0","description":"ICD-CAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autonomic nrv adrenrg inervj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95922","description":"Autonomic nrv adrenrg inervj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC43","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOE0","description":"ICD-DAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYD0","description":"ICD-DAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9814","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9814","description":"HCPCS-C9814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hfo without joints pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3923","description":"Hfo without joints pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTE0","description":"ICD-EGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIF1","description":"ICD-OJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCF1","description":"ICD-GBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8X","description":"Medium Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAF0","description":"ICD-IBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVD1","description":"ICD-NGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMC0","description":"ICD-JAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGND0","description":"ICD-FGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"DPYD (dihydropyrimidine dehydrogenase) (eg_ 5-fluorouracil/5-FU and capecitabine drug metabolism)_ gene analysis_ common variant(s) (eg_ *2A_ *4_ *5_ *6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81232","description":"DPYD (dihydropyrimidine dehydrogenase) (eg_ 5-fluorouracil/5-FU and capecitabine drug metabolism)_ gene analysis_ common variant(s) (eg_ *2A_ *4_ *5_ *6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIC0","description":"ICD-KBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood fungus culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87103","description":"Blood fungus culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBA1","description":"ICD-BCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (neoplasia)_ exome and transcriptome sequence analysis for sequence variants_ gene copy number amplifications and deletions_ gene rearrangements_ microsatellite insta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0329U","description":"Oncology (neoplasia)_ exome and transcriptome sequence analysis for sequence variants_ gene copy number amplifications and deletions_ gene rearrangements_ microsatellite insta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTF0","description":"ICD-FGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABD0","description":"ICD-FABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIE0","description":"ICD-GEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cltx post ankle fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27768","description":"Cltx post ankle fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOD1","description":"ICD-HCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKC0","description":"ICD-OKKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHME1","description":"ICD-NHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1A","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adapter_ single-use (i.e._ disposable)_ for attaching ultrasound system to upper gastrointestinal endoscope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1606","description":"Adapter_ single-use (i.e._ disposable)_ for attaching ultrasound system to upper gastrointestinal endoscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot inhibit prot s free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85306","description":"Clot inhibit prot s free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUF1","description":"ICD-EIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABD0","description":"ICD-EABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA41","description":"Low Rehab_ ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 25MCG/0.25ML IM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91311","description":"SARSCOV2 VAC 25MCG/0.25ML IM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pelvis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26990","description":"Drainage of pelvis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gene test niemann-pick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3849","description":"Gene test niemann-pick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWD0","description":"ICD-PCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAD0","description":"ICD-FIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX06","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX31","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx ovarian unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9117","description":"Onc dx ovarian unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFF0","description":"ICD-JIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSF0","description":"ICD-OBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aphakia prosth service temp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92358","description":"Aphakia prosth service temp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHE1","description":"ICD-JBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUD1","description":"ICD-NFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinal male jug-type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0325","description":"Urinal male jug-type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine chloride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82436","description":"Assay of urine chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpt doc class histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9422","description":"Rpt doc class histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAE0","description":"ICD-GAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKB1","description":"ICD-GHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor X_ (human)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7175","description":"Injection_ Factor X_ (human)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cough stimulating device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0482","description":"Cough stimulating device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAF0","description":"ICD-CEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neg microalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3061F","description":"Neg microalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epidrm a-grft f/n/hf/g addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15116","description":"Epidrm a-grft f/n/hf/g addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVA1","description":"ICD-BHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHD0","description":"ICD-NHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intro/sheath_ non-laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1894","description":"Intro/sheath_ non-laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluorouracil injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9190","description":"Fluorouracil injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj nalbuphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2300","description":"Inj nalbuphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deep sedation/general anesthesia-first 30 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9220","description":"Deep sedation/general anesthesia-first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair brake extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0961","description":"Wheelchair brake extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28485","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQB1","description":"ICD-DGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGID0","description":"ICD-FGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEA1","description":"ICD-IEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERE1","description":"ICD-GERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplant forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25310","description":"Transplant forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAB1","description":"ICD-IAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No implantable/insertable device used with device-intensive procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1890","description":"No implantable/insertable device used with device-intensive procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90999","description":"Dialysis procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine hydrochloride_ 20 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2371","description":"Injection_ phenylephrine hydrochloride_ 20 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelets Pathogen Reduced Ea Unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9988","description":"Platelets Pathogen Reduced Ea Unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYB1","description":"ICD-OAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLED0","description":"ICD-NLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBC0","description":"ICD-MCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC212","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20C","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINF1","description":"ICD-OINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNE0","description":"ICD-FFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWC1","description":"ICD-DHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rx cntact lens aphakia 1 eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92315","description":"Rx cntact lens aphakia 1 eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj ivig privigen 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1459","description":"Inj ivig privigen 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUA0","description":"ICD-IAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg during surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95955","description":"Eeg during surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQC1","description":"ICD-CHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC45","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA SHIGA-LIKE TOXIN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87427","description":"IAAD IA SHIGA-LIKE TOXIN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKD0","description":"ICD-GBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLD1","description":"ICD-GBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Os pch urine w bar/fange/tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4432","description":"Os pch urine w bar/fange/tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0746T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWC0","description":"ICD-LGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA256","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWB1","description":"ICD-PCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRD0","description":"ICD-OBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB210","description":"Special Care High _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB245","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00214","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","description":"CPT-00214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No impro med time pain med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9427","description":"No impro med time pain med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78832","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEF0","description":"ICD-MKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCF0","description":"ICD-FCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEA1","description":"ICD-GHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/ th nrv exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32664","description":"Thoracoscopy w/ th nrv exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEA1","description":"ICD-GBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0490U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","description":"CPT-0490U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin (fiasp)_ per 5 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1812","description":"Insulin (fiasp)_ per 5 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hgb lvl 11-12.9 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3280F","description":"Hgb lvl 11-12.9 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25295","description":"Release wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYA0","description":"ICD-KAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIF1","description":"ICD-CBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVC1","description":"ICD-NJVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue culture lymphocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88230","description":"Tissue culture lymphocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23420","description":"Repair of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQC0","description":"ICD-CBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLD0","description":"ICD-CGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX52","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj test 11-12 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95912","description":"Nrv cndj test 11-12 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGB0","description":"ICD-NDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGF1","description":"ICD-BBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Medcurrent_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1002","description":"Clinical Decision Support Mechanism Medcurrent_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKF1","description":"ICD-JGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Legg perthes patten bottom t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1755","description":"Legg perthes patten bottom t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2A","description":"Default_ /PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHF1","description":"ICD-IBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gr24 nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2362","description":"Gr24 nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD225","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trach/laryn tube stainless","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7522","description":"Trach/laryn tube stainless","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr e/n/e/l10.1-30sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14061","description":"Tis trnfr e/n/e/l10.1-30sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spec stains for microorganis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0476","description":"Spec stains for microorganis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ (aristada)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1944","description":"Injection_ aripiprazole lauroxil_ (aristada)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQE1","description":"ICD-GEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert endovasc prosth taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33883","description":"Insert endovasc prosth taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBB1","description":"ICD-CFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLA0","description":"ICD-NBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHA1","description":"ICD-FEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyoid myotomy & suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21685","description":"Hyoid myotomy & suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGF1","description":"ICD-GDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOD1","description":"ICD-PBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Barium swallow test not req","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3200F","description":"Barium swallow test not req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Torsion mechanism knee/ankle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2861","description":"Torsion mechanism knee/ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"H2o stat docd dehydrated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2031F","description":"H2o stat docd dehydrated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB116","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIF1","description":"ICD-CHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29837","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQB1","description":"ICD-OEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD217","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHB1","description":"ICD-AGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNF1","description":"ICD-KCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC131","description":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKF1","description":"ICD-FCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUA0","description":"ICD-CEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFB1","description":"ICD-NDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEF1","description":"ICD-AAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBC0","description":"ICD-EFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHF0","description":"ICD-EGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00924","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","description":"CPT-00924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNB0","description":"ICD-CDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBC1","description":"ICD-IEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEED0","description":"ICD-JEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUE0","description":"ICD-MEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLB0","description":"ICD-CBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJC1","description":"ICD-OCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove & graft wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25135","description":"Remove & graft wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81415","description":"Exome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0204","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0204","description":"CDT-D0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYA0","description":"ICD-LBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Portable gaseous 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0431","description":"Portable gaseous 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvf assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3020F","description":"Lvf assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rig fram pelvic pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0469","description":"Tlso rig fram pelvic pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor liver/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47146","description":"Prep donor liver/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0620U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","description":"CPT-0620U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMD1","description":"ICD-OEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYE0","description":"ICD-HIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye/revise socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65114","description":"Remove eye/revise socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLB1","description":"ICD-MDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43611","description":"Excision of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES141","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHA0","description":"ICD-GCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYF1","description":"ICD-HAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYD1","description":"ICD-OGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUC1","description":"ICD-FHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup hip spica ped plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4027","description":"Cast sup hip spica ped plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1783","description":"vaccine administration-human papillomavirus - Dose 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMD0","description":"ICD-NCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PalinGen or ProMatrX_ 0.36 mg per 0.25 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4174","description":"PalinGen or ProMatrX_ 0.36 mg per 0.25 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of iliopsoas muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27110","description":"Transfer of iliopsoas muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj hypogas plxs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64517","description":"N block inj hypogas plxs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post fusion 13/> vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22804","description":"Post fusion 13/> vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco non-user","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1036F","description":"Tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8C","description":"High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28X","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEB1","description":"ICD-EBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2091","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETA1","description":"ICD-CETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMB1","description":"ICD-BEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped size brief/diaper lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4530","description":"Ped size brief/diaper lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dxa bone density/peripheral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77081","description":"Dxa bone density/peripheral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parainfluenza ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87279","description":"Parainfluenza ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHC1","description":"ICD-FEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXF0","description":"ICD-CAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26686","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC23","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEE1","description":"ICD-CAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21086","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8F","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ evinacumab-dgnb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9079","description":"Injection_ evinacumab-dgnb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc skin abd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15830","description":"Exc skin abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTC0","description":"ICD-KHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVA0","description":"ICD-JCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEC0","description":"ICD-KEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABB1","description":"ICD-CABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anterior thoracic extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1220","description":"Anterior thoracic extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of mastoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70130","description":"X-ray exam of mastoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray 2vw frontal&latl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71020","description":"Chest x-ray 2vw frontal&latl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDD0","description":"ICD-MCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD246","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHE0","description":"ICD-IEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMB1","description":"ICD-MKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNA1","description":"ICD-OLNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laiv4 vaccine intranasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90672","description":"Laiv4 vaccine intranasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMC1","description":"ICD-ODMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSD0","description":"ICD-KFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIF0","description":"ICD-IEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6750","description":"Crown porcelain high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contraceptive hormone patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7304","description":"Contraceptive hormone patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deferoxamine mesylate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0895","description":"Deferoxamine mesylate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTF0","description":"ICD-BHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWC0","description":"ICD-PAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthro_ loose body + chondro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0289","description":"Arthro_ loose body + chondro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQC0","description":"ICD-LAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11602","description":"Exc tr-ext mal+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pouch clsd w barr attached","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5051","description":"Pouch clsd w barr attached","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ epirubicin hcl_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9178","description":"Inj_ epirubicin hcl_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whlchr ampu fxd arm leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1170","description":"Whlchr ampu fxd arm leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional brain mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96020","description":"Functional brain mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAC0","description":"ICD-OFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRC0","description":"ICD-LIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25C","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSD1","description":"ICD-OBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9857","description":"Patient admitted to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE236","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-dttb_ biosimilar_ (Ontruzant)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5112","description":"Injection_ trastuzumab-dttb_ biosimilar_ (Ontruzant)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28H","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYE1","description":"ICD-KAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXD0","description":"ICD-NJXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE136","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0526U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","description":"CPT-0526U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pet image w/ct lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78814","description":"Pet image w/ct lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26548","description":"Reconstruct finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9395","description":"Injection_ fulvestrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0504","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0504","description":"CDT-D0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sargramostim injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2820","description":"Sargramostim injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attendant Care Services_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1793","description":"Attendant Care Services_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUE0","description":"ICD-JBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXD0","description":"ICD-GCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spoke protectors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0065","description":"Spoke protectors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8H","description":"Low Rehab_ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00566","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","description":"CPT-00566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo torsion cable hip pelv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2050","description":"Hkafo torsion cable hip pelv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rare constitutional and other heritable disorders_ whole genome and mitochondrial DNA sequence analysis_ blood_ frozen & formalin-fixed paraffin-embedded (FFPE) tissue_ saliva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0265U","description":"Rare constitutional and other heritable disorders_ whole genome and mitochondrial DNA sequence analysis_ blood_ frozen & formalin-fixed paraffin-embedded (FFPE) tissue_ saliva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2472","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","description":"HCPCS-J2472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meningococcal pentavalent vaccine_ conjugated Men A_ C_ W_ Y- tetanus toxoid carrier_ and Men B-FHbp_ for intracmuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90623","description":"Meningococcal pentavalent vaccine_ conjugated Men A_ C_ W_ Y- tetanus toxoid carrier_ and Men B-FHbp_ for intracmuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65782","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD210","description":"Special Care High _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart infarct image (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78469","description":"Heart infarct image (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anabolic steroid 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80328","description":"Anabolic steroid 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert ant drainage device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66183","description":"Insert ant drainage device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ue fx orth shoul cap forearm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3981","description":"Ue fx orth shoul cap forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M/phmtrc alysishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88369","description":"M/phmtrc alysishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGE1","description":"ICD-GFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYB1","description":"ICD-LFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIC0","description":"ICD-GCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIE1","description":"ICD-CEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUF1","description":"ICD-MDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50580","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPB1","description":"ICD-CAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX13","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXC0","description":"ICD-JIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Habil sup empl waiver 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2019","description":"Habil sup empl waiver 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92639","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","description":"CPT-92639","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBF1","description":"ICD-JFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microbe susceptible disk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87184","description":"Microbe susceptible disk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sub pt/ot goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8994","description":"Sub pt/ot goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSB1","description":"ICD-HFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of pregnanediol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84135","description":"Assay of pregnanediol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDA1","description":"ICD-GDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBE1","description":"ICD-FDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acid conc sol per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4709","description":"Acid conc sol per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE130","description":"Special Care Low _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKA1","description":"ICD-NCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYE1","description":"ICD-LAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of halo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20664","description":"Application of halo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXC0","description":"ICD-GDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13C","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB56","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOF0","description":"ICD-CHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVE0","description":"ICD-NAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1083","description":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYB1","description":"ICD-LHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurofilament light chain (NfL)_ ultra-sensitive immunoassay_ serum or cerebrospinal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0443U","description":"Neurofilament light chain (NfL)_ ultra-sensitive immunoassay_ serum or cerebrospinal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ scalp_ arms and/or legs; defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2023F","description":"Adjacent tissue transfer or rearrangement_ scalp_ arms and/or legs; defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0346T","description":"Ultrasound_ elastography (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAA0","description":"ICD-OGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair rectum-vagina fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57305","description":"Repair rectum-vagina fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINA1","description":"ICD-CINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOE1","description":"ICD-HIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cid transmit coil and cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8629","description":"Cid transmit coil and cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAD0","description":"ICD-FEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBF0","description":"ICD-BGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLB0","description":"ICD-ICLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1465","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","description":"HCPCS-M1465","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLF1","description":"ICD-EDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADF1","description":"ICD-FADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA44","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGF1","description":"ICD-NBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMB1","description":"ICD-GBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAD1","description":"ICD-IEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA32","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEA0","description":"ICD-FHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXC1","description":"ICD-GAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEC1","description":"ICD-FCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped term dev_ hand_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6713","description":"Ped term dev_ hand_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFID0","description":"ICD-OFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFB1","description":"ICD-FEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test def 22+ classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0483","description":"Drug test def 22+ classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0554","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","description":"HCPCS-G0554","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJA0","description":"ICD-NBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECF1","description":"ICD-NECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEA0","description":"ICD-MBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKF1","description":"ICD-GBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moveable patient lift system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0639","description":"Moveable patient lift system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin d 25 hydroxy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82306","description":"Vitamin d 25 hydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIB1","description":"ICD-KAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDD1","description":"ICD-FEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"At least two orders for the same high-risk medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9637","description":"At least two orders for the same high-risk medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAF1","description":"ICD-AGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0667U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0667U","description":"CPT-0667U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFE0","description":"ICD-CCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Satisfy survey not complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0917","description":"Satisfy survey not complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXB1","description":"ICD-OCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSD1","description":"ICD-LGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUD0","description":"ICD-BAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab_ excludes biosimilar_ 10mg (Herceptin)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9355","description":"Injection_ trastuzumab_ excludes biosimilar_ 10mg (Herceptin)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD240","description":"Special Care Low _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:15)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1741","description":"Employment - Employment Skills Development (1:15)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAD1","description":"ICD-IAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4021","description":"Orthopedic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ elotuzumab_ 1mg (Empliciti)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9477","description":"Injection_ elotuzumab_ 1mg (Empliciti)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18H","description":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQE0","description":"ICD-PDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDA0","description":"ICD-EIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETB1","description":"ICD-KETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62192","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00732","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","description":"CPT-00732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCA0","description":"ICD-JHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emr hd pmp elec/combo_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0494","description":"Emr hd pmp elec/combo_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJC0","description":"ICD-FBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQB0","description":"ICD-OAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC53","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Als 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0426","description":"Als 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNF1","description":"ICD-OGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECE1","description":"ICD-BECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic outlet reduction_ gastric pouch application_ with endoscopy and intraluminal tube insertion_ if performed_ including all system and tissue anchoring components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9785","description":"Endoscopic outlet reduction_ gastric pouch application_ with endoscopy and intraluminal tube insertion_ if performed_ including all system and tissue anchoring components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDB1","description":"ICD-MGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNE0","description":"ICD-CHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; not otherwise specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87899","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYC1","description":"ICD-HFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lamellar bdy fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83664","description":"Lamellar bdy fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anterior thoracic derotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1260","description":"Anterior thoracic derotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop applicat rigid dsg on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6388","description":"Postop applicat rigid dsg on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAD1","description":"ICD-EHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52450","description":"Incision of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9160","description":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCE0","description":"ICD-JBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Term dev precision pinch dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6810","description":"Term dev precision pinch dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNA0","description":"ICD-NKNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay metallic 3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2543","description":"Dental onlay metallic 3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTA0","description":"ICD-NKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPC1","description":"ICD-OBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDF0","description":"ICD-NBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANB0","description":"ICD-BANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEA1","description":"ICD-FFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDD0","description":"ICD-OEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","description":"HCPCS-A9610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28G","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGD0","description":"ICD-FBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEME1","description":"ICD-OEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWF1","description":"ICD-GGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEA1","description":"ICD-JHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHA0","description":"ICD-NBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human papilloma virus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 45_ 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0354U","description":"Human papilloma virus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 45_ 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture type pulse field gel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87152","description":"Culture type pulse field gel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSE0","description":"ICD-GHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOB0","description":"ICD-KHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ovine_ 1000 usp units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3472","description":"Ovine_ 1000 usp units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKC1","description":"ICD-KGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSD1","description":"ICD-CFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung perf&ventilat diferentl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78598","description":"Lung perf&ventilat diferentl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical site infection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9312","description":"Surgical site infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWB0","description":"ICD-ODWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRA0","description":"ICD-CFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBC0","description":"ICD-KEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fqhc visit_ estab pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0467","description":"Fqhc visit_ estab pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAA0","description":"ICD-EAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55705","description":"Biopsy of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAF1","description":"ICD-MBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHB1","description":"ICD-KAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct abdomen w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74170","description":"Ct abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKE1","description":"ICD-OBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCA0","description":"ICD-CDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKE1","description":"ICD-NBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBC0","description":"ICD-MIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert knee articulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5656","description":"Socket insert knee articulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDB1","description":"ICD-NDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla ii type 1 ag equiv lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81377","description":"Hla ii type 1 ag equiv lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB256","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Specimen site not esophagus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8797","description":"Specimen site not esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIC1","description":"ICD-FFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKD1","description":"ICD-FAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA141","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0C","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICA1","description":"ICD-CICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Necropsy (autopsy) procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88099","description":"Necropsy (autopsy) procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHB1","description":"ICD-MJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4185","description":"Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVD1","description":"ICD-CEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRD1","description":"ICD-OJRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0868T","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIB0","description":"ICD-MIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"2d tte w or w/o fol w/con_co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8923","description":"2d tte w or w/o fol w/con_co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIF0","description":"ICD-FGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt serv p day <2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90967","description":"Esrd home pt serv p day <2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 sq cm_ or part thereof (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14302","description":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 sq cm_ or part thereof (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":">=50% of total number of a patient_s outpatient RA encounters assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1007","description":">=50% of total number of a patient_s outpatient RA encounters assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC56","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABED0","description":"ICD-ABED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Refill/maint portable pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96521","description":"Refill/maint portable pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0201","description":"HCPCS-B0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33875","description":"Thoracic aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX03","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLE0","description":"ICD-ICLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Annual nursing fac assessmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99318","description":"Annual nursing fac assessmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens variable asphericity bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2430","description":"Lens variable asphericity bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMB0","description":"ICD-IEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 52mg 3 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7297","description":"Levonorgestrel iu 52mg 3 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplant hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26480","description":"Transplant hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDB1","description":"ICD-JGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGD1","description":"ICD-NCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWC0","description":"ICD-CHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap gastric bypass/roux-en-y","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43644","description":"Lap gastric bypass/roux-en-y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFA0","description":"ICD-FCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDE0","description":"ICD-OEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYC1","description":"ICD-PAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUB1","description":"ICD-NLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUB1","description":"ICD-AEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Administration of a standardized_ evidence-based social determinants of health risk assessment tool_ 5-15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0136","description":"Administration of a standardized_ evidence-based social determinants of health risk assessment tool_ 5-15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALD1","description":"ICD-NALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspirin/clopidogrel rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4086F","description":"Aspirin/clopidogrel rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA07","description":"Default_ /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBF1","description":"ICD-OHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA226","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOF0","description":"ICD-HDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDD1","description":"ICD-IDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD206","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXD0","description":"ICD-JAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHA1","description":"ICD-OKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTB0","description":"ICD-OGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHA1","description":"ICD-JAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNF0","description":"ICD-GHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Es sph augmnt device removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0393T","description":"Es sph augmnt device removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTC0","description":"ICD-GHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHE0","description":"ICD-OLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHC0","description":"ICD-JFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55200","description":"Incision of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc w/ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37229","description":"Tib/per revasc w/ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDB0","description":"ICD-NGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADE0","description":"ICD-IADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISA1","description":"ICD-OISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue culture tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88239","description":"Tissue culture tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSC0","description":"ICD-DBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGD1","description":"ICD-BCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28B","description":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enter feed supkit syr by day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4034","description":"Enter feed supkit syr by day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEA1","description":"ICD-MHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx head/neck m1 mets rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9111","description":"Onc dx head/neck m1 mets rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNA1","description":"ICD-GHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTC1","description":"ICD-BGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD125","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDE0","description":"ICD-CDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFE1","description":"ICD-NAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 13.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7301","description":"Levonorgestrel iu 13.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGF0","description":"ICD-OKGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX20","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCC0","description":"ICD-IBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBED1","description":"ICD-BBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54316","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOB1","description":"ICD-OIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXF0","description":"ICD-JIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVD1","description":"ICD-GFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECD1","description":"ICD-KECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IV Injection_ bebtelovimab_ includes injection and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0222","description":"IV Injection_ bebtelovimab_ includes injection and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQB1","description":"ICD-OJQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPC0","description":"ICD-NLPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUA1","description":"ICD-BDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1118","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-66683","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","description":"CPT-66683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMC1","description":"ICD-BAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCA1","description":"ICD-ABCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat spinal canal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62282","description":"Treat spinal canal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ANNUAL ALCOHOL MISUSE SCREENING_ 15 MINUTES","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0442","description":"ANNUAL ALCOHOL MISUSE SCREENING_ 15 MINUTES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHA0","description":"ICD-JEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peri-px pacemaker device evl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93286","description":"Peri-px pacemaker device evl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscop w/arytenoidectom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31560","description":"Laryngoscop w/arytenoidectom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXC0","description":"ICD-BCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUF1","description":"ICD-NDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJF1","description":"ICD-CHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99202","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPE0","description":"ICD-GIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lipoprotein_ blood_ high resolution fractionation and quantitation of lipoproteins_ including all five major lipoprotein classes and subclasses of HDL_ LDL_ and VLDL by vertic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052U","description":"Lipoprotein_ blood_ high resolution fractionation and quantitation of lipoproteins_ including all five major lipoprotein classes and subclasses of HDL_ LDL_ and VLDL by vertic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJA1","description":"ICD-NFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLC1","description":"ICD-EHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA33","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWB1","description":"ICD-HGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28D","description":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Md home visit outside cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0273","description":"Md home visit outside cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES256","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1802","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1802","description":"CDT-D1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0568U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","description":"CPT-0568U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67145","description":"Treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYC0","description":"ICD-GDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA CLOSTRIDIUM DIFFICILE TOXIN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87324","description":"IAAD IA CLOSTRIDIUM DIFFICILE TOXIN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulpal regeneration interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3356","description":"Pulpal regeneration interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWA0","description":"ICD-KDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUE0","description":"ICD-NGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sex offend tx svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2028","description":"Sex offend tx svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCA0","description":"ICD-NDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABD0","description":"ICD-BABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMB1","description":"ICD-JDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99424","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKB1","description":"ICD-NDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coccidioidomycosis skin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86490","description":"Coccidioidomycosis skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDA1","description":"ICD-AFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLA1","description":"ICD-EBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHB1","description":"ICD-IHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Improve visual funct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0913","description":"Improve visual funct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCF1","description":"ICD-MCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain w/ noble met","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2752","description":"Crown porcelain w/ noble met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHC1","description":"ICD-MJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evacuate mole of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59870","description":"Evacuate mole of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIF0","description":"ICD-GEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis one evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90935","description":"Hemodialysis one evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHC1","description":"ICD-CCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKE1","description":"ICD-KBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQD0","description":"ICD-KAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABC0","description":"ICD-KABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0502U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","description":"CPT-0502U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11305","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUF0","description":"ICD-MHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18A","description":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTC1","description":"ICD-OHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak pelvic control belt pad/l","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5694","description":"Ak pelvic control belt pad/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQD0","description":"ICD-LIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICB1","description":"ICD-AICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWE1","description":"ICD-LDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUA1","description":"ICD-FIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immune admin oral/nasal addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90474","description":"Immune admin oral/nasal addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSD1","description":"ICD-DCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21084","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oseltamivir phosp_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9035","description":"Oseltamivir phosp_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHF0","description":"ICD-OCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin D_ 25 hydroxy D2 and D3_ by LC-MS/MS_ serum microsample_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0038U","description":"Vitamin D_ 25 hydroxy D2 and D3_ by LC-MS/MS_ serum microsample_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90639","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90639","description":"CPT-90639","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJB1","description":"ICD-CAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20A","description":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAC1","description":"ICD-GDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reimplant artery each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35697","description":"Reimplant artery each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHE0","description":"ICD-EHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44626","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst nbl mtl >=3 surfac","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6615","description":"Onlay cst nbl mtl >=3 surfac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88014","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNB0","description":"ICD-NLNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Clostridium difficile toxin A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87803","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Clostridium difficile toxin A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJC1","description":"ICD-KCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0672","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0672","description":"HCPCS-G0672","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCF1","description":"ICD-CFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2B","description":"Medium Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pierce earlobes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69090","description":"Pierce earlobes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMB1","description":"ICD-ICMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGE1","description":"ICD-OLGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGA1","description":"ICD-KGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13B","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMB1","description":"ICD-EFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBID0","description":"ICD-NBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza dna amp prob addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87503","description":"Influenza dna amp prob addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Above elbow myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6955","description":"Above elbow myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3501","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove femur lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27355","description":"Remove femur lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAB0","description":"ICD-FHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC112","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81259","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLE0","description":"ICD-FGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAC0","description":"ICD-JDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61601","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOA0","description":"ICD-DIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYD1","description":"ICD-OLYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0500U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","description":"CPT-0500U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3B","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXD0","description":"ICD-NEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78433","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENB0","description":"ICD-OENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1213","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCB0","description":"ICD-NCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVC0","description":"ICD-BBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSE0","description":"ICD-PKSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9225","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9225","description":"CDT-D9225","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC21","description":"ICD-3HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office visit during hours","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9430","description":"Office visit during hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93015","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGE0","description":"ICD-JFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0542","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","description":"HCPCS-G0542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcv <10mg daily predniso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4193F","description":"Pt rcv <10mg daily predniso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ewhfo rigid w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3765","description":"Ewhfo rigid w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLME0","description":"ICD-OLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace socket brim cust fit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4030","description":"Replace socket brim cust fit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLF0","description":"ICD-KFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pump for water circulating p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0236","description":"Pump for water circulating p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCC1","description":"ICD-FHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2D","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC105","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEA1","description":"ICD-BEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ziprasidone mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3486","description":"Ziprasidone mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-rays transcath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75894","description":"X-rays transcath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPF0","description":"ICD-OFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJD1","description":"ICD-FGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC116","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHD0","description":"ICD-NDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver_ including craniectomy or craniotomy_ when performed_ with direct or inductive coupling_ with co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61889","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver_ including craniectomy or craniotomy_ when performed_ with direct or inductive coupling_ with co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXA0","description":"ICD-JDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEB1","description":"ICD-MHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2214","description":"Pneumatic caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCA1","description":"ICD-CBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLA1","description":"ICD-KFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHE1","description":"ICD-OKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEA0","description":"ICD-EHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mech remov tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36596","description":"Mech remov tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCB1","description":"ICD-MLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHA1","description":"ICD-GAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0106U","description":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBE0","description":"ICD-OEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0768T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIE1","description":"ICD-AFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colorectal cancer screening; blood-based biomarker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0327","description":"Colorectal cancer screening; blood-based biomarker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27390","description":"Incision of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADE0","description":"ICD-CADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOE0","description":"ICD-LBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elisa hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0433","description":"Elisa hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA31","description":"ICD-3GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGC0","description":"ICD-OCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49600","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGA0","description":"ICD-OBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid met imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78015","description":"Thyroid met imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial brush biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31717","description":"Bronchial brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGID0","description":"ICD-OGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQC1","description":"ICD-HIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem duplication_ p.D835_ p.I836_ using mononuclear cells_ reported as detection or non-detection of FLT3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0023U","description":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem duplication_ p.D835_ p.I836_ using mononuclear cells_ reported as detection or non-detection of FLT3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAF0","description":"ICD-JDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAA1","description":"ICD-EBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFC1","description":"ICD-GGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKE1","description":"ICD-OKKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCC0","description":"ICD-ECCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear localization/abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78807","description":"Nuclear localization/abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain image 4+ views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78605","description":"Brain image 4+ views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl vagus nerve pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0315T","description":"Rmvl vagus nerve pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral infus pump statio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9006","description":"Parenteral infus pump statio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML30","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral appliance therapy (OAT) titration visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9955","description":"Oral appliance therapy (OAT) titration visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Itraconazole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1835","description":"Itraconazole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45331","description":"Sigmoidoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGC0","description":"ICD-NFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repr elbw med ligmnt w/tissu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24345","description":"Repr elbw med ligmnt w/tissu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIC0","description":"ICD-FFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis scale","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1639","description":"Dialysis scale","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLC0","description":"ICD-KGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXC0","description":"ICD-NJXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPB0","description":"ICD-JIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch clsd for bar w lk fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4420","description":"Ost pch clsd for bar w lk fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIC1","description":"ICD-FGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPD1","description":"ICD-NEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLB1","description":"ICD-BDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIB1","description":"ICD-NFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAA1","description":"ICD-MFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiofrequency spectroscopy_ real time_ intraoperative margin assessment_ at the time of partial mastectomy_ with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0546T","description":"Radiofrequency spectroscopy_ real time_ intraoperative margin assessment_ at the time of partial mastectomy_ with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECF0","description":"ICD-MECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQF0","description":"ICD-CHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBA0","description":"ICD-AGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOB0","description":"ICD-GHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYD1","description":"ICD-DEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCA1","description":"ICD-KFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrate iv infusion add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96361","description":"Hydrate iv infusion add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hpv combo assay ca screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0476","description":"Hpv combo assay ca screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6535","description":"Gc stocking thighlngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0770T","description":"Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual diff wbc count b-coat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85009","description":"Manual diff wbc count b-coat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assessment of a patient","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0191","description":"Assessment of a patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKC0","description":"ICD-OCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPE0","description":"ICD-CDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX36","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETE0","description":"ICD-JETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Umbilical cord occlud w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59072","description":"Umbilical cord occlud w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trluml perip athrc brchiocph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0237T","description":"Trluml perip athrc brchiocph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whfo_ rigid w/o joints","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3808","description":"Whfo_ rigid w/o joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMD0","description":"ICD-JGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIB0","description":"ICD-JEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDED1","description":"ICD-NDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIE1","description":"ICD-GGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9970","description":"Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUD0","description":"ICD-ICUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periacetabular osteotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2115","description":"Periacetabular osteotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJB0","description":"ICD-GHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 19 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP19","description":"Auto test panel pricing code_ 19 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQD0","description":"ICD-GCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In111 ibritumomab_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9542","description":"In111 ibritumomab_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAE0","description":"ICD-GBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJF1","description":"ICD-BGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFA1","description":"ICD-KCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPB0","description":"ICD-BEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSB1","description":"ICD-PCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLF0","description":"ICD-JHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dengue vaccine_ quadrivalent_ live_ 3 dose schedule_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90587","description":"Dengue vaccine_ quadrivalent_ live_ 3 dose schedule_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUE1","description":"ICD-EFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gadofosveset trisodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9583","description":"Gadofosveset trisodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPB0","description":"ICD-GGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIC0","description":"ICD-CAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUC1","description":"ICD-EAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt access bil tree sm bwl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47541","description":"Plmt access bil tree sm bwl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCE0","description":"ICD-KBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIA1","description":"ICD-GIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dextranomer/hyaluronic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8604","description":"Dextranomer/hyaluronic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGE0","description":"ICD-BCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of shoulder ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23415","description":"Release of shoulder ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Needle biopsy pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48102","description":"Needle biopsy pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28470","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDA0","description":"ICD-IFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37267","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","description":"CPT-37267","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no 30 day f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9403","description":"Doc reas no 30 day f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36620","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7514","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIC1","description":"ICD-OEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emr pwr cbl combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0493","description":"Emr pwr cbl combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mlh1 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81294","description":"Mlh1 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rolapitant_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2797","description":"Injection_ rolapitant_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis_ including reported phenotypes and imp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0349U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis_ including reported phenotypes and imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJB0","description":"ICD-JGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subfas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0819T","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subfas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elosulfase alfa_ injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1322","description":"Elosulfase alfa_ injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx contour defects 5.1-10cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11952","description":"Tx contour defects 5.1-10cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Additional spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22585","description":"Additional spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens hydrophilic toric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2521","description":"Cntct lens hydrophilic toric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOF1","description":"ICD-DFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72131","description":"Ct lumbar spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWC0","description":"ICD-PLWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transesoph doppl cardiac mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9157","description":"Transesoph doppl cardiac mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sialolithotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7980","description":"Sialolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX25","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECA1","description":"ICD-CECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Internal Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4011","description":"Internal Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3B","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA21","description":"ICD-1IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0579U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","description":"CPT-0579U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0457","description":"Chest shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCA0","description":"ICD-CCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAB0","description":"ICD-MGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep c therapy started","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9206","description":"Hep c therapy started","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bupren/nal over 10mg bupreno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0575","description":"Bupren/nal over 10mg bupreno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBD1","description":"ICD-CHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75822","description":"Vein x-ray arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFND1","description":"ICD-JFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2782","description":"Crown 3/4 cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Specimen infect agnt concntj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87015","description":"Specimen infect agnt concntj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINE0","description":"ICD-OINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA11","description":"ICD-3GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27750","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEF1","description":"ICD-MCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDME1","description":"ICD-MDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTC1","description":"ICD-AFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Baseline mrs > 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1236","description":"Baseline mrs > 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEB1","description":"ICD-BHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj cervical plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64413","description":"N block inj cervical plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWB1","description":"ICD-OCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m pertechnetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9512","description":"Tc99m pertechnetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed fx ht w/o rail w/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0291","description":"Hosp bed fx ht w/o rail w/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurawrap nerve protector_cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9353","description":"Neurawrap nerve protector_cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cryoglobulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82595","description":"Assay of cryoglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC60","description":"Very High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDF0","description":"ICD-GEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWE1","description":"ICD-GCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIB1","description":"ICD-ECIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKA1","description":"ICD-JGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNC0","description":"ICD-FGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAF1","description":"ICD-KAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA44","description":"High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper limb orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3999","description":"Upper limb orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auricular prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8045","description":"Auricular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXD0","description":"ICD-NHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPA1","description":"ICD-FFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAB0","description":"ICD-GEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pet image skull-thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78812","description":"Pet image skull-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDA1","description":"ICD-KFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEF0","description":"ICD-EEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC254","description":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4C","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Personal care ser per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1019","description":"Personal care ser per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLD1","description":"ICD-NGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXF0","description":"ICD-NKXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ spinal_ with integrated neurostimulator_ including imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0784T","description":"Insertion or replacement of percutaneous electrode array_ spinal_ with integrated neurostimulator_ including imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1336","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPA1","description":"ICD-BDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1402","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1402","description":"CDT-D1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8H","description":"Medium Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJD1","description":"ICD-KDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOD1","description":"ICD-LAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBB0","description":"ICD-IHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTB1","description":"ICD-CDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVE1","description":"ICD-FIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFF0","description":"ICD-CFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUB1","description":"ICD-MGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc type nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9290","description":"No doc type nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBA0","description":"ICD-OGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Guide cathet fluid drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10030","description":"Guide cathet fluid drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD141","description":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI fetal ea addl gestation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74713","description":"MRI fetal ea addl gestation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46735","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELF0","description":"ICD-KELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interstitial radioelement application; simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77776","description":"Interstitial radioelement application; simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCA1","description":"ICD-EBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQC1","description":"ICD-OHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETD0","description":"ICD-FETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEB0","description":"ICD-MGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHB1","description":"ICD-BIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTA0","description":"ICD-BBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVC1","description":"ICD-NHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo tibial fracture soft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2112","description":"Afo tibial fracture soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L5-S1 inters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0195T","description":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L5-S1 inters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILF0","description":"ICD-FILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged nursing facility evaluation and management service(s) beyond the  total time for the primary service (when the primary service has been selected using time on the da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0317","description":"Prolonged nursing facility evaluation and management service(s) beyond the  total time for the primary service (when the primary service has been selected using time on the da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRC1","description":"ICD-OCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES305","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ ep_ 20 or more elec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1731","description":"Cath_ ep_ 20 or more elec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDD0","description":"ICD-FIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBA1","description":"ICD-KCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPA0","description":"ICD-FEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWB1","description":"ICD-CFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINF0","description":"ICD-KINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aortic dysfunction/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81410","description":"Aortic dysfunction/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKC1","description":"ICD-GIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mold sckt ext knee shin sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5150","description":"Mold sckt ext knee shin sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWB0","description":"ICD-OBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBC0","description":"ICD-OJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11A","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient spent greater than or equal to three days in hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9861","description":"Patient spent greater than or equal to three days in hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kt/v =/> 1.2 & <1.7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3083F","description":"Kt/v =/> 1.2 & <1.7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUB0","description":"ICD-OIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso 2mod symphis-xipho pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0458","description":"Tlso 2mod symphis-xipho pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Detect agnt mult dna direc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87800","description":"Detect agnt mult dna direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYE1","description":"ICD-OKYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTF0","description":"ICD-ECTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14B","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18X","description":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC11","description":"ICD-4AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJA0","description":"ICD-BFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ olaratumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9285","description":"Injection_ olaratumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBB0","description":"ICD-KEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENF0","description":"ICD-JENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMC0","description":"ICD-MLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73521","description":"X-ray exam hips bi 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLB0","description":"ICD-BGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBD0","description":"ICD-MCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC31","description":"ICD-2CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage lymph node lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38305","description":"Drainage lymph node lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDA1","description":"ICD-MDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD254","description":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYA1","description":"ICD-HFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMD1","description":"ICD-AGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tear film img uni/bi w/i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0330T","description":"Tear film img uni/bi w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24566","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRA1","description":"ICD-HHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavior identification assessment_ by the physician or other qualified health care professional_ face-to-face with patient and caregiver(s)_ includes administration of standa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0359T","description":"Behavior identification assessment_ by the physician or other qualified health care professional_ face-to-face with patient and caregiver(s)_ includes administration of standa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGF0","description":"ICD-FEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEE0","description":"ICD-EHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTC1","description":"ICD-EGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHID0","description":"ICD-NHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; complete acute abdomen series_ including supine_ erect_ and/or decubitus views_ single view chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74022","description":"Radiologic examination_ abdomen; complete acute abdomen series_ including supine_ erect_ and/or decubitus views_ single view chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Report_ diabetes measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8485","description":"Report_ diabetes measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gauze >16 <=48 sq in w/bordr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6220","description":"Gauze >16 <=48 sq in w/bordr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAC0","description":"ICD-ABAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCD0","description":"ICD-IHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental tmj arthrogram incl i","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0320","description":"Dental tmj arthrogram incl i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87341","description":"IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4352","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","description":"HCPCS-Q4352","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/congen repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52400","description":"Cystouretero w/congen repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHC0","description":"ICD-NLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXC1","description":"ICD-KAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBE1","description":"ICD-OJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80412","description":"Crh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95984","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGME0","description":"ICD-MGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVB1","description":"ICD-GEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVE1","description":"ICD-NIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep bk ptb open end socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5535","description":"Prep bk ptb open end socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAB1","description":"ICD-CDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA05","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQF1","description":"ICD-PHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVB0","description":"ICD-JDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4B","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPB0","description":"ICD-CCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDE1","description":"ICD-CGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKD1","description":"ICD-OJKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWA1","description":"ICD-PFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOB1","description":"ICD-HAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHE1","description":"ICD-OAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXE1","description":"ICD-FEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECA1","description":"ICD-IECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24A","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADA0","description":"ICD-NADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscope w/vc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31570","description":"Laryngoscope w/vc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise nerve back of head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64744","description":"Incise nerve back of head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOB0","description":"ICD-OKOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection_ with counseling by physician or other qualified health care profe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96380","description":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection_ with counseling by physician or other qualified health care profe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9276","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","description":"HCPCS-J9276","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVA0","description":"ICD-CFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTB1","description":"ICD-BCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38382","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVA0","description":"ICD-OFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXE0","description":"ICD-CGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALC1","description":"ICD-MALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cataract measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8906","description":"Cataract measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA11","description":"ICD-3IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHB0","description":"ICD-BEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coupling gel or paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4559","description":"Coupling gel or paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKF1","description":"ICD-NBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICF0","description":"ICD-BICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst incl t/o complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58291","description":"Vag hyst incl t/o complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRC0","description":"ICD-KBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary_s home that has been made provider","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0248","description":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary_s home that has been made provider","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOE1","description":"ICD-OBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITF0","description":"ICD-NITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRE1","description":"ICD-OCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAD0","description":"ICD-MAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC11","description":"ICD-1LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAC0","description":"ICD-FHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gonadotropin hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80426","description":"Gonadotropin hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58900","description":"Biopsy of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies)_ with intravascular lithotripsy_ includes angioplasty within the same vessel (s)_ when perfo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9772","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies)_ with intravascular lithotripsy_ includes angioplasty within the same vessel (s)_ when perfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHC0","description":"ICD-JCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKE1","description":"ICD-KAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGF1","description":"ICD-OKGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt no elig for bp assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8784","description":"Pt no elig for bp assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDC1","description":"ICD-OGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEID1","description":"ICD-KEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYF0","description":"ICD-LEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove drug implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11982","description":"Remove drug implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rebound matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4296","description":"Rebound matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Residential Habilitation 4-8 Supp 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0103","description":"Residential Habilitation 4-8 Supp 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0345U","description":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDE0","description":"ICD-AEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ buccal specimen_ gene-drug interactions_ variant analysis of 33 genes_ including deletion/duplication analysis of C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0438U","description":"Drug metabolism (adverse drug reactions and drug response)_ buccal specimen_ gene-drug interactions_ variant analysis of 33 genes_ including deletion/duplication analysis of C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEF0","description":"ICD-BFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDC0","description":"ICD-MIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulance waiting 1/2 hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0420","description":"Ambulance waiting 1/2 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVF1","description":"ICD-FEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us guide tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76940","description":"Us guide tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add clasp to partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5660","description":"Add clasp to partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test one limb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95860","description":"Muscle test one limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUB0","description":"ICD-NAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24577","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKC1","description":"ICD-NGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUD1","description":"ICD-GEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Humate-p_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7187","description":"Humate-p_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWA0","description":"ICD-PFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKA0","description":"ICD-JEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB215","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWF0","description":"ICD-HCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLB0","description":"ICD-CHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIA1","description":"ICD-FIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc antibio not given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4042F","description":"Doc antibio not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEF1","description":"ICD-JDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHE0","description":"ICD-AAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87637","description":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJME0","description":"ICD-OJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enterectomy live donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44133","description":"Enterectomy live donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHC0","description":"ICD-NHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special eye evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92020","description":"Special eye evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67108","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEE0","description":"ICD-MGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FlowerDerm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4179","description":"FlowerDerm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVF1","description":"ICD-OCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tendon shortening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26477","description":"Tendon shortening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJF1","description":"ICD-KFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Varus/valgus strap padded/li","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2270","description":"Varus/valgus strap padded/li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of lower eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15820","description":"Revision of lower eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of foot at ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27889","description":"Amputation of foot at ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42800","description":"Biopsy of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHC0","description":"ICD-NJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1500","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","description":"HCPCS-M1500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGB0","description":"ICD-FGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIC1","description":"ICD-ACIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; First Level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0629T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; First Level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL46","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBE1","description":"ICD-FCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress forearm 1 space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25023","description":"Decompress forearm 1 space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRC0","description":"ICD-GGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMB1","description":"ICD-CEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAB1","description":"ICD-EBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8D","description":"Medium Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGC0","description":"ICD-BHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLE1","description":"ICD-EDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILE1","description":"ICD-BILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD160","description":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPE1","description":"ICD-KFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMD0","description":"ICD-AHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2C","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove uterus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59100","description":"Remove uterus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGA1","description":"ICD-FHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLB1","description":"ICD-NDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4410","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","description":"HCPCS-Q4410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDF1","description":"ICD-NEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWB0","description":"ICD-LAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-123 ioflupane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9584","description":"Iodine i-123 ioflupane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31292","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPB0","description":"ICD-OBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGE0","description":"ICD-OIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB36","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE221","description":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53510","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYB1","description":"ICD-GDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBE0","description":"ICD-BGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ hydroxyprogesterone caproate_ not otherwise specified_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1729","description":"Injection_ hydroxyprogesterone caproate_ not otherwise specified_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPA1","description":"ICD-KIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVD0","description":"ICD-NFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAA0","description":"ICD-OEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAME1","description":"ICD-NAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCE1","description":"ICD-EFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHB0","description":"ICD-JFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNF1","description":"ICD-GFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist joint cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25107","description":"Remove wrist joint cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including fluoroscopic guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10007","description":"Fine needle aspiration biopsy_ including fluoroscopic guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1018T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","description":"CPT-1018T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTB0","description":"ICD-FFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSC0","description":"ICD-CGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLC0","description":"ICD-ICLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPE1","description":"ICD-OBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domicil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0086","description":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domicil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15941","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein byp fem-tibial peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35585","description":"Vein byp fem-tibial peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMD1","description":"ICD-MLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whchr h-duty det arm leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1280","description":"Whchr h-duty det arm leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25560","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUB1","description":"ICD-JAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFD1","description":"ICD-OHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXD0","description":"ICD-OJXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIC1","description":"ICD-CHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJF0","description":"ICD-FIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRA0","description":"ICD-OJRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAE0","description":"ICD-MKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEF1","description":"ICD-CDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37282","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","description":"CPT-37282","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem oct rta dev setup&educaj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0604T","description":"Rem oct rta dev setup&educaj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKB1","description":"ICD-FAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myomectomy vag method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58145","description":"Myomectomy vag method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95706","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ck (cpk)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82550","description":"Assay of ck (cpk)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLB1","description":"ICD-JHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Referral To Physical_ Occupational_ Speech_ Or Recreational Therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0042","description":"Referral To Physical_ Occupational_ Speech_ Or Recreational Therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPA1","description":"ICD-KAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5278","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain appendix abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44900","description":"Drain appendix abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDB1","description":"ICD-MLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVC1","description":"ICD-KGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFA1","description":"ICD-OLFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBE1","description":"ICD-BEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped term dev_ hook_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6711","description":"Ped term dev_ hook_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD213","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLC1","description":"ICD-CHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBA0","description":"ICD-ICBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10C","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTD1","description":"ICD-MFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of foot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28022","description":"Exploration of foot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ disp_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5262","description":"Hearing aid_ disp_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-25448","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","description":"CPT-25448","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism National Decision Support Company_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1004","description":"Clinical Decision Support Mechanism National Decision Support Company_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESD0","description":"ICD-DESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVB0","description":"ICD-FCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAF1","description":"ICD-IBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWC0","description":"ICD-HBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sgd sftwre prgrm for pc/pda","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2511","description":"Sgd sftwre prgrm for pc/pda","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt_ pn_ hist grade not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8724","description":"Pt_ pn_ hist grade not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIE1","description":"ICD-CGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKD0","description":"ICD-NKKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVE1","description":"ICD-CGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTF1","description":"ICD-AHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0644","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0644","description":"HCPCS-J0644","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTE0","description":"ICD-NFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBC1","description":"ICD-CCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD113","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1474","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","description":"HCPCS-M1474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAC0","description":"ICD-JCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC151","description":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJD1","description":"ICD-GEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adj skin pro w/c cus wd<22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2622","description":"Adj skin pro w/c cus wd<22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQE1","description":"ICD-LAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHF1","description":"ICD-BGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCB1","description":"ICD-BBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQB0","description":"ICD-DIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove impacted ear wax uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69209","description":"Remove impacted ear wax uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTF0","description":"ICD-MHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31235","description":"Nasal/sinus endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 21-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99443","description":"Phone e/m phys/qhp 21-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc funct and care plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8539","description":"Doc funct and care plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAE1","description":"ICD-OJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVB0","description":"ICD-NBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed)_ Single S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78429","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed)_ Single S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC256","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker platform attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0154","description":"Walker platform attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBF0","description":"ICD-EEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin (fiasp) for administration through dme (i.e._ insulin pump) per 50 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1811","description":"Insulin (fiasp) for administration through dme (i.e._ insulin pump) per 50 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBA0","description":"ICD-JFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYA0","description":"ICD-HCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES116","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21C","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy excise lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58662","description":"Laparoscopy excise lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAC0","description":"ICD-FAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMC0","description":"ICD-ABMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5A","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB21","description":"ICD-1BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUE1","description":"ICD-KBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD245","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ATXN7 (ataxin 7) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81181","description":"ATXN7 (ataxin 7) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQF1","description":"ICD-LIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWE0","description":"ICD-KHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOC0","description":"ICD-KFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGF0","description":"ICD-OJGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAF0","description":"ICD-MKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFC0","description":"ICD-FAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMD1","description":"ICD-ABMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62190","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRF0","description":"ICD-PFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYC1","description":"ICD-KCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health club membership yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9970","description":"Health club membership yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18D","description":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intercep dental tx transitn","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8060","description":"Intercep dental tx transitn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lev 3 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0382","description":"Lev 3 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCA1","description":"ICD-NFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0013","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","description":"HCPCS-J0013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPB1","description":"ICD-BAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge porcelain base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6241","description":"Bridge porcelain base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPE0","description":"ICD-OAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNF0","description":"ICD-GDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0567U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","description":"CPT-0567U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1434","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","description":"HCPCS-M1434","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGE1","description":"ICD-CFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASF1","description":"ICD-KASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA21","description":"ICD-3HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLB1","description":"ICD-JCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXB1","description":"ICD-NKXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54440","description":"Repair of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIE1","description":"ICD-CAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ue < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8668","description":"Fun stat score ue < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 20-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88245","description":"Chromosome analysis 20-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMD1","description":"ICD-NCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASF0","description":"ICD-LASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPA1","description":"ICD-GHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cocaine hydrochloride nasal solution for topical administration_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9046","description":"Cocaine hydrochloride nasal solution for topical administration_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Next gen aco model<10min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9868","description":"Next gen aco model<10min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKE1","description":"ICD-OHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITE0","description":"ICD-OITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8I","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/ndl aspir/bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44407","description":"Colonoscopy w/ndl aspir/bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLF1","description":"ICD-MBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIID0","description":"ICD-IIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply long arm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29105","description":"Apply long arm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALF0","description":"ICD-CALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2207","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA126","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41015","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 2 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3386F","description":"Ajcc cln cncr stage 2 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDA1","description":"ICD-FIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIC1","description":"ICD-CCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36566","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Level of activity assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1003F","description":"Level of activity assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Qualified Healthcare Professional Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 21 Or More Mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2063","description":"Qualified Nonphysician Qualified Healthcare Professional Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 21 Or More Mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLD0","description":"ICD-CBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation physics consult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77370","description":"Radiation physics consult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYA0","description":"ICD-PEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMC1","description":"ICD-BIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDD0","description":"ICD-ADDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00620","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","description":"CPT-00620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCA0","description":"ICD-FGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Germline disorders_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood_ report of specific gene rearrangement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012U","description":"Germline disorders_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood_ report of specific gene rearrangement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXE0","description":"ICD-FCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct upper extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73200","description":"Ct upper extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISD0","description":"ICD-KISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNB0","description":"ICD-BGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWA0","description":"ICD-HEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNC1","description":"ICD-JHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35201","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy for bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45334","description":"Sigmoidoscopy for bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILF1","description":"ICD-CILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (prior disease)_ cerebrospinal fluid_ detection of prion protein by quaking-induced conf conversion_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0035U","description":"Neurology (prior disease)_ cerebrospinal fluid_ detection of prion protein by quaking-induced conf conversion_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUA0","description":"ICD-JAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOE0","description":"ICD-OEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJA0","description":"ICD-NKJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29899","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARF1","description":"ICD-KARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCC0","description":"ICD-ABCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSC1","description":"ICD-KGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj dobutamine hcl/250 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1250","description":"Inj dobutamine hcl/250 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla class i&ii antibody qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86828","description":"Hla class i&ii antibody qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open red simpl mandible fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7630","description":"Open red simpl mandible fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJF0","description":"ICD-KBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair middle ear structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69666","description":"Repair middle ear structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unskilled respitecare /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5151","description":"Unskilled respitecare /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD140","description":"Special Care Low _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDC0","description":"ICD-OEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastroenterology (Barrett’s esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 methylation analysis_ prognostic and predictive algorithm reported as a risk score for progression to high-g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0386U","description":"Gastroenterology (Barrett’s esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 methylation analysis_ prognostic and predictive algorithm reported as a risk score for progression to high-g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEB1","description":"ICD-MIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ coated/cov w/o del sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1875","description":"Stent_ coated/cov w/o del sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath report nongyn spcmn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0550F","description":"Cytopath report nongyn spcmn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML25","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHF1","description":"ICD-AIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGND1","description":"ICD-NGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWC1","description":"ICD-PIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYD0","description":"ICD-GFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iodine i-123 iobenguane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9582","description":"Iodine i-123 iobenguane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc md rsn no antipla/p2y12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9610","description":"Doc md rsn no antipla/p2y12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUA1","description":"ICD-IDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBED0","description":"ICD-OBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina wall partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57106","description":"Remove vagina wall partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maple syrup urine disease monitoring by patient-collected blood card sample_ quantitative measurement of allo-isoleucine_ leucine_ isoleucine_ and valine_ liquid chromatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0381U","description":"Maple syrup urine disease monitoring by patient-collected blood card sample_ quantitative measurement of allo-isoleucine_ leucine_ isoleucine_ and valine_ liquid chromatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJE0","description":"ICD-KCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual adult wc w tiltinspac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1161","description":"Manual adult wc w tiltinspac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m mertiatide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9562","description":"Tc99m mertiatide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQE1","description":"ICD-HAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIF0","description":"ICD-MJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVC1","description":"ICD-FGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visc & infraren abd 2 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34846","description":"Visc & infraren abd 2 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABB0","description":"ICD-GABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trigeminal block anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9212","description":"Trigeminal block anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Six volt bat otto bock/eq ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7360","description":"Six volt bat otto bock/eq ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid exam one ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92590","description":"Hearing aid exam one ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pho doc >1 cecal ldmk com ex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9612","description":"Pho doc >1 cecal ldmk com ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKF0","description":"ICD-KDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITE0","description":"ICD-EITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9809","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9809","description":"HCPCS-C9809","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urology surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53899","description":"Urology surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31257","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF)_ derived from augmentative algorithmic analysis of the dataset acquired via contrast cardia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0899T","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF)_ derived from augmentative algorithmic analysis of the dataset acquired via contrast cardia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28B","description":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOA0","description":"ICD-HFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33645","description":"Revision of heart veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTC1","description":"ICD-NFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lactate (ld) (ldh) enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83615","description":"Lactate (ld) (ldh) enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70250","description":"X-ray exam of skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEC1","description":"ICD-MKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of bile ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47700","description":"Exploration of bile ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGE1","description":"ICD-GIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung ventilat&perfus imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78582","description":"Lung ventilat&perfus imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILE0","description":"ICD-EILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amifostine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0207","description":"Amifostine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPF0","description":"ICD-NHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1704","description":"HCPCS-B1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEE0","description":"ICD-EFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Droperidol/fentanyl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1810","description":"Droperidol/fentanyl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (Suicidal Ideation)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 54 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0293U","description":"Psychiatry (Suicidal Ideation)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 54 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC31","description":"High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLC1","description":"ICD-ACLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bicarbonate conc pow per pac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4707","description":"Bicarbonate conc pow per pac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24C","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analysis nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88356","description":"Analysis nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semen anal sperm detection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89321","description":"Semen anal sperm detection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKD1","description":"ICD-NIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory traction device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0830","description":"Ambulatory traction device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJB1","description":"ICD-FDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQC1","description":"ICD-DCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93282","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imm admin by intramuscular injection of (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula_ second dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052A","description":"Imm admin by intramuscular injection of (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula_ second dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rho d immune globulin 50 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2788","description":"Rho d immune globulin 50 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSC1","description":"ICD-OCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21263","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVB1","description":"ICD-JFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDC0","description":"ICD-MDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCA0","description":"ICD-JCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Most favored nation (mfn) model drug add-on amount_ per dose_ (do not bill with line items that have the jw modifier)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1145","description":"Most favored nation (mfn) model drug add-on amount_ per dose_ (do not bill with line items that have the jw modifier)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBE1","description":"ICD-IGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKE1","description":"ICD-JDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOA1","description":"ICD-OHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOE1","description":"ICD-LFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breathing circuits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4618","description":"Breathing circuits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17286","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMF1","description":"ICD-AHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCB0","description":"ICD-CCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAC0","description":"ICD-JBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng anti r-viral thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4271F","description":"Pt rcvng anti r-viral thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4C","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of intraosseous basivertebral nerve_ each additional vertebral body_ including imaging guidance (e.g._ fluoroscopy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9753","description":"Destruction of intraosseous basivertebral nerve_ each additional vertebral body_ including imaging guidance (e.g._ fluoroscopy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIB1","description":"ICD-BGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical revision intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44680","description":"Surgical revision intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD205","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj celiac pelus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64530","description":"N block inj celiac pelus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHA1","description":"ICD-MJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; first 60 minutes (List separately in ad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96547","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; first 60 minutes (List separately in ad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDID0","description":"ICD-CDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIA1","description":"ICD-IFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDF1","description":"ICD-ADDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATB0","description":"ICD-NATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMF1","description":"ICD-IFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0677T","description":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo plastic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1930","description":"Afo plastic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBB1","description":"ICD-JCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKD1","description":"ICD-GGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEC1","description":"ICD-NLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thrombolytic art therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37211","description":"Thrombolytic art therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMD0","description":"ICD-MLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUD1","description":"ICD-AHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx multple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21347","description":"Opn tx nasomax fx multple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPF1","description":"ICD-FEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVB0","description":"ICD-GAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Not Crossing Major Side Branches","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33895","description":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Not Crossing Major Side Branches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko supracondylar socket mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1860","description":"Ko supracondylar socket mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYC0","description":"ICD-PJYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE140","description":"Special Care High _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18G","description":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMC0","description":"ICD-IBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMA0","description":"ICD-FCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFB1","description":"ICD-NAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLF1","description":"ICD-IGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ABO GNOTYP NEXT GNRJ SEQ ABO","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0221U","description":"ABO GNOTYP NEXT GNRJ SEQ ABO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVC0","description":"ICD-OEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJF0","description":"ICD-GEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous methb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88741","description":"Transcutaneous methb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUC1","description":"ICD-OHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGD0","description":"ICD-OLGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10D","description":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNA0","description":"ICD-OBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPC1","description":"ICD-GEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIC1","description":"ICD-JCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; mechano-electrical skin interface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0457T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; mechano-electrical skin interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUA0","description":"ICD-OJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMA1","description":"ICD-JFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEF0","description":"ICD-CDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr umbil hern block > 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49587","description":"Rpr umbil hern block > 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFF1","description":"ICD-FGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31766","description":"Reconstruction of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBF0","description":"ICD-NBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIME0","description":"ICD-NIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNA1","description":"ICD-NJNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLC1","description":"ICD-OHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML23","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 5 genotyping (HPA-5)_ ITGA2 (integrin_ alpha 2 [CD49B_ alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81109","description":"Human Platelet Antigen 5 genotyping (HPA-5)_ ITGA2 (integrin_ alpha 2 [CD49B_ alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA114","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cervix/repair vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57555","description":"Remove cervix/repair vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Appendico-vesicostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50845","description":"Appendico-vesicostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray spleen/liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75810","description":"Vein x-ray spleen/liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRE1","description":"ICD-KCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDF1","description":"ICD-OEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLE0","description":"ICD-KHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJF0","description":"ICD-CGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor viia (antihemophilic factor_ recombinant)-jncw (sevenfact)_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7212","description":"Factor viia (antihemophilic factor_ recombinant)-jncw (sevenfact)_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGC1","description":"ICD-FAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB245","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGE0","description":"ICD-JAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93619","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTE0","description":"ICD-CCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1073T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1073T","description":"CPT-1073T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBB1","description":"ICD-NDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKB0","description":"ICD-KCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4020","description":"Ophthalmology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio lwr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73706","description":"Ct angio lwr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric febrile illness (Kawasaki disease [KD])_ interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1)_ RNA_ using reverse transc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0389U","description":"Pediatric febrile illness (Kawasaki disease [KD])_ interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1)_ RNA_ using reverse transc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High activity knee frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5930","description":"High activity knee frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g._ virtual check-in_ by a physician or other qualified health care professiona","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2012","description":"Brief communication technology-based service_ e.g._ virtual check-in_ by a physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITC0","description":"ICD-JITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd biopsy single/multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43239","description":"Egd biopsy single/multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBA1","description":"ICD-NGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUB1","description":"ICD-NCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTE0","description":"ICD-BGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA216","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ including placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])_ without place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27278","description":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ including placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])_ without place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAD0","description":"ICD-NKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abdominal pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1270","description":"Abdominal pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy arm/elbow soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24065","description":"Biopsy arm/elbow soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracolumbar or lumbar vertebral body tethering_ including thoracoscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0790T","description":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracolumbar or lumbar vertebral body tethering_ including thoracoscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29834","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate oral 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8610","description":"Methotrexate oral 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMD0","description":"ICD-MKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64654","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","description":"CPT-64654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEA0","description":"ICD-BHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVD1","description":"ICD-NJVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMB1","description":"ICD-IDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSC1","description":"ICD-LHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Melan follow-up complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015F","description":"Melan follow-up complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDC1","description":"ICD-ABDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0101","description":"HCPCS-B0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMB0","description":"ICD-MJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFME1","description":"ICD-GFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQB1","description":"ICD-LDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYD0","description":"ICD-GHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIB0","description":"ICD-ICIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62141","description":"Repair of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28G","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermabind ch_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4288","description":"Dermabind ch_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMF1","description":"ICD-NGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pmkr_ other than sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2621","description":"Pmkr_ other than sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUB0","description":"ICD-KAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD136","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ gemcitabine hydrochloride_ (Infugem)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9198","description":"Injection_ gemcitabine hydrochloride_ (Infugem)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPC0","description":"ICD-OKPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWA0","description":"ICD-HIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVF1","description":"ICD-CAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNB0","description":"ICD-OJNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28X","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXB1","description":"ICD-CAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYA1","description":"ICD-OIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services received by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9692","description":"Hospice services received by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQE1","description":"ICD-LEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl&rplcmt ss impl dfb pg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0614T","description":"Rmvl&rplcmt ss impl dfb pg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPE1","description":"ICD-FEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES205","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94760","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of palm tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26170","description":"Removal of palm tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXA1","description":"ICD-BAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Filtered nebulizer admin set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7006","description":"Filtered nebulizer admin set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proton trmt intermediate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77523","description":"Proton trmt intermediate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOF1","description":"ICD-PEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Andrology (infertility)_ sperm-capacitation assessment of ganglioside GM1 distribution patterns_ fluorescence microscopy_ fresh/ frozen specimen_ reported as % of capacitated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0255U","description":"Andrology (infertility)_ sperm-capacitation assessment of ganglioside GM1 distribution patterns_ fluorescence microscopy_ fresh/ frozen specimen_ reported as % of capacitated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBE0","description":"ICD-EEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLC1","description":"ICD-OLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Stanson_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1010","description":"Clinical Decision Support Mechanism Stanson_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rout foot care per visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0390","description":"Rout foot care per visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWA1","description":"ICD-PLWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bleomycin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9040","description":"Bleomycin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Histrelin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1675","description":"Histrelin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA33","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCA0","description":"ICD-OHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIC1","description":"ICD-GFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; data upload_ analysis and initial report configura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0535T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; data upload_ analysis and initial report configura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00842","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","description":"CPT-00842","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj beta interferon sq 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3028","description":"Inj beta interferon sq 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid seat support base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2231","description":"Solid seat support base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYE0","description":"ICD-DFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73660","description":"X-ray exam of toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not trans to hosp at d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8915","description":"Pt not trans to hosp at d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUB1","description":"ICD-GDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mrgfus strtctc les abltj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0398T","description":"Mrgfus strtctc les abltj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWF0","description":"ICD-PEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNB0","description":"ICD-NCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDB0","description":"ICD-MFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSB0","description":"ICD-PCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12D","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Musc tst done w/nerv tst lim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95885","description":"Musc tst done w/nerv tst lim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCE1","description":"ICD-MBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter for hysterography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58340","description":"Catheter for hysterography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMD0","description":"ICD-GAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"V-band gastroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43842","description":"V-band gastroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFA0","description":"ICD-KDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFD1","description":"ICD-CFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIA0","description":"ICD-EHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHC0","description":"ICD-AHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj lo_ initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9004","description":"Mccd_ risk adj lo_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBC0","description":"ICD-KHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colorectal cancer screening results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1277","description":"Colorectal cancer screening results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOB1","description":"ICD-LAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUC0","description":"ICD-FCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0523U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","description":"CPT-0523U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPA1","description":"ICD-BGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44960","description":"Appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNB0","description":"ICD-KFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQB0","description":"ICD-KIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOB1","description":"ICD-CCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx gastr intub w/asp specs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43755","description":"Dx gastr intub w/asp specs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMF0","description":"ICD-FDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHD0","description":"ICD-OGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-evalest ptproblem focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0170","description":"Re-evalest ptproblem focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMB1","description":"ICD-IIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLF1","description":"ICD-KFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acupunct w/o stimul addl 15m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97811","description":"Acupunct w/o stimul addl 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0804T","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLE1","description":"ICD-NFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71047","description":"Radiologic examination_ chest; 3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0695U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695U","description":"CPT-0695U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28X","description":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXD1","description":"ICD-JAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc leukoreduced irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9040","description":"Rbc leukoreduced irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHF1","description":"ICD-OLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATD1","description":"ICD-MATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9463","description":"Injection_ aprepitant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB124","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAD1","description":"ICD-CAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44156","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPC0","description":"ICD-OCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLE0","description":"ICD-MCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAB1","description":"ICD-KCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDC1","description":"ICD-JBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAE1","description":"ICD-MKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUD1","description":"ICD-OEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heparin infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1520","description":"Heparin infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTE1","description":"ICD-ADTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymph system imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78195","description":"Lymph system imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBB1","description":"ICD-OKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18A","description":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSC0","description":"ICD-OGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip socket fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27222","description":"Treat hip socket fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16251","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBF1","description":"ICD-EFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASE0","description":"ICD-GASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGD0","description":"ICD-GGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKF0","description":"ICD-NKKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interprof phone/online 5-10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99446","description":"Interprof phone/online 5-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Torsion mechanism wrist/elbo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3891","description":"Torsion mechanism wrist/elbo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUD1","description":"ICD-KHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNF1","description":"ICD-OLNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB54","description":"Very High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24A","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKB0","description":"ICD-FIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBD0","description":"ICD-JCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYF1","description":"ICD-DBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14A","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAF0","description":"ICD-IFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDB0","description":"ICD-BDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEC1","description":"ICD-KIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLF1","description":"ICD-ACLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFND0","description":"ICD-KFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of oral tissue soft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7286","description":"Biopsy of oral tissue soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYD0","description":"ICD-DEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGF0","description":"ICD-CHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45349","description":"Sigmoidoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJB0","description":"ICD-FBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63704","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quant pupillometry w/rprt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0341T","description":"Quant pupillometry w/rprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise excess skin & tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15839","description":"Excise excess skin & tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Edetate disodium per 150 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3520","description":"Edetate disodium per 150 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRD0","description":"ICD-PLRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63278","description":"Bx/exc xdrl spine lesn scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not achieve a PDC of at least 75% for their asthma controller medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9811","description":"Patient did not achieve a PDC of at least 75% for their asthma controller medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pharyngeal walls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42894","description":"Revision of pharyngeal walls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBB1","description":"ICD-ADBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot plate molded stirrup at","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2250","description":"Foot plate molded stirrup at","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of adp & amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82030","description":"Assay of adp & amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEE0","description":"ICD-OCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Establish access to artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36100","description":"Establish access to artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJD0","description":"ICD-KGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXC1","description":"ICD-OHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18B","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant maintenance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6080","description":"Implant maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVB0","description":"ICD-CFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pessary rubber_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4561","description":"Pessary rubber_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cetuximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9055","description":"Cetuximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dorsi & plantar flex ass/res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2220","description":"Dorsi & plantar flex ass/res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJC0","description":"ICD-FFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFC0","description":"ICD-KAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36902","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCD1","description":"ICD-IFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAB1","description":"ICD-OIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat recline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1003","description":"Pwr seat recline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0668","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","description":"HCPCS-J0668","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISF0","description":"ICD-DISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLA1","description":"ICD-GHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEB1","description":"ICD-NKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogen test marrow b/4 tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3155F","description":"Cytogen test marrow b/4 tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIND0","description":"ICD-OIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMF0","description":"ICD-NIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dist revas ligation hemo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36838","description":"Dist revas ligation hemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA13","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4383","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","description":"HCPCS-Q4383","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exome re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81417","description":"Exome re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKF0","description":"ICD-KCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open drainage liver lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47010","description":"Open drainage liver lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD155","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAB0","description":"ICD-GDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialyzer_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4690","description":"Dialyzer_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWA1","description":"ICD-OBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMC0","description":"ICD-AAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2003","description":"Moderate (45 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAA1","description":"ICD-IHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal neck/armpit lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38550","description":"Removal neck/armpit lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening cocaine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80353","description":"Drug screening cocaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair rectourethral fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45820","description":"Repair rectourethral fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV and VV delays_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0225T","description":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV and VV delays_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKB1","description":"ICD-FGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQB1","description":"ICD-HAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIA0","description":"ICD-MLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYB0","description":"ICD-GDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAC1","description":"ICD-EAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9140","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla typing dr/dq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86816","description":"Hla typing dr/dq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWA1","description":"ICD-DHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-38227","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","description":"CPT-38227","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVB1","description":"ICD-BBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHC1","description":"ICD-AHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCE0","description":"ICD-MBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29823","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23470","description":"Reconstruct shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PermeaDerm C_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2018","description":"PermeaDerm C_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLA1","description":"ICD-NDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spontaneous nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92541","description":"Spontaneous nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis repeated eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90947","description":"Dialysis repeated eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLC1","description":"ICD-IBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDE1","description":"ICD-OFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Capecitabine_ oral_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8521","description":"Capecitabine_ oral_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1485","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","description":"HCPCS-M1485","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCB0","description":"ICD-ADCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC31","description":"ICD-1KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy dilate/fx repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31630","description":"Bronchoscopy dilate/fx repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interferon beta-1a inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1826","description":"Interferon beta-1a inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis access system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1881","description":"Dialysis access system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJA0","description":"ICD-KEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Theragenesis_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2008","description":"Theragenesis_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWF0","description":"ICD-ODWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIB0","description":"ICD-JGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABB1","description":"ICD-IABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0596U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","description":"CPT-0596U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTA0","description":"ICD-ECTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55000","description":"Drainage of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOC0","description":"ICD-OGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01620","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","description":"CPT-01620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYC1","description":"ICD-GIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGME1","description":"ICD-AGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr trunk 10.1-30sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14001","description":"Tis trnfr trunk 10.1-30sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCED1","description":"ICD-BCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXB0","description":"ICD-KAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACF0","description":"ICD-OACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHE1","description":"ICD-OLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion mr imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19085","description":"Bx breast 1st lesion mr imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ coagulation Factor Xa (recombinant)_ inactivated-zhzo (Andexxa)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7169","description":"Injection_ coagulation Factor Xa (recombinant)_ inactivated-zhzo (Andexxa)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLC1","description":"ICD-ODLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24363","description":"Replace elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ring flange plastic/leather","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1100","description":"Ring flange plastic/leather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMA0","description":"ICD-MHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWD0","description":"ICD-KBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASF0","description":"ICD-PASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQD0","description":"ICD-OKQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow disarticulation switch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6940","description":"Elbow disarticulation switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA35","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWE1","description":"ICD-LCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDA1","description":"ICD-NDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow child myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7191","description":"Elbow child myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNF0","description":"ICD-FGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE112","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AJCC breast cancer stage I: T1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9705","description":"AJCC breast cancer stage I: T1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCF0","description":"ICD-BDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dispense fee initial 30 day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0333","description":"Dispense fee initial 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAB1","description":"ICD-OAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPA0","description":"ICD-FHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11A","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stimulation pacing heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93623","description":"Stimulation pacing heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vaginectomy partial w/nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57109","description":"Vaginectomy partial w/nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABF0","description":"ICD-NABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other pt/ot goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8991","description":"Other pt/ot goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISF1","description":"ICD-GISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIA0","description":"ICD-EDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0504","description":"HCPCS-B0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin beta_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9973","description":"Epoetin beta_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0683U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683U","description":"CPT-0683U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHD0","description":"ICD-FGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt dchg home post op day 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9601","description":"Pt dchg home post op day 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thaw cryoprsvrd reprod tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89354","description":"Thaw cryoprsvrd reprod tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Finger splint_ static","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4049","description":"Finger splint_ static","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCE1","description":"ICD-KFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXE1","description":"ICD-CDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUD1","description":"ICD-CGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit im injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99506","description":"Home visit im injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4B","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFE0","description":"ICD-GHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"So cap design w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3671","description":"So cap design w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPF1","description":"ICD-CAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Had Prior Adverse Reaction Caused By Zoster Vaccine Or Its Components Any Time During Or Before The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2161","description":"Patient Had Prior Adverse Reaction Caused By Zoster Vaccine Or Its Components Any Time During Or Before The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIC1","description":"ICD-OJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEE0","description":"ICD-KFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for blood smear_ peripheral_ interpretation by physician with written report (List separately in addition to code for primary procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0854T","description":"Digitization of glass microscope slides for blood smear_ peripheral_ interpretation by physician with written report (List separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD114","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLD1","description":"ICD-BHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPA1","description":"ICD-ODPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCD0","description":"ICD-NGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWD1","description":"ICD-LDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trach care kit for new trach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4625","description":"Trach care kit for new trach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMC1","description":"ICD-AGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy dilate w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31631","description":"Bronchoscopy dilate w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"2high risk med ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9367","description":"2high risk med ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPE0","description":"ICD-BEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHE0","description":"ICD-CAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thromboemb risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1180F","description":"Thromboemb risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA135","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGA1","description":"ICD-CGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUC1","description":"ICD-CDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incontinent rectal insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4337","description":"Incontinent rectal insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLD0","description":"ICD-BDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHID1","description":"ICD-KHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16025","description":"Dress/debrid p-thick burn m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQA1","description":"ICD-LGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCID1","description":"ICD-BCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBE1","description":"ICD-IDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0503","description":"HCPCS-A0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAB0","description":"ICD-JBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESC1","description":"ICD-DESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1303","description":"HCPCS-B1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHD1","description":"ICD-FCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDB0","description":"ICD-ADDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCD0","description":"ICD-MBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair semi-recl detach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1110","description":"Wheelchair semi-recl detach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXB0","description":"ICD-NKXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0010","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUA0","description":"ICD-GAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTD0","description":"ICD-GBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDE1","description":"ICD-BFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23D","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLB1","description":"ICD-ECLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIB1","description":"ICD-GHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFA1","description":"ICD-BAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGB1","description":"ICD-NKGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELD0","description":"ICD-KELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDB1","description":"ICD-BIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 3 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64492","description":"Inj paravert f jnt c/t 3 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMD0","description":"ICD-CHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFB1","description":"ICD-KDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agents (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ and Trichomonas vaginalis_ multiplex amplified probe technique_ vaginal_ endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0455U","description":"Infectious agents (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ and Trichomonas vaginalis_ multiplex amplified probe technique_ vaginal_ endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mecp2 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81302","description":"Mecp2 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kanamycin sulfate 500 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1840","description":"Kanamycin sulfate 500 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27178","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJE0","description":"ICD-KHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMB0","description":"ICD-BDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20700","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMC1","description":"ICD-JIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAE1","description":"ICD-KIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERA1","description":"ICD-LERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63273","description":"Excise intrspinl lesion scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUE1","description":"ICD-FDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24A","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD235","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81343","description":"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJC0","description":"ICD-GAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC56","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIC0","description":"ICD-KHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","description":"HCPCS-M1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enteral feeding supply kit; elastomeric control fed_ per day_ includes but not limited to feeding/flushing syringe_ administration set tubing_ dressings_ tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4148","description":"Enteral feeding supply kit; elastomeric control fed_ per day_ includes but not limited to feeding/flushing syringe_ administration set tubing_ dressings_ tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23146","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXF1","description":"ICD-CBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Histoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86698","description":"Histoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHF0","description":"ICD-GIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam l-2 spine 4/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72110","description":"X-ray exam l-2 spine 4/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severeacute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA\u0002LNP_ spike","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0113A","description":"Immunization administration by intramuscular injection of severeacute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA\u0002LNP_ spike","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shrt leg ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4040","description":"Cast sup shrt leg ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stocking sup grips 4 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0982","description":"Stocking sup grips 4 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES113","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Safety frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0516","description":"Safety frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ceftizoxime sodium / 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0715","description":"Ceftizoxime sodium / 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alprostadil for injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0270","description":"Alprostadil for injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visual audiometry (vra)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92579","description":"Visual audiometry (vra)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5A","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD140","description":"Reduced Physical Function _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDF0","description":"ICD-EHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIF0","description":"ICD-NHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEND1","description":"ICD-CEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAE1","description":"ICD-GFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infliximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1745","description":"Infliximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBB1","description":"ICD-IGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo doub solid stirrup calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1990","description":"Afo doub solid stirrup calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBA1","description":"ICD-OHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRC0","description":"ICD-OKRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSB1","description":"ICD-KBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMA1","description":"ICD-OHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAC1","description":"ICD-MFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMB1","description":"ICD-IGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKF1","description":"ICD-KCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOC1","description":"ICD-CAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGC0","description":"ICD-FAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLD0","description":"ICD-GGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABC1","description":"ICD-BABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cms medical evidence form 2728 for dialysis patients: initial form completed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1265","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUB1","description":"ICD-GFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMA0","description":"ICD-GIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJF0","description":"ICD-BFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ovulation tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84830","description":"Ovulation tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPE0","description":"ICD-NJPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRD0","description":"ICD-OLRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECE0","description":"ICD-NECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36215","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLB0","description":"ICD-EDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit nb care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99502","description":"Home visit nb care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26561","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVB1","description":"ICD-OEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHD0","description":"ICD-GIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNA1","description":"ICD-CBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEE0","description":"ICD-FAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHA1","description":"ICD-BEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTC1","description":"ICD-JHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTD1","description":"ICD-JBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove skull plate/flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62142","description":"Remove skull plate/flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAB0","description":"ICD-IEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0185","description":"Injection_ aprepitant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFE1","description":"ICD-OEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIC0","description":"ICD-OLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absolute quantitation of myocardial blood flow_ positron emission tomography (PET)_ rest and stress (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0482T","description":"Absolute quantitation of myocardial blood flow_ positron emission tomography (PET)_ rest and stress (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC31","description":"ICD-1AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCB0","description":"ICD-KDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENC1","description":"ICD-GENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0139","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","description":"HCPCS-J0139","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQC1","description":"ICD-DIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper gi endo not barrtts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3141F","description":"Upper gi endo not barrtts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30310","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOF1","description":"ICD-PCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGF1","description":"ICD-GFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of nasal septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30520","description":"Repair of nasal septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRB1","description":"ICD-OCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No rsk fac or 1 mod risk te","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8970","description":"No rsk fac or 1 mod risk te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTA0","description":"ICD-CBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext line w easy lock connect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4673","description":"Ext line w easy lock connect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ phylogenetic-based report of strain relatedness_ per submitted isolate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0010U","description":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ phylogenetic-based report of strain relatedness_ per submitted isolate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINC0","description":"ICD-OINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIB0","description":"ICD-AIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50135","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1023","description":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAB0","description":"ICD-GIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dxa bone density axial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77080","description":"Dxa bone density axial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anacaulase-bcdb_ 8.8% gel_ 1 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7353","description":"Anacaulase-bcdb_ 8.8% gel_ 1 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0618U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","description":"CPT-0618U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLC1","description":"ICD-NLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Int mam art used for cabg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4110F","description":"Int mam art used for cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo assay seven anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81506","description":"Endo assay seven anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIB1","description":"ICD-BFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXB1","description":"ICD-FCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYB1","description":"ICD-HCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99316","description":"Nursing fac discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76519","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGME1","description":"ICD-GGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20604","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQE0","description":"ICD-GEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefepime hydrochloride (baxter)_ not therapeutically equivalent to maxipime_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0701","description":"Injection_ cefepime hydrochloride (baxter)_ not therapeutically equivalent to maxipime_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRD1","description":"ICD-KBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18C","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEC0","description":"ICD-MEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCC1","description":"ICD-MBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFD0","description":"ICD-BAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8003","description":"HCPCS-C8003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDC0","description":"ICD-OJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac rehab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93797","description":"Cardiac rehab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIC1","description":"ICD-BEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10C","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc back les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21930","description":"Exc back les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC255","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult disp brief/diap abv xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4543","description":"Adult disp brief/diap abv xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOF0","description":"ICD-DIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKE1","description":"ICD-BFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPF1","description":"ICD-JGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"R&l hrt art/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93460","description":"R&l hrt art/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlorpromazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3230","description":"Chlorpromazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code  13-16 test","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP16","description":"Auto test panel pricing code  13-16 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Russell viper venom diluted","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85613","description":"Russell viper venom diluted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - bitewing radiographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0373","description":"intraoral tomosynthesis - bitewing radiographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYA0","description":"ICD-PGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEF0","description":"ICD-IDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Program intake assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1023","description":"Program intake assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligate/strip long leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37722","description":"Ligate/strip long leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31296","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC236","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk molded distal cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5668","description":"Bk molded distal cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MLG-Complete_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4256","description":"MLG-Complete_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 3RD DOSE MODERNA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 3RD DOSE MODERNA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92641","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","description":"CPT-92641","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53505","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0625U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","description":"CPT-0625U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zidovudine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3485","description":"Zidovudine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLD1","description":"ICD-EGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo plastic molded w/ankle j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1970","description":"Afo plastic molded w/ankle j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEC1","description":"ICD-EIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLB0","description":"ICD-IBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJD1","description":"ICD-OGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYB1","description":"ICD-HDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILD0","description":"ICD-NILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHA1","description":"ICD-EEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXF1","description":"ICD-NLXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4A","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXA1","description":"ICD-GIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoluminal bx urtr rnl plvs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50606","description":"Endoluminal bx urtr rnl plvs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject skin lesions </w 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11900","description":"Inject skin lesions </w 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove kidney living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50320","description":"Remove kidney living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Youth size brief/diaper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4533","description":"Youth size brief/diaper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNE0","description":"ICD-NFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBB1","description":"ICD-KGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSA1","description":"ICD-OLSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKA0","description":"ICD-JIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINC1","description":"ICD-FINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB16","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Most recent tobacco status is not tobacco free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9792","description":"Most recent tobacco status is not tobacco free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVF0","description":"ICD-OFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0670T","description":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc ext at dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9069","description":"Onc dx sclc/nsclc ext at dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCF1","description":"ICD-KBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53454","description":"Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDC0","description":"ICD-MCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDF1","description":"ICD-BDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27556","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMB1","description":"ICD-JHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUE1","description":"ICD-BEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rozanolixizumab-noli_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9333","description":"Injection_ rozanolixizumab-noli_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIB0","description":"ICD-BAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTE0","description":"ICD-KGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECA0","description":"ICD-FECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myelography neck spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72240","description":"Myelography neck spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXB0","description":"ICD-JFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96171","description":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAB1","description":"ICD-GGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAE1","description":"ICD-KFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRE0","description":"ICD-PGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0488U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","description":"CPT-0488U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYC1","description":"ICD-PCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O2/water vapor enrich w/o he","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1406","description":"O2/water vapor enrich w/o he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYB1","description":"ICD-DIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee disarticulat leather so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5640","description":"Knee disarticulat leather so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1114","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAE1","description":"ICD-OCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWB1","description":"ICD-HAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAB0","description":"ICD-ABAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block spenopalatine gangl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64505","description":"N block spenopalatine gangl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quick disconn hook adapter o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6628","description":"Quick disconn hook adapter o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCA1","description":"ICD-BHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bl exchange/transfuse non-nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36455","description":"Bl exchange/transfuse non-nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33236","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNF1","description":"ICD-JGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vacc 2 dose adolesc im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90743","description":"Hepb vacc 2 dose adolesc im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAD1","description":"ICD-NEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal invas px w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59897","description":"Fetal invas px w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Admit w/in 180d req remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9410","description":"Admit w/in 180d req remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSE0","description":"ICD-PCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Guide nerv destr elec stim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95873","description":"Guide nerv destr elec stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1837","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","description":"HCPCS-J1837","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01190","description":"CPT-01190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDD0","description":"ICD-BHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVE1","description":"ICD-KFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEB1","description":"ICD-EEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVB0","description":"ICD-BIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFC1","description":"ICD-BHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCD0","description":"ICD-MHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24B","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA151","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTF1","description":"ICD-MFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient with diagnosis of osteoporosis on date of encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1153","description":"Patient with diagnosis of osteoporosis on date of encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJA1","description":"ICD-BDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOA1","description":"ICD-DCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise/drain tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68420","description":"Incise/drain tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 3 genotyping (HPA-3)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex]_ antigen CD41 [GPIIb]) (eg_ neonatal alloimmune thrombo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81107","description":"Human Platelet Antigen 3 genotyping (HPA-3)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex]_ antigen CD41 [GPIIb]) (eg_ neonatal alloimmune thrombo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDA1","description":"ICD-OEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUB0","description":"ICD-NJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES215","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCC1","description":"ICD-MFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERD1","description":"ICD-KERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 6/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72052","description":"X-ray exam neck spine 6/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAC0","description":"ICD-CHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - comprehensive series of radiographic images - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0387","description":"intraoral tomosynthesis - comprehensive series of radiographic images - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIE0","description":"ICD-ADIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tcranial magn stim tx plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90867","description":"Tcranial magn stim tx plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01210","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","description":"CPT-01210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUD0","description":"ICD-CEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0676T","description":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTC0","description":"ICD-KDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Direct advanced life support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99288","description":"Direct advanced life support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPE1","description":"ICD-FBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIA1","description":"ICD-OJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINF1","description":"ICD-CINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCB0","description":"ICD-MLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Predominatly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6082","description":"Implant Supported Crown - Porcelain Fused To Predominatly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ravulizumab-cwvz_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1303","description":"Injection_ ravulizumab-cwvz_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture of specimen by kit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87084","description":"Culture of specimen by kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBE1","description":"ICD-KCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATE0","description":"ICD-MATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOB0","description":"ICD-LDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIB1","description":"ICD-NAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg arterial three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33535","description":"Cabg arterial three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein byp grft fem-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35583","description":"Vein byp grft fem-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNB1","description":"ICD-FFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31825","description":"Repair of windpipe defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plaelet rich plasma unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9020","description":"Plaelet rich plasma unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous carboxyhb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88740","description":"Transcutaneous carboxyhb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Legion pneumophilia ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87278","description":"Legion pneumophilia ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removable retainer adjust","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8681","description":"Removable retainer adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTC0","description":"ICD-IBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE160","description":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNC0","description":"ICD-OHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco counseling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1320","description":"Tobacco counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTC0","description":"ICD-IGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lenticular lens_ trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2321","description":"Lenticular lens_ trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQA0","description":"ICD-HBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4042","description":"Cast sup lng leg splnt fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Forearm/arm cuffs free motio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3720","description":"Forearm/arm cuffs free motio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDE0","description":"ICD-BHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHC0","description":"ICD-OCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4928","description":"Surgical mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCE0","description":"ICD-KFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exam feces for meat fibers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89160","description":"Exam feces for meat fibers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBA1","description":"ICD-IEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTF1","description":"ICD-ODTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKE0","description":"ICD-CEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCD1","description":"ICD-NBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iliac bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20956","description":"Iliac bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQB0","description":"ICD-LHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQE0","description":"ICD-PIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin-oxygen affinity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82820","description":"Hemoglobin-oxygen affinity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip clevis/thrust bearing fr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2600","description":"Hip clevis/thrust bearing fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC06","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHE0","description":"ICD-GCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dxa bone density study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77085","description":"Dxa bone density study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIA0","description":"ICD-GIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28E","description":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44238","description":"Laparoscope proc intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML51","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Born 1945-1965","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9448","description":"Born 1945-1965","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC54","description":"Medium Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ bandage liner_ upper extremity_ any size or length_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6595","description":"Gradient compression bandaging supply_ bandage liner_ upper extremity_ any size or length_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16376","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16376","description":"CPT-16376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAD0","description":"ICD-BHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8006","description":"HCPCS-C8006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVB0","description":"ICD-OCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVA0","description":"ICD-BGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATC0","description":"ICD-GATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat uterus infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59830","description":"Treat uterus infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric electric hand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7008","description":"Pediatric electric hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITB0","description":"ICD-MITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise palsy hand tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25316","description":"Revise palsy hand tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level II_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0751T","description":"Digitization of glass microscope slides for level II_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUE0","description":"ICD-BIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE205","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEE1","description":"ICD-MJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQF0","description":"ICD-PLQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB221","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDB1","description":"ICD-IHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUD0","description":"ICD-OJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQD1","description":"ICD-PJQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUD0","description":"ICD-CBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; first 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96138","description":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUC0","description":"ICD-NAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHB0","description":"ICD-KIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOC0","description":"ICD-DHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam drsg <=16 sq in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6209","description":"Foam drsg <=16 sq in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIF1","description":"ICD-GIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCF1","description":"ICD-NFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj arthroscopy debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7877","description":"Tmj arthroscopy debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCA0","description":"ICD-OLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOC0","description":"ICD-OBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61537","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLD1","description":"ICD-KFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACF1","description":"ICD-MACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27727","description":"Repair of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bilat dil retinal exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3000","description":"Bilat dil retinal exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61524","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Progressive lens per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2781","description":"Progressive lens per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diast bp 80-89 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3079F","description":"Diast bp 80-89 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCE0","description":"ICD-CFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIA1","description":"ICD-NJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trtmnt simulation 3d image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0393","description":"Trtmnt simulation 3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWE1","description":"ICD-GFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Flow Cytometry (Ie_ Fluorescence-Activated Cell Sorting [Facs])_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86363","description":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Flow Cytometry (Ie_ Fluorescence-Activated Cell Sorting [Facs])_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Free jejunum flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43496","description":"Free jejunum flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1238","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII/von Willebrand factor complex_ recombinant (Altuviiio)_ per Factor VIII IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7214","description":"Injection_ Factor VIII/von Willebrand factor complex_ recombinant (Altuviiio)_ per Factor VIII IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOC1","description":"ICD-OAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Omental flap extra-abdom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49904","description":"Omental flap extra-abdom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artiss fibrin sealant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9250","description":"Artiss fibrin sealant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ whole blood or buccal_ DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0460U","description":"Oncology_ whole blood or buccal_ DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye suture during surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67335","description":"Eye suture during surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vinblastine sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9360","description":"Vinblastine sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYD1","description":"ICD-HAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLD1","description":"ICD-GFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFC0","description":"ICD-CGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMF1","description":"ICD-CDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21C","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Warming card for nwt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0232","description":"Warming card for nwt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth trachea bronchi surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54851","description":"Anesth trachea bronchi surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug Assay_ Presumptive_ 30 Or More Drugs Or Metabolites_ Urine_ Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms) Using Multiple Reaction Monitoring (Mrm)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0227U","description":"Drug Assay_ Presumptive_ 30 Or More Drugs Or Metabolites_ Urine_ Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms) Using Multiple Reaction Monitoring (Mrm)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral hygiene instruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1330","description":"Oral hygiene instruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36583","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAF0","description":"ICD-FDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLA0","description":"ICD-OKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place stereo cath brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0169T","description":"Place stereo cath brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJE1","description":"ICD-NAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sps ankle device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1816","description":"Sps ankle device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt ed re comp thxpy rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4268F","description":"Pt ed re comp thxpy rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise lumb artif disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0165T","description":"Revise lumb artif disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Beta not given no reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9188","description":"Beta not given no reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conformal radn thxpy rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4181F","description":"Conformal radn thxpy rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop ren fail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8575","description":"Postop ren fail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot press off load supp dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9283","description":"Foot press off load supp dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0636T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTD0","description":"ICD-EBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8X","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETC1","description":"ICD-KETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-covered item or service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9270","description":"Non-covered item or service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVF1","description":"ICD-FGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUC0","description":"ICD-BGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDA0","description":"ICD-EEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEA0","description":"ICD-IDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0503","description":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin chromotography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83021","description":"Hemoglobin chromotography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUD0","description":"ICD-MHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXA0","description":"ICD-KEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPB0","description":"ICD-KCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","description":"HCPCS-J3392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0705","description":"Transfer device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVB1","description":"ICD-GHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKB0","description":"ICD-BDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVD0","description":"ICD-JHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHF1","description":"ICD-GHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMF1","description":"ICD-OKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92002","description":"Eye exam new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dihydrocodeinone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6045","description":"Dihydrocodeinone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pp eval/edu not perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9358","description":"Pp eval/edu not perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUA0","description":"ICD-EHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMC1","description":"ICD-EBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUB1","description":"ICD-GCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lysis penil circumic lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54162","description":"Lysis penil circumic lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroestradiol f18_ diagnostic_ 1 mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9060","description":"Fluoroestradiol f18_ diagnostic_ 1 mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGC1","description":"ICD-BGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCE0","description":"ICD-FCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB131","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA21","description":"ICD-4CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adults who are deliberately phased out of medication assisted treatment (MAT) prior to 180 days of continuous treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1035","description":"Adults who are deliberately phased out of medication assisted treatment (MAT) prior to 180 days of continuous treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Init bk ptb plaster direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5500","description":"Init bk ptb plaster direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add pwr tiller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0984","description":"Add pwr tiller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pms2 known familial variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81318","description":"Pms2 known familial variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQF0","description":"ICD-DBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Technetium tc-99m aerosol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9567","description":"Technetium tc-99m aerosol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEF0","description":"ICD-BHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ ultra-rapid sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0426U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ ultra-rapid sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQC0","description":"ICD-KDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap ileo/jejuno-stomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44187","description":"Lap ileo/jejuno-stomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUA1","description":"ICD-CFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGF1","description":"ICD-JAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28234","description":"Incision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBC1","description":"ICD-MFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vascular flow imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78445","description":"Vascular flow imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brush biopsy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7288","description":"Brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13C","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRC1","description":"ICD-LGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOA1","description":"ICD-LGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELF0","description":"ICD-IELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt immunity to hep a docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3215F","description":"Pt immunity to hep a docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVE0","description":"ICD-NEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIF0","description":"ICD-MCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYE0","description":"ICD-GFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPC0","description":"ICD-JFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophoretic test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82664","description":"Electrophoretic test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place ndl musc/tis for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20555","description":"Place ndl musc/tis for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEE0","description":"ICD-MDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAC1","description":"ICD-AIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy elbow joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24100","description":"Biopsy elbow joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD126","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"American amnion_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4307","description":"American amnion_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDD0","description":"ICD-JCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reeva FT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4314","description":"Reeva FT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2D","description":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB240","description":"Special Care High _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo by other than infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0083","description":"Chemo by other than infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNE1","description":"ICD-OGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLE0","description":"ICD-OCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGE1","description":"ICD-FFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26535","description":"Revise finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flotufolastat f 18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9608","description":"Flotufolastat f 18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAF0","description":"ICD-AHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artificial insemination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58322","description":"Artificial insemination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHD0","description":"ICD-GCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin fungi culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87101","description":"Skin fungi culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWE1","description":"ICD-CGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYE0","description":"ICD-LGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYF0","description":"ICD-OIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXB0","description":"ICD-JCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54348","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC144","description":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDF1","description":"ICD-EHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYB0","description":"ICD-CCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPB1","description":"ICD-CBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX54","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRD0","description":"ICD-KCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUC1","description":"ICD-KEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hcg free betachain test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84704","description":"Hcg free betachain test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sewhfo airplane w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3976","description":"Sewhfo airplane w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJD1","description":"ICD-OLJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVD1","description":"ICD-GCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAF0","description":"ICD-FHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAF0","description":"ICD-MCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m gluceptate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9550","description":"Tc99m gluceptate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYB1","description":"ICD-DHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCA0","description":"ICD-KDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEC1","description":"ICD-KCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2388","description":"Foam drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISC0","description":"ICD-KISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYC0","description":"ICD-KBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis training incompl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90993","description":"Dialysis training incompl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRE0","description":"ICD-OGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBC1","description":"ICD-ADBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX10","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1115","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMB1","description":"ICD-KDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In111 satumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4642","description":"In111 satumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Appliance removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7997","description":"Appliance removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFB1","description":"ICD-BDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Uxtr/Perph Nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0440T","description":"Abltj Perc Cryoabltj Img Gdn Uxtr/Perph Nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTE0","description":"ICD-OHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42650","description":"Dilation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelets leukocytes reduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9031","description":"Platelets leukocytes reduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAC1","description":"ICD-MCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUA1","description":"ICD-MKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVD1","description":"ICD-FGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBA1","description":"ICD-MDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLB0","description":"ICD-CGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9741","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFE1","description":"ICD-CBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDF0","description":"ICD-JGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFC1","description":"ICD-OLFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDME0","description":"ICD-MDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUA1","description":"ICD-NDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95721","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthodontic rem appliance tx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8210","description":"Orthodontic rem appliance tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGD1","description":"ICD-CCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67999","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy/lung bx each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31628","description":"Bronchoscopy/lung bx each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Water distilled w/nebulizer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7018","description":"Water distilled w/nebulizer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSF0","description":"ICD-LDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nsclc dx unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9067","description":"Onc dx nsclc dx unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAD0","description":"ICD-IDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCC1","description":"ICD-ECCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy shoulder tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23066","description":"Biopsy shoulder tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQF0","description":"ICD-OHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPD0","description":"ICD-OGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB02","description":"Low Rehab_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHD1","description":"ICD-BEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGA1","description":"ICD-OCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUF1","description":"ICD-OGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sgd accessory_ mounting sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2512","description":"Sgd accessory_ mounting sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anti-inhibitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7198","description":"Anti-inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIB1","description":"ICD-KGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCE0","description":"ICD-JFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endocrinology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4004","description":"Endocrinology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTA1","description":"ICD-EFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKA0","description":"ICD-KBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00731","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","description":"CPT-00731","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVF1","description":"ICD-JCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGB1","description":"ICD-JCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zoledronic acid 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3489","description":"Zoledronic acid 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOC1","description":"ICD-GHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEB0","description":"ICD-MDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAF1","description":"ICD-NDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11A","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNB1","description":"ICD-OCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ana crown exp 1-3 per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4231","description":"Ana crown exp 1-3 per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGB0","description":"ICD-GGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RUNX1 (runt related transcription factor 1) (eg_ acute myeloid leukemia_ familial platelet disorder with associated myeloid malignancy)_ gene analysis_ targeted sequence analy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81334","description":"RUNX1 (runt related transcription factor 1) (eg_ acute myeloid leukemia_ familial platelet disorder with associated myeloid malignancy)_ gene analysis_ targeted sequence analy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQF1","description":"ICD-KGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTB0","description":"ICD-OHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACB0","description":"ICD-CACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIE1","description":"ICD-GAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACC1","description":"ICD-GACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENA1","description":"ICD-FENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB11","description":"ICD-2IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA60","description":"Ultra High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUC0","description":"ICD-EDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUF1","description":"ICD-BFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32994","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWF1","description":"ICD-OLWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBC1","description":"ICD-OFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPC0","description":"ICD-NHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEB0","description":"ICD-AHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair fistula w/colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45825","description":"Repair fistula w/colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHA0","description":"ICD-EAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CROM GNOTYP CD55 EXONS 1-10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0182U","description":"CROM GNOTYP CD55 EXONS 1-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUA1","description":"ICD-IEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOF1","description":"ICD-OCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBE1","description":"ICD-IEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFB0","description":"ICD-KFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ureteral reflux study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78740","description":"Ureteral reflux study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No reason_ no refer hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9526","description":"No reason_ no refer hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEE1","description":"ICD-IDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravasc us heart add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92978","description":"Intravasc us heart add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCF0","description":"ICD-CGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFA0","description":"ICD-JIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYD1","description":"ICD-GAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXA0","description":"ICD-ODXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28H","description":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJF1","description":"ICD-CAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB54","description":"Low Rehab_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQB0","description":"ICD-HAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX46","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNF1","description":"ICD-BDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tourniquet for dialysis_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4929","description":"Tourniquet for dialysis_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACE1","description":"ICD-BACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0534U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","description":"CPT-0534U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWA0","description":"ICD-GGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33770","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVA1","description":"ICD-CGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECF1","description":"ICD-AECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9976","description":"Documentation of patient reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg > 48 in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6236","description":"Hydrocolld drg > 48 in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"So vest canvas/web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3675","description":"So vest canvas/web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB31","description":"ICD-4BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFA1","description":"ICD-CEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSC0","description":"ICD-LHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOB1","description":"ICD-GBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML26","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainable plastic pch w fcpl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4375","description":"Drainable plastic pch w fcpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9980","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clean rem part denture mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9935","description":"Clean rem part denture mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA54","description":"Low Rehab_ ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUD0","description":"ICD-AEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28210","description":"Repair/graft of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNC0","description":"ICD-NDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGE1","description":"ICD-BIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUA1","description":"ICD-ACUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr ang lwr ext w or w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73725","description":"Mr ang lwr ext w or w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAA1","description":"ICD-CDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC11","description":"ICD-2JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSB0","description":"ICD-PHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSF1","description":"ICD-DDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQC0","description":"ICD-LGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low density lipoprotein(ldl)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2120","description":"Low density lipoprotein(ldl)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTE0","description":"ICD-CDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSE1","description":"ICD-KGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of chest wall respiratory sensor electrode or electrode array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0468T","description":"Removal of chest wall respiratory sensor electrode or electrode array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSD1","description":"ICD-GDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Probe_ Image-Guided_ Robotic_ Waterjet Ablation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2596","description":"Probe_ Image-Guided_ Robotic_ Waterjet Ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (IIV4)_ split virus_ preservative free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90686","description":"Influenza virus vaccine_ quadrivalent (IIV4)_ split virus_ preservative free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ gemtuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9203","description":"Injection_ gemtuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inr measurement performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3555F","description":"Pt inr measurement performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJB1","description":"ICD-KHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOC1","description":"ICD-LEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAF1","description":"ICD-AIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINA1","description":"ICD-KINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0103","description":"HCPCS-B0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assist oocyte fertilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89281","description":"Assist oocyte fertilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJC1","description":"ICD-JCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPE1","description":"ICD-FDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16370","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16370","description":"CPT-16370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fix g/colon tube w/device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49460","description":"Fix g/colon tube w/device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL51","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGD0","description":"ICD-KGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oasis burn matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4103","description":"Oasis burn matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft subclav-brchial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35512","description":"Art byp grft subclav-brchial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1010","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUA0","description":"ICD-NCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBC0","description":"ICD-AHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Single energy x-ray study","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0130","description":"Single energy x-ray study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC224","description":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFA0","description":"ICD-NDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fistula repair transperine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57308","description":"Fistula repair transperine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQF1","description":"ICD-HGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmic biometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92136","description":"Ophthalmic biometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45116","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast exam abdominl aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75625","description":"Contrast exam abdominl aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWD0","description":"ICD-KEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUA1","description":"ICD-KGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Als iv drug therapy supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0394","description":"Als iv drug therapy supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas on statin or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9507","description":"Doc reas on statin or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAE0","description":"ICD-OFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIA1","description":"ICD-JAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRB0","description":"ICD-PJRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOF0","description":"ICD-KFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8F","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYE0","description":"ICD-KBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLA0","description":"ICD-ECLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVD0","description":"ICD-OAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Above knee wood socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5644","description":"Above knee wood socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary colon ca dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81435","description":"Hereditary colon ca dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)–based antimicrobial susceptibility for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0311U","description":"Infectious disease (bacterial)_ quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)–based antimicrobial susceptibility for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indirect immunofluorescence","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0483","description":"Indirect immunofluorescence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGC1","description":"ICD-BIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPE1","description":"ICD-KCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBD1","description":"ICD-OIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBA1","description":"ICD-FCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth w/o gen/neurax anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4560F","description":"Anesth w/o gen/neurax anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9698","description":"Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31605","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGD1","description":"ICD-JDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0454U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC14","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES326","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1250","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCND0","description":"ICD-GCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKD1","description":"ICD-OAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWD0","description":"ICD-DDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXD0","description":"ICD-NKXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroretinography (ERG)_ with interpretation and report; multifocal (mfERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92274","description":"Electroretinography (ERG)_ with interpretation and report; multifocal (mfERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJB0","description":"ICD-OIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXA0","description":"ICD-CEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home care supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99340","description":"Domicil/r-home care supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJB0","description":"ICD-OJJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC205","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0631U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0631U","description":"CPT-0631U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct interprete max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0366","description":"Cone beam ct interprete max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKD1","description":"ICD-CHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETA1","description":"ICD-AETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVE0","description":"ICD-NCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8C","description":"High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90380","description":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGE1","description":"ICD-NIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKE0","description":"ICD-GDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLC0","description":"ICD-FGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid check both ears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92593","description":"Hearing aid check both ears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Miscellaneous external component_ supply or accessory for use with the Argus II Retinal Prosthesis System","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8608","description":"Miscellaneous external component_ supply or accessory for use with the Argus II Retinal Prosthesis System","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBF1","description":"ICD-GHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJB1","description":"ICD-OEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Procainamide hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2690","description":"Procainamide hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAC1","description":"ICD-JGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJB0","description":"ICD-JFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq dev soft tiss 1st imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10035","description":"Perq dev soft tiss 1st imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair nasal stenosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30465","description":"Repair nasal stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55862","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8953","description":"Oncology mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETF1","description":"ICD-NETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; adenovirus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87809","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; adenovirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAD0","description":"ICD-NJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHD1","description":"ICD-KDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIA0","description":"ICD-CEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVE1","description":"ICD-GAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0551T","description":"Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPE0","description":"ICD-BCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJA1","description":"ICD-CCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDC1","description":"ICD-OKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18B","description":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSD1","description":"ICD-OHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adhesive bandage_ first-aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6413","description":"Adhesive bandage_ first-aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRD0","description":"ICD-PDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adults who are not ambulatory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1068","description":"Adults who are not ambulatory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXB0","description":"ICD-ODXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIA1","description":"ICD-NCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tap block unil by injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64486","description":"Tap block unil by injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB13","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory setting substance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9475","description":"Ambulatory setting substance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAB0","description":"ICD-CBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUF0","description":"ICD-IFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE214","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCA1","description":"ICD-FBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nervous system surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64999","description":"Nervous system surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSE0","description":"ICD-KFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5A","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2001","description":"HCPCS-A2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe wedge sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3340","description":"Shoe wedge sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOD0","description":"ICD-HDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJB1","description":"ICD-CCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of somatostatin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84307","description":"Assay of somatostatin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEC1","description":"ICD-OIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ob us detailed sngl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76811","description":"Ob us detailed sngl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGF0","description":"ICD-NAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fam-trastuzumab deruxtecan-nxki_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9358","description":"Injection_ fam-trastuzumab deruxtecan-nxki_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complex rehabilitative power wheelchair accessory_ power seat elevation system_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2298","description":"Complex rehabilitative power wheelchair accessory_ power seat elevation system_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIB0","description":"ICD-OJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHB0","description":"ICD-IIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGB0","description":"ICD-CDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No pcp proph low cd4 norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9217","description":"No pcp proph low cd4 norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYE0","description":"ICD-CAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCC0","description":"ICD-BCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPC0","description":"ICD-GEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYF1","description":"ICD-GAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2384","description":"Pneumatic caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7190","description":"Factor viii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWD0","description":"ICD-HBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTE1","description":"ICD-GHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSF1","description":"ICD-DHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE204","description":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNB1","description":"ICD-KHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKA0","description":"ICD-GEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ewhfo w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3766","description":"Ewhfo w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27881","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMD0","description":"ICD-OBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0907T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","description":"CPT-0907T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVF1","description":"ICD-FFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPA1","description":"ICD-JAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB56","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVF1","description":"ICD-CEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pressure treatment esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43460","description":"Pressure treatment esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAE0","description":"ICD-CAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEF0","description":"ICD-NDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place cath thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36221","description":"Place cath thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOE0","description":"ICD-CFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEB0","description":"ICD-JEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Critical care addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99292","description":"Critical care addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDA0","description":"ICD-OBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo dbl solid stirrup band/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2020","description":"Kafo dbl solid stirrup band/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWB1","description":"ICD-KEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIF1","description":"ICD-FIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMD1","description":"ICD-NKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNF0","description":"ICD-NFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calcitonin stimul panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80410","description":"Calcitonin stimul panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1011","description":"Family assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50080","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMC1","description":"ICD-NAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXD0","description":"ICD-JEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open ablate liver tumor rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47380","description":"Open ablate liver tumor rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acupunct w/stimul 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97813","description":"Acupunct w/stimul 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28545","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore wound abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20102","description":"Explore wound abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHB0","description":"ICD-ICHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDE0","description":"ICD-GBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50130","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTE1","description":"ICD-JBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMA1","description":"ICD-GFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTE1","description":"ICD-IBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYD1","description":"ICD-HHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOD0","description":"ICD-CFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1095T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1095T","description":"CPT-1095T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smear wet mount saline/ink","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87210","description":"Smear wet mount saline/ink","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVD1","description":"ICD-CFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intens behave ther cardio dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0446","description":"Intens behave ther cardio dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOA1","description":"ICD-CGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDC1","description":"ICD-NBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of foot bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28122","description":"Partial removal of foot bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5944","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5944","description":"CDT-D5944","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free circulating DNA analysis of 83 or more genes_ interrogation for sequence variants_ gene copy number a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0326U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free circulating DNA analysis of 83 or more genes_ interrogation for sequence variants_ gene copy number a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJF1","description":"ICD-FEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXB1","description":"ICD-KCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test panel pricing code_ 22+ tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP22","description":"Auto.test panel pricing code_ 22+ tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBD0","description":"ICD-OBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUB0","description":"ICD-JDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx contour defects >10.0 cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11954","description":"Tx contour defects >10.0 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTD1","description":"ICD-GBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Combo ankle/foot prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5975","description":"Combo ankle/foot prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99239","description":"Hospital discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEB1","description":"ICD-NFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; each additional target lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76983","description":"Ultrasound_ elastography; each additional target lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXF1","description":"ICD-OKXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRF1","description":"ICD-GIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27715","description":"Revision of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKB1","description":"ICD-KHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31267","description":"Endoscopy maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ventral hern init reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49560","description":"Rpr ventral hern init reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clozapine_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0136","description":"Clozapine_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIF1","description":"ICD-OIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gi protein loss exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78282","description":"Gi protein loss exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLB1","description":"ICD-OJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCA1","description":"ICD-KCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLA0","description":"ICD-AGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0076","description":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFB1","description":"ICD-JDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo below knee alignable sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5910","description":"Endo below knee alignable sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61641","description":"Dilate ic vasospasm add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA42","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJE0","description":"ICD-OKJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBD0","description":"ICD-CIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAD1","description":"ICD-AGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBF0","description":"ICD-JHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; intercalary_ complete (ie_ cylindrical) (List separately in addition to code for prim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20934","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; intercalary_ complete (ie_ cylindrical) (List separately in addition to code for prim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWD0","description":"ICD-DAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28F","description":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKF1","description":"ICD-NLKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Next Generation ACO model_ 10-20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9869","description":"Next Generation ACO model_ 10-20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKB1","description":"ICD-OJKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull/brain biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61750","description":"Incise skull/brain biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEB1","description":"ICD-KCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMF1","description":"ICD-IIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAA0","description":"ICD-CFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEF0","description":"ICD-ECEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCF0","description":"ICD-OHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy for foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44390","description":"Colonoscopy for foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTC0","description":"ICD-MFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUA0","description":"ICD-JBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNF1","description":"ICD-ODNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADD1","description":"ICD-MADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBB0","description":"ICD-GGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBND1","description":"ICD-CBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAB0","description":"ICD-FCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection glatiramer acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1595","description":"Injection glatiramer acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKF0","description":"ICD-NDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0479U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","description":"CPT-0479U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvef>=40% doc normal or mild","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8395","description":"Lvef>=40% doc normal or mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ercp remove forgn body duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43275","description":"Ercp remove forgn body duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0801","description":"HCPCS-A0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ready gradient sleev/glov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8421","description":"Ready gradient sleev/glov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYC0","description":"ICD-OGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB225","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUF1","description":"ICD-IEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise reconst elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24371","description":"Revise reconst elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSF0","description":"ICD-HDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSF0","description":"ICD-PKSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bls-emergency","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0429","description":"Bls-emergency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIE0","description":"ICD-EAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMF0","description":"ICD-MEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVB0","description":"ICD-FGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUA0","description":"ICD-IBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXE0","description":"ICD-CAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKF0","description":"ICD-NJKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam spinal canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76800","description":"Us exam spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fix partial denture section","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9120","description":"Fix partial denture section","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2146","description":"Leg Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ avelumab_ 10mg (bavencio)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9491","description":"Injection_ avelumab_ 10mg (bavencio)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCB1","description":"ICD-NDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWD1","description":"ICD-CBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYB0","description":"ICD-LHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debridement of a periimplant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6101","description":"Debridement of a periimplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXA0","description":"ICD-JCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBB1","description":"ICD-NJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEC1","description":"ICD-NBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ histochemical stain on frozen tissue block (List separately in addition to code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0758T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ histochemical stain on frozen tissue block (List separately in addition to code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mast rad urban type","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19306","description":"Mast rad urban type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood Component Or Product Not Otherwise Classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9099","description":"Blood Component Or Product Not Otherwise Classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel)_ radiological supervision and interpretation; each additional non-coronary vessel (list separately in addition to c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75946","description":"Intravascular ultrasound (non-coronary vessel)_ radiological supervision and interpretation; each additional non-coronary vessel (list separately in addition to c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHED0","description":"ICD-JHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0880T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARA0","description":"ICD-DARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRC0","description":"ICD-PBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETE0","description":"ICD-OETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHB0","description":"ICD-AFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bp scrn perf rec interval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8783","description":"Bp scrn perf rec interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8G","description":"Low Rehab_ ADL Index 0-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26785","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTC0","description":"ICD-FGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOF1","description":"ICD-DHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUA1","description":"ICD-NAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENB1","description":"ICD-OENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUB0","description":"ICD-ABUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFF0","description":"ICD-NCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCE0","description":"ICD-AHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hfo w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3921","description":"Hfo w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB104","description":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine pregnancy test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81025","description":"Urine pregnancy test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGE0","description":"ICD-JCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMB0","description":"ICD-OKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1368","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flowcytometry/ tc 1 marker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88184","description":"Flowcytometry/ tc 1 marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQC1","description":"ICD-CAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63053","description":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test 4 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95864","description":"Muscle test 4 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing complete hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81379","description":"Hla i typing complete hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62258","description":"Replace brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28636","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB220","description":"Clinically Complex _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25670","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso corset front","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0972","description":"Lso corset front","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHB1","description":"ICD-BCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Graft repair of spine defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63710","description":"Graft repair of spine defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0106","description":"HCPCS-A0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESC1","description":"ICD-HESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYB0","description":"ICD-DBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEF0","description":"ICD-KHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem endovas vena cava filter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37193","description":"Rem endovas vena cava filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin frct swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5818","description":"Endo knee-shin frct swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33710","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUC1","description":"ICD-JHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rear whl complete solid tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0069","description":"Rear whl complete solid tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQD1","description":"ICD-HFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKC1","description":"ICD-JHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVC0","description":"ICD-BDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHF1","description":"ICD-GGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25B","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWE0","description":"ICD-GHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1404","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1404","description":"CDT-D1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAC0","description":"ICD-EIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59812","description":"Treatment of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31205","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METF1","description":"ICD-METF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSB1","description":"ICD-GCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87590","description":"N.gonorrhoeae dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIE0","description":"ICD-FEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOF0","description":"ICD-GAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYA0","description":"ICD-OAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHA0","description":"ICD-NAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXE0","description":"ICD-BGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDB1","description":"ICD-FEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1102","description":"HCPCS-B1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIE0","description":"ICD-KIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove self-contd penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54415","description":"Remove self-contd penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/cont_ com","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8921","description":"Tte w or w/o fol w/cont_ com","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oth resp proc_ indiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0238","description":"Oth resp proc_ indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50780","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUD1","description":"ICD-OFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMA1","description":"ICD-KCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUF1","description":"ICD-KBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEC0","description":"ICD-EIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFF1","description":"ICD-OGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBC0","description":"ICD-FFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBE1","description":"ICD-CFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Symptom&sign symm polyneuro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1500F","description":"Symptom&sign symm polyneuro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Musculoskeletal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20999","description":"Musculoskeletal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed total elect w/ matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0296","description":"Hosp bed total elect w/ matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHF0","description":"ICD-NCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove exostosis maxilla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21032","description":"Remove exostosis maxilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIC1","description":"ICD-CEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBC0","description":"ICD-NFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALC1","description":"ICD-OALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHE0","description":"ICD-CHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDB1","description":"ICD-JCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFA1","description":"ICD-BGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCF0","description":"ICD-JFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vitamin k phytonadione inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3430","description":"Vitamin k phytonadione inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76516","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGC1","description":"ICD-JEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45384","description":"Colonoscopy w/lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cptr dbs alys car elec dta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0206T","description":"Cptr dbs alys car elec dta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYB1","description":"ICD-KFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJA1","description":"ICD-GCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheeled cart_ port cyl/conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1354","description":"Wheeled cart_ port cyl/conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELD1","description":"ICD-EELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC16","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAD0","description":"ICD-CEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES124","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRD0","description":"ICD-CIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 4999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4725","description":"Dialys sol fld vol > 4999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext amb insulin delivery sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9274","description":"Ext amb insulin delivery sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRC1","description":"ICD-PIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Topical fluoride varnish","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1206","description":"Topical fluoride varnish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28I","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No start/rec antvir tx hep c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9499","description":"No start/rec antvir tx hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27509","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12C","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCE0","description":"ICD-ACCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGE0","description":"ICD-NEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJC1","description":"ICD-BFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFD1","description":"ICD-NLFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIE1","description":"ICD-EAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJD1","description":"ICD-KIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPF1","description":"ICD-KCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1801","description":"HCPCS-A1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maxilla open reduct compound","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7710","description":"Maxilla open reduct compound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Swallow current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8996","description":"Swallow current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27705","description":"Incision of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s) of sclerosant for spider veins (telangiectasia)_ limb or trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36468","description":"Injection(s) of sclerosant for spider veins (telangiectasia)_ limb or trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test socket hip disarticulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5626","description":"Test socket hip disarticulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMB0","description":"ICD-NJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treponema pallidum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86780","description":"Treponema pallidum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of heel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73650","description":"X-ray exam of heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIF0","description":"ICD-JHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDB0","description":"ICD-JBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCA1","description":"ICD-JDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1202","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1202","description":"CDT-D1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpretation required","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36907","description":"Transluminal balloon angioplasty_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpretation required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21246","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor stent ather s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9602","description":"Perc d-e cor stent ather s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v index add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88155","description":"Cytopath c/v index add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral prescription drug chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8999","description":"Oral prescription drug chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metacarpophalangeal implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8630","description":"Metacarpophalangeal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX54","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUC0","description":"ICD-FEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDD1","description":"ICD-BCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76390","description":"Mr spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23462","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/snare","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44394","description":"Colonoscopy w/snare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9275","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","description":"HCPCS-J9275","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYF1","description":"ICD-PCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Renin stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80416","description":"Renin stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Procalcitonin (pct)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84145","description":"Procalcitonin (pct)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKE1","description":"ICD-NJKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBD1","description":"ICD-FFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGB0","description":"ICD-CCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio abdom w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74175","description":"Ct angio abdom w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Uvl md cabinet sys 6 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0694","description":"Uvl md cabinet sys 6 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quality care for the treatment of ear_ nose_ and throat disorders mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1367","description":"Quality care for the treatment of ear_ nose_ and throat disorders mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 1 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3384F","description":"Ajcc cln cncr stage 1 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eo elas w/metal jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3710","description":"Eo elas w/metal jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJD1","description":"ICD-ODJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14A","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEME0","description":"ICD-FEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25445","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32215","description":"Treat chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKE1","description":"ICD-NKKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGA0","description":"ICD-CBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFB0","description":"ICD-NFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA116","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28F","description":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJE1","description":"ICD-KFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCA0","description":"ICD-FHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Or Care Partner Decline Assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0036","description":"Patient Or Care Partner Decline Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIC1","description":"ICD-KBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compress burn mask face/neck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6513","description":"Compress burn mask face/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sps wrist device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1806","description":"Sps wrist device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain neck/chest lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21501","description":"Drain neck/chest lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75801","description":"Lymph vessel x-ray arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUC1","description":"ICD-OLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUF0","description":"ICD-ABUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caster fork replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2226","description":"Caster fork replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1048T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1048T","description":"CPT-1048T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGF1","description":"ICD-JEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTF0","description":"ICD-BGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71551","description":"MRI chest w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"40-75y w/type 1/2 w/ldl-c rs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9676","description":"40-75y w/type 1/2 w/ldl-c rs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTD0","description":"ICD-EDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ThyGeNEXT® Thyroid Oncogene Panel_ Interpace Diagnostics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0245U","description":"ThyGeNEXT® Thyroid Oncogene Panel_ Interpace Diagnostics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPC0","description":"ICD-NFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67903","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXA0","description":"ICD-NAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLC0","description":"ICD-CDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHB0","description":"ICD-IBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0797T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUE0","description":"ICD-KHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIA0","description":"ICD-GHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indwelling trach insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8511","description":"Indwelling trach insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36660","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1034T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1034T","description":"CPT-1034T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPF1","description":"ICD-CBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYC1","description":"ICD-DIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJE0","description":"ICD-NEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCD0","description":"ICD-GGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive Care Management Services For A Single High-Risk Disease_ E.G._ Principal Care Management_ At Least 30 Minutes Of Physician  Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2064","description":"Comprehensive Care Management Services For A Single High-Risk Disease_ E.G._ Principal Care Management_ At Least 30 Minutes Of Physician  Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKA1","description":"ICD-GDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVF0","description":"ICD-JAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGC0","description":"ICD-OKGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCD1","description":"ICD-BGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPD1","description":"ICD-BBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHE0","description":"ICD-BAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bladder neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51845","description":"Repair bladder neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOE1","description":"ICD-PHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOB0","description":"ICD-PGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWB1","description":"ICD-CCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50557","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEE1","description":"ICD-GDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0571","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","description":"HCPCS-G0571","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of aldosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82088","description":"Assay of aldosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVC0","description":"ICD-NBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDA1","description":"ICD-OLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFE1","description":"ICD-OKFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOA1","description":"ICD-KIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUF1","description":"ICD-GDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGD1","description":"ICD-KGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQD1","description":"ICD-HEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWC0","description":"ICD-CCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9701","description":"Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRA1","description":"ICD-GDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"So 8 abd restraint pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3650","description":"So 8 abd restraint pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01250","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","description":"CPT-01250","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92634","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","description":"CPT-92634","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAC0","description":"ICD-NEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAE1","description":"ICD-NKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand tendon/muscle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26494","description":"Hand tendon/muscle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enuresis alarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8270","description":"Enuresis alarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulse gen sys tx endolymp fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2120","description":"Pulse gen sys tx endolymp fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of eye thickness","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76514","description":"Echo exam of eye thickness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21184","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHA1","description":"ICD-OEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMB1","description":"ICD-GDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1081","description":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGC1","description":"ICD-JHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSE0","description":"ICD-CCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dolasetron mesylate oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0180","description":"Dolasetron mesylate oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2C","description":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVD0","description":"ICD-NAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCF1","description":"ICD-KCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVC1","description":"ICD-ODVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOD0","description":"ICD-LCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHME0","description":"ICD-NHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (hospira) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9294","description":"Injection_ pemetrexed (hospira) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXE1","description":"ICD-FFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc scr uter mal or us/samp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9618","description":"Doc scr uter mal or us/samp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Not Referred_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0039","description":"Patient Not Referred_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJD1","description":"ICD-KBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemical peel nonfacial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15793","description":"Chemical peel nonfacial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQE1","description":"ICD-CBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYD0","description":"ICD-PAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interscapular-thor switch ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6970","description":"Interscapular-thor switch ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein amniotic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82106","description":"Alpha-fetoprotein amniotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGE0","description":"ICD-BFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8I","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWB1","description":"ICD-OFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dementia mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8761","description":"Dementia mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCE0","description":"ICD-EDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8E","description":"Very High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUB0","description":"ICD-NCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of skull tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61563","description":"Excision of skull tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARD0","description":"ICD-DARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAC1","description":"ICD-MGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE104","description":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8B","description":"Medium Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fracture assessment via dxa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77086","description":"Fracture assessment via dxa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC35","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNF1","description":"ICD-JBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDA1","description":"ICD-NEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metaproterenol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7669","description":"Metaproterenol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Receiving <=5 Mg Daily Prednisone (Or Equivalent)_ Or Ra Activity Is Worsening_ Or Glucocorticoid Use Is For Less Than 6 Months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2112","description":"Patient Receiving <=5 Mg Daily Prednisone (Or Equivalent)_ Or Ra Activity Is Worsening_ Or Glucocorticoid Use Is For Less Than 6 Months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEND0","description":"ICD-JEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDC1","description":"ICD-NDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pseudoaneurysm injection trt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36002","description":"Pseudoaneurysm injection trt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq lamot/lam crv/thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0274T","description":"Perq lamot/lam crv/thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIC0","description":"ICD-OCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPF0","description":"ICD-FCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPD0","description":"ICD-KDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASA0","description":"ICD-HASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTC0","description":"ICD-MLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay urine catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82382","description":"Assay urine catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIID1","description":"ICD-NIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSE1","description":"ICD-GFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glucagon hydrochloride/1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1610","description":"Glucagon hydrochloride/1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having records of negative or managed positive TB screen (e.g._ patient does not return for Mantoux (PPD) skin test evaluation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9932","description":"Documentation of patient reason(s) for not having records of negative or managed positive TB screen (e.g._ patient does not return for Mantoux (PPD) skin test evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1411","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","description":"HCPCS-M1411","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long arm ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4007","description":"Cast sup long arm ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90481","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","description":"CPT-90481","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQA0","description":"ICD-HIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive ear/neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69155","description":"Extensive ear/neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPD1","description":"ICD-JCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Teflon or equal cable lining","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6665","description":"Teflon or equal cable lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB11","description":"ICD-3CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEND0","description":"ICD-OEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUA1","description":"ICD-IIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJF1","description":"ICD-KIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infect disease (bact)_ DNA_ 27 resistance genes_ PCR amplification and probe hybridization in microarray format (molecular detection and identification of AmpC_ carbapenemas)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004U","description":"Infect disease (bact)_ DNA_ 27 resistance genes_ PCR amplification and probe hybridization in microarray format (molecular detection and identification of AmpC_ carbapenemas)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMD1","description":"ICD-MCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATA0","description":"ICD-AATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep b vac series prev recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4157F","description":"Hep b vac series prev recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8F","description":"Medium Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIF1","description":"ICD-IFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA12","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69706","description":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Portable home suction pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0743","description":"Portable home suction pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prednisolone acetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2650","description":"Prednisolone acetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXD0","description":"ICD-FHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCME1","description":"ICD-KCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVC0","description":"ICD-OGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDED0","description":"ICD-JDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEB1","description":"ICD-NBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1131","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKF0","description":"ICD-FHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIE1","description":"ICD-CFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cranial Electrotherapy Stimulation (Ces) System_ Includes All Supplies And Accessories_ Any Type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1002","description":"Cranial Electrotherapy Stimulation (Ces) System_ Includes All Supplies And Accessories_ Any Type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJE0","description":"ICD-OGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31020","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD112","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDC0","description":"ICD-FGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUE1","description":"ICD-EGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAE1","description":"ICD-NJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRA1","description":"ICD-GIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHC1","description":"ICD-EGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13D","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA26","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6980","description":"Bridge repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gammagard liquid injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1569","description":"Gammagard liquid injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonprim loc anat bx site tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3250F","description":"Nonprim loc anat bx site tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANB1","description":"ICD-GANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0680","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","description":"HCPCS-G0680","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27006","description":"Incision of hip tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect clavicle tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23200","description":"Resect clavicle tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13152","description":"Cmplx rpr e/n/e/l 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No bp measure doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8756","description":"No bp measure doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIE0","description":"ICD-KBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGB1","description":"ICD-OHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINB1","description":"ICD-BINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPA0","description":"ICD-JCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0106","description":"HCPCS-C0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23C","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBED0","description":"ICD-NBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Graft_ vascular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1768","description":"Graft_ vascular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAD1","description":"ICD-JHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01442","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","description":"CPT-01442","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8H","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gallium Ga-68 gozetotide_ diagnostic_ (Illuccix)_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9596","description":"Gallium Ga-68 gozetotide_ diagnostic_ (Illuccix)_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artificial insemination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58321","description":"Artificial insemination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","description":"HCPCS-M1375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYE1","description":"ICD-OFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco-use counsel 3-10 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0436","description":"Tobacco-use counsel 3-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRC1","description":"ICD-PLRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBC0","description":"ICD-ADBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Malig tumor > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7441","description":"Malig tumor > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical exposure prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55860","description":"Surgical exposure prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy pyeloplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50544","description":"Laparoscopy pyeloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVC1","description":"ICD-CFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEE1","description":"ICD-GFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWF1","description":"ICD-KBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDF1","description":"ICD-GBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIB0","description":"ICD-CAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acesso_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4311","description":"Acesso_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIF0","description":"ICD-CFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPD1","description":"ICD-OJPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Set-up cardiovert-defibrill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93745","description":"Set-up cardiovert-defibrill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRC1","description":"ICD-LBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29870","description":"Knee arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of spine 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72020","description":"X-ray exam of spine 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJE0","description":"ICD-JCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit tocolysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9349","description":"Hit tocolysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQD1","description":"ICD-ODQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFF1","description":"ICD-OLFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLD0","description":"ICD-ACLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISE1","description":"ICD-GISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nusinersen_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2326","description":"Injection_ nusinersen_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk addl 5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13102","description":"Cmplx rpr trunk addl 5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVD0","description":"ICD-BIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEA0","description":"ICD-MIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gravity assisted traction de","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0941","description":"Gravity assisted traction de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJA1","description":"ICD-CEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd optical endomicroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43252","description":"Egd optical endomicroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA55","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optimizing Chronic Disease Management Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0056","description":"Optimizing Chronic Disease Management Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retreat root canal molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3348","description":"Retreat root canal molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"DermaBind FM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4313","description":"DermaBind FM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown-indirect resin based","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6710","description":"Crown-indirect resin based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFE1","description":"ICD-JEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIA0","description":"ICD-BBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of cannula(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36823","description":"Insertion of cannula(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCD0","description":"ICD-BCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rheumatoid factor test qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86430","description":"Rheumatoid factor test qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"General Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4007","description":"General Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUC1","description":"ICD-GEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUA1","description":"ICD-BGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHF1","description":"ICD-IIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients receiving high doses of immunosuppressive therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1063","description":"Patients receiving high doses of immunosuppressive therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2641","description":"Brachytx_ non-stranded_p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Personal Emergency Response System (Monthly Maintenance)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1895","description":"Personal Emergency Response System (Monthly Maintenance)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXD0","description":"ICD-BEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLB0","description":"ICD-AHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCND1","description":"ICD-CCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Most recent hemoblobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3051F","description":"Most recent hemoblobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMF1","description":"ICD-KEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFB1","description":"ICD-OHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDA1","description":"ICD-IFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLD0","description":"ICD-BCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCB1","description":"ICD-MHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLA0","description":"ICD-NHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUB1","description":"ICD-MHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt edu re alcoh drnkng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4158F","description":"Pt edu re alcoh drnkng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18F","description":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occult blood feces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82270","description":"Occult blood feces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res Copd/As Bill Sid-Bnef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9681","description":"Onsite Ac C Tx Nsg Fac Res Copd/As Bill Sid-Bnef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Masters two step","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3904","description":"Masters two step","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB14","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0D","description":"High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diphenhydramine hcl injectio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1200","description":"Diphenhydramine hcl injectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFB0","description":"ICD-BCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQC0","description":"ICD-OIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANE1","description":"ICD-JANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28G","description":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of glycated protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82985","description":"Assay of glycated protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81450","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIND0","description":"ICD-BIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOF0","description":"ICD-CIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUB0","description":"ICD-JHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glycopyrrolate comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7642","description":"Glycopyrrolate comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54385","description":"Repair penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOC0","description":"ICD-OCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration_ autologous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0540T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration_ autologous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQA0","description":"ICD-LGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace tissue expander","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11970","description":"Replace tissue expander","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Laser Surgical Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0617","description":"Hospital Special Treatment Room Support Component (Hstrsc) Laser Surgical Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33745","description":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen dressing >48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6023","description":"Collagen dressing >48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmptr ophth img optic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92133","description":"Cmptr ophth img optic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99232","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasm)_ optical genome mapping for copy number alterations_ aneuploidy_ and balanced/complex structural rearrangements_ DNA from blood or bone marr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0413U","description":"Oncology (hematolymphoid neoplasm)_ optical genome mapping for copy number alterations_ aneuploidy_ and balanced/complex structural rearrangements_ DNA from blood or bone marr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQF0","description":"ICD-KGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myomectomy abdom complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58146","description":"Myomectomy abdom complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB50","description":"High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABA0","description":"ICD-AABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Granulocytes_ pheresis unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9050","description":"Granulocytes_ pheresis unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEB0","description":"ICD-AFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJC1","description":"ICD-CBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma scrn hgh risk direc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0117","description":"Glaucoma scrn hgh risk direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin pro/pos wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2608","description":"Skin pro/pos wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disease progn ra poor docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3475F","description":"Disease progn ra poor docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72197","description":"MRI pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gliadin (Deamidated) (Dgp) Antibody_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86258","description":"Gliadin (Deamidated) (Dgp) Antibody_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asp not presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9437","description":"Asp not presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4243","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4243","description":"HCPCS-Q4243","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLD0","description":"ICD-NHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHA1","description":"ICD-IEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI uppr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73220","description":"MRI uppr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55725","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAF0","description":"ICD-OJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUB0","description":"ICD-FGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNA0","description":"ICD-CHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES245","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1301","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1301","description":"CDT-D1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputate metacarpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26910","description":"Amputate metacarpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVB1","description":"ICD-JAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osseous surgl-3teethperquad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4261","description":"Osseous surgl-3teethperquad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXF1","description":"ICD-OFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJA1","description":"ICD-KCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 0.5cm<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11640","description":"Exc f/e/e/n/l mal+mrg 0.5cm<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus)_ derived from anatomical image da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0745T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus)_ derived from anatomical image da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWA1","description":"ICD-PKWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tail bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27080","description":"Removal of tail bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Transcriptome Sequencing Of Paired Malignant And Normal Rna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0298U","description":"Oncology (Pan Tumor)_ Whole Transcriptome Sequencing Of Paired Malignant And Normal Rna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; each additional hour_ including physiological and laboratory assessments (eg_ perfu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0896T","description":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; each additional hour_ including physiological and laboratory assessments (eg_ perfu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair maxillofacial defects","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7955","description":"Repair maxillofacial defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening pregabalin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80366","description":"Drug screening pregabalin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQE1","description":"ICD-CDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41005","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Viper venom prothrombin time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85612","description":"Viper venom prothrombin time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPF1","description":"ICD-KBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEB0","description":"ICD-BEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0851","description":"Pwc gp 3 hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hf measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8548","description":"Hf measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWB0","description":"ICD-CDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cephalin floculation test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2028","description":"Cephalin floculation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEA0","description":"ICD-AFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct chest spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72130","description":"Ct chest spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21C","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIB0","description":"ICD-CEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54420","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dem severity classified mild","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1490F","description":"Dem severity classified mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Signature APatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4260","description":"Signature APatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAD1","description":"ICD-OBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myelography l-s spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72265","description":"Myelography l-s spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5D","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEC0","description":"ICD-GAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQE1","description":"ICD-HCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74018","description":"Radiologic examination_ abdomen; 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFC1","description":"ICD-CHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv eccrine glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64650","description":"Chemodenerv eccrine glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEE0","description":"ICD-OKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99380","description":"Nursing fac care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mouth piece","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4617","description":"Mouth piece","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Per pm reeval est pat 65+ yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99397","description":"Per pm reeval est pat 65+ yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMA1","description":"ICD-KFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQD1","description":"ICD-LCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood gases any combination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82803","description":"Blood gases any combination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIF1","description":"ICD-BEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47122","description":"Extensive removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPB0","description":"ICD-GIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWD0","description":"ICD-OGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGF1","description":"ICD-BEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE151","description":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB03","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2C","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNF0","description":"ICD-CGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise excess skin arm/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15837","description":"Excise excess skin arm/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0622U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","description":"CPT-0622U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25360","description":"Revision of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVE0","description":"ICD-CGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24498","description":"Reinforce humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESD1","description":"ICD-GESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65800","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7401","description":"Mometasone furoate sinus implant_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debride infected skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11000","description":"Debride infected skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJE1","description":"ICD-BGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRF1","description":"ICD-CHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHB1","description":"ICD-AHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rprt bone scint xref w xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3570F","description":"Rprt bone scint xref w xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meg evoked each addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95967","description":"Meg evoked each addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L5657","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","description":"HCPCS-L5657","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (with or without the patient present)_ face-to-face with gua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97156","description":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (with or without the patient present)_ face-to-face with gua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVB1","description":"ICD-BGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thyroid imaging w/blood flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78013","description":"Thyroid imaging w/blood flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGC0","description":"ICD-OHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBC1","description":"ICD-OKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49592","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Internal root repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3333","description":"Internal root repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQD0","description":"ICD-LGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAF1","description":"ICD-BCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUA1","description":"ICD-OBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adoptive immunotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2107","description":"Adoptive immunotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXD0","description":"ICD-JIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHA0","description":"ICD-CIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"R&l hrt cath w/ventriclgrphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93453","description":"R&l hrt cath w/ventriclgrphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RenoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4321","description":"RenoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28D","description":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogen micrarray copy nmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81228","description":"Cytogen micrarray copy nmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFC0","description":"ICD-JIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0305","description":"HCPCS-A0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22B","description":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCB0","description":"ICD-OHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metoclopramide hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2765","description":"Metoclopramide hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65270","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPF0","description":"ICD-FEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKD1","description":"ICD-JGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWF0","description":"ICD-DIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Facial moulage sectional","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5911","description":"Facial moulage sectional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA11","description":"ICD-1KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJA0","description":"ICD-BAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOA1","description":"ICD-PAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBF0","description":"ICD-FIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITC1","description":"ICD-MITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBF0","description":"ICD-BBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4372","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","description":"HCPCS-Q4372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42970","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCB0","description":"ICD-MJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of finger splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29130","description":"Application of finger splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKF1","description":"ICD-OAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPF0","description":"ICD-JFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antineutrophil Cytoplasmic Antibody (Anca); Titer_ Each Antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86037","description":"Antineutrophil Cytoplasmic Antibody (Anca); Titer_ Each Antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exposure impact tooth orthod","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7280","description":"Exposure impact tooth orthod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie_ external genitalia_ perineum_ abdominal wall) due to soft tissue infection or trauma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15778","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie_ external genitalia_ perineum_ abdominal wall) due to soft tissue infection or trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93316","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of shoulders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73050","description":"X-ray exam of shoulders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No oder pjp for med reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9219","description":"No oder pjp for med reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gen w/c cushion wdth >=22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2602","description":"Gen w/c cushion wdth >=22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNC0","description":"ICD-GDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA136","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBA0","description":"ICD-FFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTD1","description":"ICD-NKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECB1","description":"ICD-EECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Full mouth debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4355","description":"Full mouth debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8040","description":"Nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza imm order/admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4037F","description":"Influenza imm order/admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOD0","description":"ICD-DDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEB0","description":"ICD-OBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA21","description":"ICD-4KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49596","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring_ including deployment and calibration of the sensor_ right heart c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33289","description":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring_ including deployment and calibration of the sensor_ right heart c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXA1","description":"ICD-KFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDF0","description":"ICD-CGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALF1","description":"ICD-IALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vc lesion w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31545","description":"Remove vc lesion w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAF1","description":"ICD-GEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNB1","description":"ICD-FCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGB1","description":"ICD-FDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDA0","description":"ICD-FBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lo sag ri an/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0642","description":"Lo sag ri an/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMD0","description":"ICD-NAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISA1","description":"ICD-CISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJC1","description":"ICD-GBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKC1","description":"ICD-OKKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPF1","description":"ICD-GAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Toc dur aneth to icu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9657","description":"Toc dur aneth to icu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPC0","description":"ICD-KCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKE0","description":"ICD-OCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Promoting wellness mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0005","description":"Promoting wellness mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCB1","description":"ICD-KCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB21","description":"ICD-1KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; each additional 30 minutes (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96548","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; each additional 30 minutes (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABC1","description":"ICD-FABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGC0","description":"ICD-OGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPA0","description":"ICD-FDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocyte culture primed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86822","description":"Lymphocyte culture primed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26460","description":"Incise hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fabrication of a custom removable clear plastic temporary aesthetic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9938","description":"Fabrication of a custom removable clear plastic temporary aesthetic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYC0","description":"ICD-OLYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADE1","description":"ICD-OADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJND0","description":"ICD-OJND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0674U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674U","description":"CPT-0674U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEA1","description":"ICD-FEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDC1","description":"ICD-IDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOE1","description":"ICD-GEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTD1","description":"ICD-ADTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2956","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2956","description":"CDT-D2956","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00124","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","description":"CPT-00124","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXC0","description":"ICD-GCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55600","description":"Incise sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXC0","description":"ICD-BIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIED0","description":"ICD-FIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX14","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydroxyurea 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0176","description":"Hydroxyurea 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBC0","description":"ICD-JEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Voice goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9172","description":"Voice goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy remove lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46610","description":"Anoscopy remove lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCE1","description":"ICD-AFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Solid Organ Neoplasm)_ Targeted Genomic Sequence Dna Analysis Of 505 Genes_ Interrogation For Somatic Alterations (Snvs [Single Nucleotide Variant]_ Small Insertions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0250U","description":"Oncology (Solid Organ Neoplasm)_ Targeted Genomic Sequence Dna Analysis Of 505 Genes_ Interrogation For Somatic Alterations (Snvs [Single Nucleotide Variant]_ Small Insertions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLC0","description":"ICD-CBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRA1","description":"ICD-DGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D7252","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D7252","description":"CDT-D7252","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0519U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","description":"CPT-0519U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARE1","description":"ICD-PARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace socket above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5701","description":"Replace socket above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect leg/ankle tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27616","description":"Resect leg/ankle tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOC0","description":"ICD-PCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: moderate complexity_ requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97162","description":"Physical therapy evaluation: moderate complexity_ requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQB0","description":"ICD-KEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKC1","description":"ICD-FCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYD1","description":"ICD-HFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGE0","description":"ICD-JBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35103","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQD0","description":"ICD-KHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30460","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL22","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUE0","description":"ICD-ADUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gjb6 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81254","description":"Gjb6 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse liver ducts & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47765","description":"Fuse liver ducts & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJB0","description":"ICD-FAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA22","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace duod/jej tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49451","description":"Replace duod/jej tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWA0","description":"ICD-PJWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28675","description":"Repair of toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXD0","description":"ICD-FFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC01","description":"Very High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Language screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5363","description":"Language screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUE0","description":"ICD-BFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temp fml iu valve-pmp rplcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0597T","description":"Temp fml iu valve-pmp rplcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0944T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","description":"CPT-0944T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18D","description":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDC1","description":"ICD-NCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair art intramural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33507","description":"Repair art intramural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCC1","description":"ICD-NKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAF1","description":"ICD-OLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBA1","description":"ICD-CFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJED1","description":"ICD-OJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00873","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","description":"CPT-00873","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKC0","description":"ICD-GHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection pantroprazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0164","description":"Injection pantroprazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFD0","description":"ICD-JGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEA0","description":"ICD-NHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGND1","description":"ICD-BGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1453","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","description":"HCPCS-M1453","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJF1","description":"ICD-KDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray kidneys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75833","description":"Vein x-ray kidneys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEC0","description":"ICD-NDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGB1","description":"ICD-NIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYD0","description":"ICD-CEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct uppr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73202","description":"Ct uppr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYD0","description":"ICD-OKYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bath tub rail floor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0242","description":"Bath tub rail floor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trismus appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5937","description":"Trismus appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQD0","description":"ICD-PHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53025","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHD0","description":"ICD-BAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKF1","description":"ICD-FFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Disease Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4010","description":"Infectious Disease Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCB0","description":"ICD-MKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open red simp malar/zygom fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7650","description":"Open red simp malar/zygom fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOE0","description":"ICD-OLOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYE1","description":"ICD-DBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24A","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYD1","description":"ICD-KGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQB1","description":"ICD-OFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap paraesophag hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43281","description":"Lap paraesophag hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auditory Evoked Potentials; For Hearing Status Determination_ Broadband Stimuli_ With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92651","description":"Auditory Evoked Potentials; For Hearing Status Determination_ Broadband Stimuli_ With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLB0","description":"ICD-IGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recd f/u w/in 7d disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9405","description":"Recd f/u w/in 7d disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1052T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1052T","description":"CPT-1052T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFB1","description":"ICD-BGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAA0","description":"ICD-BHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Basic life disability exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99450","description":"Basic life disability exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACD1","description":"ICD-IACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHC0","description":"ICD-CBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQA0","description":"ICD-GCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cidofovir injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0740","description":"Cidofovir injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49614","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99304","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45110","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAC0","description":"ICD-KDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKF1","description":"ICD-OKKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Erwinaze injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9019","description":"Erwinaze injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE250","description":"Special Care Low _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comm trans waiver/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2038","description":"Comm trans waiver/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87591","description":"N.gonorrhoeae dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Methadone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2067","description":"Medication Assisted Treatment_ Methadone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYB1","description":"ICD-PCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMA1","description":"ICD-EAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQC1","description":"ICD-CEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUE1","description":"ICD-GAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replc tth&acrlc on mtl frmwk","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5670","description":"Replc tth&acrlc on mtl frmwk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ONC SLD TUM ALYS BRCA1 BRCA2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172U","description":"ONC SLD TUM ALYS BRCA1 BRCA2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCA0","description":"ICD-JGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC51","description":"High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHE0","description":"ICD-EAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPB1","description":"ICD-FEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx complx malar w/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21366","description":"Opn tx complx malar w/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRF1","description":"ICD-PHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWF0","description":"ICD-OGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMF1","description":"ICD-NFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of skin abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10060","description":"Drainage of skin abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of anal septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46070","description":"Incision of anal septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15D","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE210","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g._ audit_ DAST)_ and brief intervention_ 5-14 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2011","description":"Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g._ audit_ DAST)_ and brief intervention_ 5-14 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGC0","description":"ICD-NAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90593","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","description":"CPT-90593","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACA1","description":"ICD-JACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQC0","description":"ICD-CHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSC0","description":"ICD-KBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLND0","description":"ICD-NLND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVD0","description":"ICD-OJVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJB1","description":"ICD-NHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22A","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOF0","description":"ICD-KBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens gas impermeable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2530","description":"Contact lens gas impermeable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXD1","description":"ICD-GIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct angiography neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70498","description":"Ct angiography neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXB0","description":"ICD-KFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reproductive Medicine (Endometrial Receptivity Analysis)_ Rna Gene Expression Profile_ 238 Genes By Next-Generation Sequencing_ Endometrial Tissue_ Predictive Algorithm Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0253U","description":"Reproductive Medicine (Endometrial Receptivity Analysis)_ Rna Gene Expression Profile_ 238 Genes By Next-Generation Sequencing_ Endometrial Tissue_ Predictive Algorithm Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genotype dna/rna hiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87906","description":"Genotype dna/rna hiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9849","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOA0","description":"ICD-DDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35884","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPD1","description":"ICD-OCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIA1","description":"ICD-MFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHE1","description":"ICD-GDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMA1","description":"ICD-MHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHA0","description":"ICD-BGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLF1","description":"ICD-MJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDD1","description":"ICD-CFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo urethral suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51990","description":"Laparo urethral suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKD1","description":"ICD-FIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of spleen partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38101","description":"Removal of spleen partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap ing hernia repair recur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49651","description":"Lap ing hernia repair recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPE1","description":"ICD-NEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83069","description":"Assay of urine hemoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81167","description":"BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tte f-up or lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93308","description":"Tte f-up or lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0502","description":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ethosuximide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80168","description":"Assay of ethosuximide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVF1","description":"ICD-OLVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIF1","description":"ICD-KEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSC1","description":"ICD-LFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2D","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEC0","description":"ICD-KFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ esophageal sphincter augmentation procedure_ placement of sphincter augmentation device (ie_ magnetic band)_ including cruroplasty when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43284","description":"Laparoscopy_ surgical_ esophageal sphincter augmentation procedure_ placement of sphincter augmentation device (ie_ magnetic band)_ including cruroplasty when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYD1","description":"ICD-KHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMA0","description":"ICD-EHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXF0","description":"ICD-FDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSB0","description":"ICD-KGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bactericidal level serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87197","description":"Bactericidal level serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0673","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0673","description":"HCPCS-G0673","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood platelet aggregation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85576","description":"Blood platelet aggregation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0441T","description":"Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRD0","description":"ICD-OJRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0101","description":"HCPCS-C0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1439","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","description":"HCPCS-M1439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHD0","description":"ICD-JFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test def 8-14 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0481","description":"Drug test def 8-14 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bendamustine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9033","description":"Bendamustine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18A","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 hd sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0859","description":"Pwc gp3 hd sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise ulnar nerve at elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64718","description":"Revise ulnar nerve at elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2044","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","description":"HCPCS-A2044","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRA0","description":"ICD-DHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC31","description":"ICD-3AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAD0","description":"ICD-EAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient alive as of the last day of the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9787","description":"Patient alive as of the last day of the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acp discuss-no dscnmkr docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1124F","description":"Acp discuss-no dscnmkr docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOB0","description":"ICD-LBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHF1","description":"ICD-MGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional neuromuscularstim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0764","description":"Functional neuromuscularstim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0803","description":"HCPCS-C0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTD0","description":"ICD-OFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flu immunize order/admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8482","description":"Flu immunize order/admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMB0","description":"ICD-CBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orth foot add charge split s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3257","description":"Orth foot add charge split s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acid perfusion of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91030","description":"Acid perfusion of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc depletion of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38212","description":"Rbc depletion of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQF0","description":"ICD-HCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27437","description":"Revise kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise bladder & ureter(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51565","description":"Revise bladder & ureter(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTC0","description":"ICD-KGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28H","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBB0","description":"ICD-OGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDA1","description":"ICD-MEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUF1","description":"ICD-BIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vbac delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59610","description":"Vbac delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRB0","description":"ICD-DIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cervical cap contraceptive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4261","description":"Cervical cap contraceptive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUF0","description":"ICD-EDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABD1","description":"ICD-IABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37700","description":"Revise leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTA0","description":"ICD-AFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Capillary blood draw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36416","description":"Capillary blood draw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNE1","description":"ICD-BHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bio imm resp mod presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9506","description":"Bio imm resp mod presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8E","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDC0","description":"ICD-EDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEB1","description":"ICD-NDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUF0","description":"ICD-GEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove in/ex hem groups 2+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46260","description":"Remove in/ex hem groups 2+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1503","description":"HCPCS-C1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl trach puncture dilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8514","description":"Repl trach puncture dilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGC0","description":"ICD-CCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMB1","description":"ICD-NIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIC1","description":"ICD-FIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93283","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJE0","description":"ICD-OHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA24","description":"Low Rehab_ ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Positional nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92542","description":"Positional nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6527","description":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRC0","description":"ICD-GIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement facemask interfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7031","description":"Replacement facemask interfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef spec metabolic noninherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4154","description":"Ef spec metabolic noninherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUD0","description":"ICD-OLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt queried symp resp insuff","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1503F","description":"Pt queried symp resp insuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAD1","description":"ICD-AIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59136","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","description":"CPT-00930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIB0","description":"ICD-NJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRA1","description":"ICD-CIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mumps antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86735","description":"Mumps antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6600","description":"Gradient compression bandaging supply_ high density foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65400","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKC0","description":"ICD-BGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of psa free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84154","description":"Assay of psa free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Work hardening add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97546","description":"Work hardening add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBE0","description":"ICD-CDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUC1","description":"ICD-GDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fresnell prism press-on lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2718","description":"Fresnell prism press-on lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRD0","description":"ICD-LDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 81 Years Of Age And Older With Evidence Of Frailty During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2125","description":"Patients 81 Years Of Age And Older With Evidence Of Frailty During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDID1","description":"ICD-JDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGA1","description":"ICD-FIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postoperative biliary duct calculus removal_ percutaneous via t-tube tract_ basket_ or snare (eg_ burhenne technique)_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74327","description":"Postoperative biliary duct calculus removal_ percutaneous via t-tube tract_ basket_ or snare (eg_ burhenne technique)_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of haloperidol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80173","description":"Assay of haloperidol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31368","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEE1","description":"ICD-NAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Porcelain/ceramic retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6548","description":"Porcelain/ceramic retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB134","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Warfarin respon genetic test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9143","description":"Warfarin respon genetic test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX10","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACB0","description":"ICD-OACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGA1","description":"ICD-GBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMC1","description":"ICD-FIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1102","description":"HCPCS-A1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILB1","description":"ICD-FILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIE0","description":"ICD-MCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBC0","description":"ICD-CCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65275","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelet deplete of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38213","description":"Platelet deplete of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ translumin non-laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1725","description":"Cath_ translumin non-laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEA0","description":"ICD-NFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spacer with mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8101","description":"Spacer with mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTF1","description":"ICD-OJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACE1","description":"ICD-GACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQD0","description":"ICD-HBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLC0","description":"ICD-KDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sacituzumab govitecan-hziy_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9066","description":"Injection_ sacituzumab govitecan-hziy_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMD0","description":"ICD-AFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01484","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","description":"CPT-01484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lab labial veneer resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2961","description":"Lab labial veneer resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal chrmoml aneuploidy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81420","description":"Fetal chrmoml aneuploidy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARC1","description":"ICD-KARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth sitting procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60451","description":"Anesth sitting procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00834","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","description":"CPT-00834","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ho abduction static plastic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1660","description":"Ho abduction static plastic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occlude fallopian tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58615","description":"Occlude fallopian tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hast w/oxygen titrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94453","description":"Hast w/oxygen titrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61583","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWF1","description":"ICD-PEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device_ vascular hemostatic seal_ mechano-electr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0455T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device_ vascular hemostatic seal_ mechano-electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHD0","description":"ICD-JEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTA1","description":"ICD-IBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow harvest autolog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38232","description":"Bone marrow harvest autolog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual wc accessory_ handrim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2205","description":"Manual wc accessory_ handrim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFE1","description":"ICD-NHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNA0","description":"ICD-BGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSB1","description":"ICD-GBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDF1","description":"ICD-FBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEC0","description":"ICD-ADEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB210","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biovance 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4154","description":"Biovance 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay for infectious agent antibody(ies)_ qualitative or semiquantitative_ single-step method (eg_ reagent strip);","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86318","description":"Immunoassay for infectious agent antibody(ies)_ qualitative or semiquantitative_ single-step method (eg_ reagent strip);","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1422","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","description":"HCPCS-M1422","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLB1","description":"ICD-NHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILF1","description":"ICD-MILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vacc 2 dose adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90739","description":"Hepb vacc 2 dose adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain outer ear canal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69020","description":"Drain outer ear canal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23D","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSD0","description":"ICD-DCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator jun","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3207","description":"Hightop w/ supp/pronator jun","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval on foot not performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8415","description":"Eval on foot not performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing brief counseling (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2201","description":"Documentation of medical reason(s) for not providing brief counseling (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDF1","description":"ICD-MGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of metatarsal heads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28114","description":"Removal of metatarsal heads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQE0","description":"ICD-OKQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUA1","description":"ICD-MHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLE1","description":"ICD-GBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVF1","description":"ICD-CCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC30","description":"Medium Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Yersinia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86793","description":"Yersinia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vincristine sulfate 1 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9370","description":"Vincristine sulfate 1 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteot hum xtrnl lngth dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0594T","description":"Osteot hum xtrnl lngth dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGF1","description":"ICD-FDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQF1","description":"ICD-KIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDC0","description":"ICD-ACDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tibial arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29855","description":"Tibial arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYF1","description":"ICD-DEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast_ Followed By Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0638T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast_ Followed By Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUE0","description":"ICD-OFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXE0","description":"ICD-GHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA146","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBC0","description":"ICD-EHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHC1","description":"ICD-JHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB26","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker folding adjust/fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0135","description":"Walker folding adjust/fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anterior asis pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1250","description":"Anterior asis pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKE1","description":"ICD-JEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPA0","description":"ICD-GIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDB0","description":"ICD-OLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31600","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No unpln rup post cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9390","description":"No unpln rup post cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove unilat space maintain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1520","description":"Remove unilat space maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUF1","description":"ICD-GEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJF1","description":"ICD-CCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 1 hd 301-450 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0801","description":"Pov group 1 hd 301-450 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLA1","description":"ICD-OGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc sed rate automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85652","description":"Rbc sed rate automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSC1","description":"ICD-CBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECB1","description":"ICD-AECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screeningmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0202","description":"Screeningmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDD1","description":"ICD-NKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m oxidronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9561","description":"Tc99m oxidronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablation_ Malignant Breast Tumor(S)_ Percutaneous_ Cryotherapy_ Including Imaging Guidance When Performed_ Unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0581T","description":"Ablation_ Malignant Breast Tumor(S)_ Percutaneous_ Cryotherapy_ Including Imaging Guidance When Performed_ Unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ lumasiran_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9074","description":"Injection_ lumasiran_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hydroceles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55041","description":"Removal of hydroceles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inhalation solution for dme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7699","description":"Inhalation solution for dme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEF1","description":"ICD-OBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXB1","description":"ICD-KGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supported housing_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0043","description":"Supported housing_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOB1","description":"ICD-HHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJE1","description":"ICD-OFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severity angina by actvty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1010F","description":"Severity angina by actvty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tirofiban hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3246","description":"Tirofiban hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted to palliative care services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1017","description":"Patient admitted to palliative care services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFB0","description":"ICD-GDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWE1","description":"ICD-DEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay phosphohexose enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84087","description":"Assay phosphohexose enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE150","description":"Special Care High _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRC1","description":"ICD-CHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAD1","description":"ICD-JDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iliac art angio_cardiac cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0278","description":"Iliac art angio_cardiac cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJE1","description":"ICD-KDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Positioning cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0190","description":"Positioning cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQB0","description":"ICD-ODQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/long tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34805","description":"Endovas aaa repr w/long tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom grad sleeve med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8422","description":"Custom grad sleeve med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upgrade of pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33214","description":"Upgrade of pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41520","description":"Reconstruction tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skilled Nursing Facility Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4033","description":"Skilled Nursing Facility Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61541","description":"Incision of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deoxyribonuclease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86215","description":"Deoxyribonuclease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXE0","description":"ICD-GGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLD0","description":"ICD-AHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate (Fresenius Kabi)_ not therapeutically equivalent to J1596_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1598","description":"Injection_ glycopyrrolate (Fresenius Kabi)_ not therapeutically equivalent to J1596_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aflibercept hd_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0177","description":"Injection_ aflibercept hd_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD154","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corplex_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4232","description":"Corplex_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYE0","description":"ICD-GCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73060","description":"X-ray exam of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIF0","description":"ICD-AFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ex h rate sz 30+ day ri only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0386T","description":"Ex h rate sz 30+ day ri only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPF1","description":"ICD-OJPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKF0","description":"ICD-GAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMD1","description":"ICD-ICMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harvest vein for bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35500","description":"Harvest vein for bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWD1","description":"ICD-KEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEC0","description":"ICD-NJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKB0","description":"ICD-NJKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligate leg veins open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37761","description":"Ligate leg veins open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHB1","description":"ICD-MKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBC0","description":"ICD-GEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMC1","description":"ICD-CIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fistula repair & colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57307","description":"Fistula repair & colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFE1","description":"ICD-CCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3290","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3290","description":"HCPCS-J3290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHB0","description":"ICD-BIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4D","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen dua rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8687","description":"Implt nrostm pls gen dua rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0220","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLD0","description":"ICD-NKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSE1","description":"ICD-PCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull & explore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61253","description":"Pierce skull & explore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSF0","description":"ICD-OKSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAC1","description":"ICD-JEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of toe lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28092","description":"Removal of toe lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHC1","description":"ICD-FIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCE1","description":"ICD-GDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC43","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc no comp or mort w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9269","description":"Doc no comp or mort w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE244","description":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25680","description":"Treat wrist fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETC0","description":"ICD-CETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin barrier with flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4373","description":"Skin barrier with flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHF1","description":"ICD-NJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARB0","description":"ICD-OARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEA1","description":"ICD-JBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDE0","description":"ICD-CGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEME1","description":"ICD-BEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBE0","description":"ICD-FEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary colon ca dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81436","description":"Hereditary colon ca dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth penis nodes removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93651","description":"Anesth penis nodes removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26070","description":"Explore/treat hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50727","description":"Revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0570","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","description":"HCPCS-G0570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB34","description":"Low Rehab_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMA1","description":"ICD-NBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit tpn 1 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9365","description":"Hit tpn 1 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFB1","description":"ICD-CAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body pos current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8981","description":"Body pos current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBD0","description":"ICD-EEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD125","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIB1","description":"ICD-IBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ apadamtase alfa_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9167","description":"Injection_ apadamtase alfa_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCC0","description":"ICD-MHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1224","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGE1","description":"ICD-KDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIB0","description":"ICD-EIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHD1","description":"ICD-BHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNC1","description":"ICD-BFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ transpl pkg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2152","description":"Solid organ transpl pkg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGD1","description":"ICD-OFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUC1","description":"ICD-GAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cetirizine hydrochloride_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1201","description":"Injection_ cetirizine hydrochloride_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQD0","description":"ICD-PJQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCED0","description":"ICD-JCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deb subq tissue 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11042","description":"Deb subq tissue 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Individual_ Initial Assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0591T","description":"Health And Well-Being Coaching Face-To-Face; Individual_ Initial Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18C","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGE0","description":"ICD-GEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLB0","description":"ICD-CCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of arm & girdle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23900","description":"Amputation of arm & girdle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPA1","description":"ICD-BHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hd inj >24h/gcs >15/no res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9596","description":"Hd inj >24h/gcs >15/no res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGME1","description":"ICD-KGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWE0","description":"ICD-OFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKD0","description":"ICD-JFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKC0","description":"ICD-NDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC11","description":"ICD-1HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVF1","description":"ICD-KAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAE0","description":"ICD-NAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHB1","description":"ICD-ADHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0615","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","description":"HCPCS-J0615","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTF1","description":"ICD-IDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of g6pd enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82955","description":"Assay of g6pd enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37230","description":"Tib/per revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transport portable ekg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0076","description":"Transport portable ekg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0806","description":"Replacement of lower extremity joint with Motor <22.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9981","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ each additional vessel or separate lesion_ normal or abnormal connections (List separately in addition to c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33904","description":"Percutaneous pulmonary artery revascularization by stent placement_ each additional vessel or separate lesion_ normal or abnormal connections (List separately in addition to c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUA0","description":"ICD-GIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAA0","description":"ICD-NJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fos c chld non-ther per mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0042","description":"Fos c chld non-ther per mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glasses cros hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5190","description":"Glasses cros hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth chest lining biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52251","description":"Anesth chest lining biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINC0","description":"ICD-CINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fractionation ketosteroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83593","description":"Fractionation ketosteroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/.25-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2311","description":"Lens sphc trifo 7.25-12/.25-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v auto redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88166","description":"Cytopath tbs c/v auto redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFC0","description":"ICD-FGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWF0","description":"ICD-LIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical home level iii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9150","description":"Medical home level iii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVD1","description":"ICD-JAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHB0","description":"ICD-EGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11103","description":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj potassium chloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3480","description":"Inj potassium chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29851","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory syncytial ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87280","description":"Respiratory syncytial ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bath conductivity meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1550","description":"Bath conductivity meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUE0","description":"ICD-EIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBE1","description":"ICD-IHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33426","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUC1","description":"ICD-OAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28225","description":"Release of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKD0","description":"ICD-OGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRB0","description":"ICD-ODRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHD1","description":"ICD-MGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBC1","description":"ICD-AHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIC0","description":"ICD-NDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reciprocating peritoneal dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1630","description":"Reciprocating peritoneal dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infusion pump_ non-prog_temp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2626","description":"Infusion pump_ non-prog_temp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC53","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD150","description":"Clinically Complex _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67413","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrizalent (ccIIV4)_ derived from cell cultures_ subunit_ antibiotic free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90756","description":"Influenza virus vaccine_ quadrizalent (ccIIV4)_ derived from cell cultures_ subunit_ antibiotic free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial thyroid excision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60210","description":"Partial thyroid excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIF0","description":"ICD-NAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria x10sv endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33266","description":"Ablate atria x10sv endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Serum clotting time tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4771","description":"Serum clotting time tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFE0","description":"ICD-FCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apis_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2010","description":"Apis_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther/proph/diag iv inf init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96365","description":"Ther/proph/diag iv inf init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ONC PAN-TUM DNA&RNA GNRJ SEQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0211U","description":"ONC PAN-TUM DNA&RNA GNRJ SEQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEED0","description":"ICD-MEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ spinal_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0785T","description":"Revision or removal of neurostimulator electrode array_ spinal_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGC0","description":"ICD-NJGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX15","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stationary compressed gas 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0424","description":"Stationary compressed gas 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAD0","description":"ICD-BBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cpap full face mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7030","description":"Cpap full face mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDA0","description":"ICD-MGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCF0","description":"ICD-GGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAD1","description":"ICD-AFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUA0","description":"ICD-ICUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High risk recurrence pro ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8465","description":"High risk recurrence pro ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation physics consult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77336","description":"Radiation physics consult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Event recorder_ cardiac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1764","description":"Event recorder_ cardiac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADC1","description":"ICD-CADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWF1","description":"ICD-OHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFF1","description":"ICD-CFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA11","description":"ICD-4CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBA0","description":"ICD-FBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inner skull vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61702","description":"Inner skull vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69801","description":"Incise inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68115","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove tear gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68550","description":"Remove tear gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOA0","description":"ICD-HDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1st course antitnf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8868","description":"1st course antitnf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDF1","description":"ICD-KDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUF1","description":"ICD-FAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWE0","description":"ICD-PJWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMF1","description":"ICD-FFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDC1","description":"ICD-GFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEC1","description":"ICD-ECEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28G","description":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anterior swing band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2335","description":"Anterior swing band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmv antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86644","description":"Cmv antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6525","description":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38381","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemical peel nonfacial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15792","description":"Chemical peel nonfacial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFF1","description":"ICD-FIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61313","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMF0","description":"ICD-CEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMD0","description":"ICD-JHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0508U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0508U","description":"CPT-0508U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAC0","description":"ICD-CAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUD0","description":"ICD-NCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPF1","description":"ICD-NHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIF1","description":"ICD-JEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lith ion batt cid_non-earlvl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8623","description":"Lith ion batt cid_non-earlvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Serial tonometry exam(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92100","description":"Serial tonometry exam(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inhaled corticosteroids rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4140F","description":"Inhaled corticosteroids rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1383","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","description":"HCPCS-M1383","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impression casting ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0395","description":"Impression casting ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBB0","description":"ICD-GHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95712","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCD0","description":"ICD-NLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVE1","description":"ICD-FAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCB1","description":"ICD-EDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES145","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCE0","description":"ICD-EHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBC1","description":"ICD-NJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE210","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDF1","description":"ICD-MEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATE0","description":"ICD-BATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRB1","description":"ICD-HCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49321","description":"Laparoscopy biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEC0","description":"ICD-IAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKD1","description":"ICD-KGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66989","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFF0","description":"ICD-BCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cimetidine hydroc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0023","description":"Injection_ cimetidine hydroc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5298","description":"Hearing aid noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Als esophageal intub suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0396","description":"Als esophageal intub suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJF1","description":"ICD-JIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary angioplasty_ single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intrav","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7533","description":"Percutaneous transluminal coronary angioplasty_ single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intrav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYTOG CONST ALYS INTERROG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0209U","description":"CYTOG CONST ALYS INTERROG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0734","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSF0","description":"ICD-GBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0802T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABC0","description":"ICD-CABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMD0","description":"ICD-CIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIF1","description":"ICD-MGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWA1","description":"ICD-PJWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVD1","description":"ICD-FDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLE1","description":"ICD-FDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJF1","description":"ICD-CDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA31","description":"ICD-1IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAE0","description":"ICD-IDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRC0","description":"ICD-LHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXF0","description":"ICD-FCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRC0","description":"ICD-HFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prgrmg dev eval impltbl sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93260","description":"Prgrmg dev eval impltbl sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL60","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/a/gen/trk20.1-30.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12006","description":"Rpr s/n/a/gen/trk20.1-30.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLF1","description":"ICD-BBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilated macular exam was not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9977","description":"Dilated macular exam was not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMA0","description":"ICD-NCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSC1","description":"ICD-GCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45393","description":"Colonoscopy w/decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUC0","description":"ICD-BAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percut allergy skin tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95004","description":"Percut allergy skin tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAME0","description":"ICD-NAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASB1","description":"ICD-KASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of serum sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84295","description":"Assay of serum sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHED0","description":"ICD-CHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDF0","description":"ICD-OEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavral qualit analys voice","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92524","description":"Behavral qualit analys voice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDF1","description":"ICD-CIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAA1","description":"ICD-GCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of retinal detachment; by scleral buckling or vitrectomy_ on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67112","description":"Repair of retinal detachment; by scleral buckling or vitrectomy_ on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDC0","description":"ICD-BGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23615","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mobilize erupted/malpos toot","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7282","description":"Mobilize erupted/malpos toot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOE0","description":"ICD-KGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunofix e-phoresis serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86334","description":"Immunofix e-phoresis serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOF1","description":"ICD-HAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDE1","description":"ICD-EDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOD1","description":"ICD-PAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAD1","description":"ICD-CDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98981","description":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBF0","description":"ICD-JDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBC1","description":"ICD-ODBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUB1","description":"ICD-ICUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILB0","description":"ICD-FILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Humidifier for use w/ regula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0555","description":"Humidifier for use w/ regula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXC1","description":"ICD-KGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRA0","description":"ICD-OCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATC0","description":"ICD-MATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O&p supply/accessory/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L9900","description":"O&p supply/accessory/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWE0","description":"ICD-HGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orchiopexy (fowler-stephens)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54650","description":"Orchiopexy (fowler-stephens)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Swingaway detach footrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0052","description":"Swingaway detach footrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICF0","description":"ICD-EICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trb@ gene rearrange dirprobe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81341","description":"Trb@ gene rearrange dirprobe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/endoscopic fnb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45392","description":"Colonoscopy w/endoscopic fnb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYD1","description":"ICD-CBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit new age 40-64","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99386","description":"Prev visit new age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0320","description":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment social skills group_ administered by physician or other qualified health care professional face-to-face with multiple patients","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0372T","description":"Adaptive behavior treatment social skills group_ administered by physician or other qualified health care professional face-to-face with multiple patients","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXF0","description":"ICD-KEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supply/accessory/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9900","description":"Supply/accessory/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCF1","description":"ICD-EDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSD1","description":"ICD-OCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9131","description":"Onc dx brst unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote assessment of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including interpretation with follow-up with the patient withi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2250","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including interpretation with follow-up with the patient withi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3D","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam filled caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2387","description":"Foam filled caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69554","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYB0","description":"ICD-KDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise lwr jaw cyst w/repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21047","description":"Excise lwr jaw cyst w/repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICE0","description":"ICD-OICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Memory goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9169","description":"Memory goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASB0","description":"ICD-LASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSE0","description":"ICD-OCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3D","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place cath intracranial art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36228","description":"Place cath intracranial art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAC1","description":"ICD-BHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYB1","description":"ICD-KAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIF1","description":"ICD-FHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMC1","description":"ICD-EAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evoked auditory tst complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92588","description":"Evoked auditory tst complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of tendons at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25301","description":"Fusion of tendons at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJE0","description":"ICD-OLJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radium ra223 dichloride ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9606","description":"Radium ra223 dichloride ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85420","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMF0","description":"ICD-GHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Molded inner boot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2280","description":"Molded inner boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69637","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee disc/dial lock/adj flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2425","description":"Knee disc/dial lock/adj flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJID0","description":"ICD-OJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJE1","description":"ICD-OAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24115","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41007","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct urethra stage 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53420","description":"Reconstruct urethra stage 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49322","description":"Laparoscopy aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyperbaric o2 chamber disps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4575","description":"Hyperbaric o2 chamber disps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAC1","description":"ICD-GGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand held low vision aids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2600","description":"Hand held low vision aids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66852","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calcitrol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0169","description":"Calcitrol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gardner vag dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87510","description":"Gardner vag dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flu imm no admin doc rea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8483","description":"Flu imm no admin doc rea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lateral trochanteric pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1290","description":"Lateral trochanteric pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHB1","description":"ICD-ACHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/2.12-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2108","description":"Spherocylinder 4.25d/2.12-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX07","description":"High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anthrax vaccine sc or im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90581","description":"Anthrax vaccine sc or im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFC0","description":"ICD-FCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWC1","description":"ICD-CHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone a inj prs-free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3300","description":"Triamcinolone a inj prs-free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 0.5/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11420","description":"Exc h-f-nk-sp b9+marg 0.5/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no 7d f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9406","description":"Doc reas no 7d f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald_ tv caption decoder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5271","description":"Ald_ tv caption decoder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSE0","description":"ICD-PHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB212","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKF0","description":"ICD-NEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITA0","description":"ICD-CITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp fem-ant-post tib/prl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35566","description":"Art byp fem-ant-post tib/prl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFME0","description":"ICD-KFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXA1","description":"ICD-BGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy w/tumor excise","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31640","description":"Bronchoscopy w/tumor excise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITC0","description":"ICD-GITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mdd mild","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3088F","description":"Mdd mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth low intestine scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81051","description":"Anesth low intestine scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYE1","description":"ICD-DDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatric symptoms not assessed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9743","description":"Psychiatric symptoms not assessed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Depo-estradiol cypionate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1000","description":"Depo-estradiol cypionate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWD0","description":"ICD-LAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMF0","description":"ICD-NAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOE1","description":"ICD-DIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKF1","description":"ICD-BDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0224T","description":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of wrist capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25085","description":"Incision of wrist capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUF1","description":"ICD-KHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/ leg re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1190","description":"Wheelchair amputee w/ leg re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABF0","description":"ICD-KABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWA0","description":"ICD-OFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMC0","description":"ICD-NCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA15","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No surg proc w/in 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8628","description":"No surg proc w/in 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGA0","description":"ICD-NGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBD1","description":"ICD-OHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Targeted Sequence Analysis (Eg_ 4 Oncology)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81352","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Targeted Sequence Analysis (Eg_ 4 Oncology)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNA1","description":"ICD-NBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUD0","description":"ICD-JGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOC1","description":"ICD-HBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abduct rotation bar w/o shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3150","description":"Abduct rotation bar w/o shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOC0","description":"ICD-HIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ surgical wound pathogens_ 34 microorganisms and identification of 21 associated antibiotic-resistance genes_ multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0370U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ surgical wound pathogens_ 34 microorganisms and identification of 21 associated antibiotic-resistance genes_ multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGB0","description":"ICD-NFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYC0","description":"ICD-DDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPE0","description":"ICD-OHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16373","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16373","description":"CPT-16373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27535","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50390","description":"Drainage of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75831","description":"Vein x-ray kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic & hip control thigh c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1680","description":"Pelvic & hip control thigh c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22614","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJE1","description":"ICD-CCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation that the patient declined therapy change or alternative therapies were unavailable_ has documented contraindications_ or has not been treated with an oral system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9765","description":"Documentation that the patient declined therapy change or alternative therapies were unavailable_ has documented contraindications_ or has not been treated with an oral system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92310","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRD1","description":"ICD-CHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct lwr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73702","description":"Ct lwr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUD0","description":"ICD-BFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB134","description":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reass appr remo filt 3ms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9542","description":"Doc reass appr remo filt 3ms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXA0","description":"ICD-GFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCF1","description":"ICD-IDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1495","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","description":"HCPCS-M1495","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOC0","description":"ICD-LCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1B","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUF1","description":"ICD-NGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1030T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1030T","description":"CPT-1030T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRE0","description":"ICD-LGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBF1","description":"ICD-FEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMB0","description":"ICD-ACMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABF0","description":"ICD-CABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit day life activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99509","description":"Home visit day life activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8H","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23C","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQB0","description":"ICD-HDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Middle cerebral artery echo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76821","description":"Middle cerebral artery echo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELD0","description":"ICD-CELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22D","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFD1","description":"ICD-KIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMD1","description":"ICD-CIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTE1","description":"ICD-KDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBC0","description":"ICD-OFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adj skin pro/pos cus<22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2624","description":"Adj skin pro/pos cus<22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27658","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAD1","description":"ICD-MJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPB0","description":"ICD-OKPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise spinal cord ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63180","description":"Revise spinal cord ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBC0","description":"ICD-NDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1468","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","description":"HCPCS-M1468","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPD0","description":"ICD-FFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx duod intub w/asp specs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43757","description":"Dx duod intub w/asp specs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alginate dressing > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6198","description":"Alginate dressing > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26455","description":"Incision of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVB1","description":"ICD-BEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxygen probe used w oximeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4606","description":"Oxygen probe used w oximeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBD0","description":"ICD-IBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIE0","description":"ICD-MIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2098","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVF1","description":"ICD-JFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2134","description":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPA0","description":"ICD-CBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0759","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","description":"HCPCS-J0759","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSB1","description":"ICD-PJSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBE1","description":"ICD-EGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB31","description":"ICD-1CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHME1","description":"ICD-GHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDE1","description":"ICD-MDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc surv no stroke after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9261","description":"Doc surv no stroke after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTE1","description":"ICD-NLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7509","description":"Methylprednisolone oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFE0","description":"ICD-NLFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOC1","description":"ICD-LGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj codeine phosphate /30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0745","description":"Inj codeine phosphate /30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUA0","description":"ICD-IEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPB1","description":"ICD-OFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore wound chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20101","description":"Explore wound chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0606U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","description":"CPT-0606U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23D","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis B virus (HBV) status not assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9913","description":"Hepatitis B virus (HBV) status not assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAED1","description":"ICD-FAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPF0","description":"ICD-JIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUB0","description":"ICD-CCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Outrigger bil w/ vert extens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1085","description":"Outrigger bil w/ vert extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCC0","description":"ICD-GHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWC1","description":"ICD-GDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIC1","description":"ICD-MAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIE0","description":"ICD-AEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML13","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraocular fomivirsen na","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1452","description":"Intraocular fomivirsen na","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ transbronchial ablation of lesion(s) by microwave energy_ including fluoroscopic guidance_ whe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9751","description":"Bronchoscopy_ rigid or flexible_ transbronchial ablation of lesion(s) by microwave energy_ including fluoroscopic guidance_ whe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQB1","description":"ICD-CIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko single upright pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1843","description":"Ko single upright pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCD1","description":"ICD-OCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPC0","description":"ICD-OIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDME0","description":"ICD-EDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELF1","description":"ICD-KELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOF0","description":"ICD-OIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ONC NONSM CLL LNG CA ALYS 23","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0179U","description":"ONC NONSM CLL LNG CA ALYS 23","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYB1","description":"ICD-HIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Performance Not Met: The Residual Change Score Is Less Than 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2167","description":"Performance Not Met: The Residual Change Score Is Less Than 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of finger tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26471","description":"Fusion of finger tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTC0","description":"ICD-NJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-62330","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","description":"CPT-62330","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHC0","description":"ICD-IDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optx thigh fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27269","description":"Optx thigh fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAC0","description":"ICD-OJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic apheresis; with extracorporeal immunoadsorption_ selective adsorption or selective filtration and plasma reinfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36516","description":"Therapeutic apheresis; with extracorporeal immunoadsorption_ selective adsorption or selective filtration and plasma reinfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASC0","description":"ICD-KASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEA1","description":"ICD-MEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDD1","description":"ICD-OIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of breast implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19328","description":"Removal of breast implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDA0","description":"ICD-CCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1400","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","description":"HCPCS-M1400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnioband_ guardian 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4151","description":"Amnioband_ guardian 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20B","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replantation hand complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20808","description":"Replantation hand complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDA0","description":"ICD-JIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBF1","description":"ICD-JCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB55","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXC0","description":"ICD-JEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50610","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAC0","description":"ICD-GAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impltj Nonbiol/Synth Implt Fasc Rnfcmt Abdl Wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0437T","description":"Impltj Nonbiol/Synth Implt Fasc Rnfcmt Abdl Wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 0 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3382F","description":"Ajcc cln cncr stage 0 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBA0","description":"ICD-JBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0573U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","description":"CPT-0573U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLA0","description":"ICD-GDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2104","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLF1","description":"ICD-IHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIA0","description":"ICD-MFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Afstyla)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7210","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Afstyla)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKD0","description":"ICD-ODKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDE0","description":"ICD-FIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-63032","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","description":"CPT-63032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDA0","description":"ICD-JCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBE0","description":"ICD-EHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECC1","description":"ICD-AECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUC0","description":"ICD-FAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61850","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIC0","description":"ICD-EEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHD0","description":"ICD-ODHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAE0","description":"ICD-MCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFC1","description":"ICD-JHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv combination assay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0475","description":"Hiv combination assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy_ flexible_ transoral_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0884T","description":"Esophagoscopy_ flexible_ transoral_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58558","description":"Hysteroscopy biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0643U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0643U","description":"CPT-0643U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAC0","description":"ICD-MGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15D","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reop req bld grft oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8577","description":"Reop req bld grft oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ipratropium bromide comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7645","description":"Ipratropium bromide comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEF0","description":"ICD-MFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6029","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","description":"HCPCS-L6029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTB0","description":"ICD-NCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20611","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special anesthesia procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99135","description":"Special anesthesia procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0361T","description":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-corrosive finish","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2780","description":"Non-corrosive finish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRC0","description":"ICD-OHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRC0","description":"ICD-LGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with invasive interface (e.g._ tracheostomy tube)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0450","description":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with invasive interface (e.g._ tracheostomy tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHC1","description":"ICD-OAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTA1","description":"ICD-MFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHB1","description":"ICD-EGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIE0","description":"ICD-BDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJA0","description":"ICD-GCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVC0","description":"ICD-BFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUD1","description":"ICD-EFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXF1","description":"ICD-NCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACC0","description":"ICD-MACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOA1","description":"ICD-DBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heat & moisture exchange sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7509","description":"Heat & moisture exchange sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Larynscop remve cart + scop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31561","description":"Larynscop remve cart + scop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25274","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ossicular implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8613","description":"Ossicular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35111","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTF0","description":"ICD-FCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm ear level receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5284","description":"Ald fm/dm ear level receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBA0","description":"ICD-GBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB104","description":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28F","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGC1","description":"ICD-GAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant mid ear hearing pros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5095","description":"Implant mid ear hearing pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL44","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEB1","description":"ICD-OGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPF0","description":"ICD-FHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96130","description":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBC0","description":"ICD-NCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lpn/lvn services up to 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1003","description":"Lpn/lvn services up to 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by groin incision_ unilateral (Li","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34714","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by groin incision_ unilateral (Li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23540","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1603","description":"HCPCS-B1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31528","description":"Laryngoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28X","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB26","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITE0","description":"ICD-FITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCA1","description":"ICD-OHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occlusive eye patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6412","description":"Occlusive eye patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0224","description":"Injection_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX10","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95833","description":"Body muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFED1","description":"ICD-EFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiolipin antibody ea ig","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86147","description":"Cardiolipin antibody ea ig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWF1","description":"ICD-PLWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69650","description":"Release middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYC0","description":"ICD-HHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEA1","description":"ICD-JCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETF0","description":"ICD-GETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparotomy islet cell transp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0343","description":"Laparotomy islet cell transp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0764T","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINA1","description":"ICD-GINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx transantral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21385","description":"Opn tx orbit fx transantral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone biopsy trocar/needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20220","description":"Bone biopsy trocar/needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy oocyte polar body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89291","description":"Biopsy oocyte polar body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove elbow joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24102","description":"Remove elbow joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of sialic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84275","description":"Assay of sialic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOF0","description":"ICD-PCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHB0","description":"ICD-CDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20C","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95983","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast Material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0633T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast Material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVF0","description":"ICD-CIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJA1","description":"ICD-CHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7552","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fragmenting of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50590","description":"Fragmenting of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASC0","description":"ICD-DASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDB0","description":"ICD-BFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB234","description":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKD1","description":"ICD-NLKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL05","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prednisone_ oral_ per 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7506","description":"Prednisone_ oral_ per 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8G","description":"Very High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthodontic procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8999","description":"Orthodontic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82626","description":"Dehydroepiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1202","description":"HCPCS-C1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intra-atrial pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93610","description":"Intra-atrial pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQC1","description":"ICD-DBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01340","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","description":"CPT-01340","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKB0","description":"ICD-GCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRA0","description":"ICD-GHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrocardiogram report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93010","description":"Electrocardiogram report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Path rprt w/ pt pn cat et al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3267F","description":"Path rprt w/ pt pn cat et al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped crit care transport addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99467","description":"Ped crit care transport addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKE1","description":"ICD-OCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBA0","description":"ICD-NDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23532","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of biotinidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82261","description":"Assay of biotinidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1022","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1022","description":"HCPCS-E1022","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINC0","description":"ICD-NINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous tibial nerve stimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0736","description":"Transcutaneous tibial nerve stimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair commode seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0968","description":"Wheelchair commode seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWF0","description":"ICD-CBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUD1","description":"ICD-FFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBD0","description":"ICD-AGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20C","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFA0","description":"ICD-JCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFD1","description":"ICD-GFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18X","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLD0","description":"ICD-OBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDF1","description":"ICD-MDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8I","description":"Low Rehab_ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRC1","description":"ICD-GIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient  compression arm sleeve_ custom_ heavy weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6577","description":"Gradient  compression arm sleeve_ custom_ heavy weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQE1","description":"ICD-OHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQF1","description":"ICD-DGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; set-up and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99453","description":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; set-up and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lisocabtagene maraleucel_ up to 110 million autologous anti-cd19 car-positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9076","description":"Lisocabtagene maraleucel_ up to 110 million autologous anti-cd19 car-positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNA0","description":"ICD-GGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIME0","description":"ICD-BIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vabra aspirator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4480","description":"Vabra aspirator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRC1","description":"ICD-KGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibula bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20955","description":"Fibula bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQC0","description":"ICD-HFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01842","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","description":"CPT-01842","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of spinal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64772","description":"Incision of spinal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixation of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23700","description":"Fixation of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB114","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob prov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1255","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob prov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGB1","description":"ICD-NBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVD0","description":"ICD-GFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJE0","description":"ICD-GBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKA0","description":"ICD-BCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens pmma color vision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2503","description":"Cntct lens pmma color vision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEC1","description":"ICD-AGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occult blood test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4773","description":"Occult blood test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47142","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPF1","description":"ICD-GGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHB0","description":"ICD-FIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDA0","description":"ICD-EGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99309","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18F","description":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVD1","description":"ICD-KCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1609","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1609","description":"HCPCS-C1609","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18B","description":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect shoulder tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23078","description":"Resect shoulder tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFA0","description":"ICD-ODFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHE0","description":"ICD-FEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES336","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albumin (human)_5%_ 50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9041","description":"Albumin (human)_5%_ 50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2C","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1267","description":"Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso flex trunk/thor pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0450","description":"Tlso flex trunk/thor pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQA0","description":"ICD-DGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDD0","description":"ICD-MJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01652","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","description":"CPT-01652","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker w trunk support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0140","description":"Walker w trunk support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBA0","description":"ICD-IDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laiv3 vaccine intranasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90660","description":"Laiv3 vaccine intranasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLE0","description":"ICD-EBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of fetal fibronectin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82731","description":"Assay of fetal fibronectin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTF0","description":"ICD-OBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA17","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tubing with heating element","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4604","description":"Tubing with heating element","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50694","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASA1","description":"ICD-LASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYD1","description":"ICD-KBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYF0","description":"ICD-OBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDC0","description":"ICD-JGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAF0","description":"ICD-NFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt trans to hosp post d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8914","description":"Pt trans to hosp post d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIA1","description":"ICD-IGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGD0","description":"ICD-NHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSE1","description":"ICD-KFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped dynamic seating frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2295","description":"Ped dynamic seating frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23330","description":"Remove shoulder foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARD1","description":"ICD-OARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABA1","description":"ICD-KABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1815","description":"Insulin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLE0","description":"ICD-NBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of bladder neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52500","description":"Revision of bladder neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped gastro ed given caregvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4058F","description":"Ped gastro ed given caregvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHF0","description":"ICD-OHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Io ga n-stim subsq w/reprog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95982","description":"Io ga n-stim subsq w/reprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multi-durometer below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5665","description":"Multi-durometer below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1488","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","description":"HCPCS-M1488","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Oral And/Or Oropharyngeal Cancer)_ Gene Expression Profiling By Rna Sequencing At Least 20 Molecular Features (Eg_ Human And/Or Microbial Mrna)_ Saliva_ Algorithm Re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0296U","description":"Oncology (Oral And/Or Oropharyngeal Cancer)_ Gene Expression Profiling By Rna Sequencing At Least 20 Molecular Features (Eg_ Human And/Or Microbial Mrna)_ Saliva_ Algorithm Re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXF1","description":"ICD-JGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHME0","description":"ICD-EHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECB1","description":"ICD-CECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPC1","description":"ICD-CBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKF0","description":"ICD-FCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect hip/pelv tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27059","description":"Resect hip/pelv tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHE0","description":"ICD-NBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFA0","description":"ICD-BCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25C","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst w/enterocele repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58270","description":"Vag hyst w/enterocele repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology autism_ 32 amines by LC-MS/MS_ using plasma_ algorithm reported as metabolic signature associated with autism spectrum disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0063U","description":"Neurology autism_ 32 amines by LC-MS/MS_ using plasma_ algorithm reported as metabolic signature associated with autism spectrum disorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure of salivary fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42600","description":"Closure of salivary fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWD1","description":"ICD-HFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62321","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta)_ quantification_ including reverse transcription_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87523","description":"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta)_ quantification_ including reverse transcription_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCC1","description":"ICD-IBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYD1","description":"ICD-KIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXE0","description":"ICD-ODXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPC1","description":"ICD-GBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hsv dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87530","description":"Hsv dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; implantable monitor only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0532T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; implantable monitor only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCA1","description":"ICD-CDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Are Not Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0047","description":"Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Are Not Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4423","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","description":"HCPCS-Q4423","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJF0","description":"ICD-FDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC260","description":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 cast hi noble met","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2780","description":"Crown 3/4 cast hi noble met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of jaw muscle/bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21296","description":"Revision of jaw muscle/bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28238","description":"Revision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVD0","description":"ICD-BCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEE0","description":"ICD-NFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLA1","description":"ICD-OJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIE0","description":"ICD-FIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove tissue expander(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11971","description":"Remove tissue expander(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFID1","description":"ICD-NFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0502","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0502","description":"CDT-D0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0883T","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATD1","description":"ICD-FATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urofollitropin_ 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3355","description":"Urofollitropin_ 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27830","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKB1","description":"ICD-JGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clsd red simpl mandible fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7640","description":"Clsd red simpl mandible fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Term dev mech hook vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6706","description":"Term dev mech hook vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clear outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69205","description":"Clear outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLD1","description":"ICD-GHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triptorelin_ extended-release_ 3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3316","description":"Injection_ triptorelin_ extended-release_ 3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10A","description":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPA0","description":"ICD-KDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High compres band w>=3in<5inyd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6452","description":"High compres band w>=3in<5inyd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revoshield + amniotic barrier_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4289","description":"Revoshield + amniotic barrier_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJD1","description":"ICD-NCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTD1","description":"ICD-EHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWD0","description":"ICD-GHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Additional switch_ ext power","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6611","description":"Additional switch_ ext power","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol > 100gm prote","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4199","description":"Parenteral sol > 100gm prote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHB1","description":"ICD-MBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB11","description":"ICD-1IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98008","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","description":"CPT-98008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMC1","description":"ICD-FEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYC1","description":"ICD-KGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHC1","description":"ICD-BBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18E","description":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermatological procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96999","description":"Dermatological procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILD1","description":"ICD-EILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTB0","description":"ICD-CBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Multiple Studies At","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78431","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Multiple Studies At","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reposition intraocular lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66825","description":"Reposition intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRC1","description":"ICD-CFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10D","description":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHE0","description":"ICD-BDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84120","description":"Assay of urine porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amino acids quan 6 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82139","description":"Amino acids quan 6 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLD0","description":"ICD-EFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00320","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","description":"CPT-00320","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLE1","description":"ICD-AFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phoenix wound matrix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2015","description":"Phoenix wound matrix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDA1","description":"ICD-MFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB31","description":"High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLND1","description":"ICD-NLND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNE1","description":"ICD-JDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB02","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBE1","description":"ICD-ACBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEB1","description":"ICD-GDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-33882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","description":"CPT-33882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01935","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01935","description":"CPT-01935","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abciximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0130","description":"Abciximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prochlorperazine 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0183","description":"Prochlorperazine 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUA1","description":"ICD-BCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quality care in mental health and substance use disorders mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1369","description":"Quality care in mental health and substance use disorders mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGED1","description":"ICD-GGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVA0","description":"ICD-FDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCE0","description":"ICD-BCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIB0","description":"ICD-BCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syst antimicrobial thx rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4131F","description":"Syst antimicrobial thx rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIB0","description":"ICD-OHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVA0","description":"ICD-GDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJA1","description":"ICD-OJJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTD0","description":"ICD-BFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phenytoin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1165","description":"Phenytoin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQD1","description":"ICD-GEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHE1","description":"ICD-GCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28C","description":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYE0","description":"ICD-KFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB21","description":"ICD-2IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUF1","description":"ICD-OCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITF1","description":"ICD-NITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKD0","description":"ICD-OHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUF1","description":"ICD-OBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSE0","description":"ICD-HDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJD1","description":"ICD-BFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00865","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","description":"CPT-00865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEC1","description":"ICD-AEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDD1","description":"ICD-KIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBD0","description":"ICD-KGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"K flow/funct image multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78709","description":"K flow/funct image multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNC1","description":"ICD-NCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap radical hyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58548","description":"Lap radical hyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC211","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENE1","description":"ICD-BENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit sympathomim diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9348","description":"Hit sympathomim diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evasc rpr iliac art bifr s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0255T","description":"Evasc rpr iliac art bifr s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01732","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","description":"CPT-01732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","description":"CPT-00470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXC1","description":"ICD-FBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thrombomodulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85337","description":"Thrombomodulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAD0","description":"ICD-CAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHE1","description":"ICD-EFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHE1","description":"ICD-IGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29035","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair paravag defect lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57423","description":"Repair paravag defect lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVA1","description":"ICD-FGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAB0","description":"ICD-NHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXA0","description":"ICD-BFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prefabricated resin crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2932","description":"Prefabricated resin crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal focal laser ablation of malignant prostate tissue_ including transrectal imaging guidance_ with MR-fused images or other enhanced ultrasound imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0655T","description":"Transperineal focal laser ablation of malignant prostate tissue_ including transrectal imaging guidance_ with MR-fused images or other enhanced ultrasound imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADD1","description":"ICD-GADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJC1","description":"ICD-JBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDD1","description":"ICD-FIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX33","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDA0","description":"ICD-GEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWF1","description":"ICD-HBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLF0","description":"ICD-NGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAC0","description":"ICD-IBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ hydroxocobalamin_ intravenous_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3424","description":"Injection_ hydroxocobalamin_ intravenous_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1739","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1739","description":"HCPCS-C1739","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gba gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81251","description":"Gba gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac shunt imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78428","description":"Cardiac shunt imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIF0","description":"ICD-BFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95865","description":"Muscle test larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg_ carrier testing)_ includes SMN2 (survival of motor neur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81329","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg_ carrier testing)_ includes SMN2 (survival of motor neur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXB0","description":"ICD-OAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair ortho appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8691","description":"Repair ortho appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWA0","description":"ICD-OEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0240T","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESC1","description":"ICD-GESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thromblytic art/ven therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37213","description":"Thromblytic art/ven therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKF0","description":"ICD-BFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61535","description":"Remove brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALA0","description":"ICD-IALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32_ 33_ 34_ 54_ or 56 for more than 90 consecutive days during","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1284","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32_ 33_ 34_ 54_ or 56 for more than 90 consecutive days during","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12018","description":"Rpr f/e/e/n/l/m >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSF0","description":"ICD-HBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC31","description":"ICD-3IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNE1","description":"ICD-CDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKF1","description":"ICD-GCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXC0","description":"ICD-OKXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOE1","description":"ICD-PBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carotid intima atheroma eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93895","description":"Carotid intima atheroma eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recd cortico >=10mg/day >60d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9467","description":"Recd cortico >=10mg/day >60d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sc r pos/lat pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0649","description":"Lso sc r pos/lat pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFE1","description":"ICD-KHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJD0","description":"ICD-OKJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0858T","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQE0","description":"ICD-DCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating The Patient Has Received Or Is Currently Receiving Palliative Or Hospice Care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9996","description":"Documentation Stating The Patient Has Received Or Is Currently Receiving Palliative Or Hospice Care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHC0","description":"ICD-FGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB230","description":"Special Care Low _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1x scrn hcv infect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9451","description":"1x scrn hcv infect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31750","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient encounter during the performance period with hospice and palliative care specialty code 17","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1365","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSD1","description":"ICD-GBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of amputation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24935","description":"Revision of amputation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Finasteride_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0138","description":"Finasteride_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Team conf w/o pat by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99368","description":"Team conf w/o pat by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRC0","description":"ICD-KCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64580","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFA1","description":"ICD-BBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJA0","description":"ICD-KCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NFCT AGT HIV GNRJ SEQ ALYS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0219U","description":"NFCT AGT HIV GNRJ SEQ ALYS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23B","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunotherapy one injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95115","description":"Immunotherapy one injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPF1","description":"ICD-KEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYB1","description":"ICD-GBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTC1","description":"ICD-JFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection into brain canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61055","description":"Injection into brain canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald neck_ loop ind receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5283","description":"Ald neck_ loop ind receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQD0","description":"ICD-DCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove palate/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42120","description":"Remove palate/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce shoulder bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23491","description":"Reinforce shoulder bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMC0","description":"ICD-NGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIE0","description":"ICD-MDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML36","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAD1","description":"ICD-FEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; ta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81176","description":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; ta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gasket or seal_ for use with prosthetic socket insert_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7700","description":"Gasket or seal_ for use with prosthetic socket insert_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10D","description":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhv-6 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87531","description":"Hhv-6 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLD0","description":"ICD-MJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBF0","description":"ICD-GEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEB1","description":"ICD-KIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLB1","description":"ICD-NGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXD1","description":"ICD-GDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N-et; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2002","description":"N-et; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHE1","description":"ICD-BDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIB0","description":"ICD-IAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYD1","description":"ICD-GCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for spleen x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38200","description":"Injection for spleen x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTA0","description":"ICD-MGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ emapalumab-lzsg_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9050","description":"Injection_ emapalumab-lzsg_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNA1","description":"ICD-FHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neisseria meningitidis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86741","description":"Neisseria meningitidis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sermorelin acetate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0515","description":"Sermorelin acetate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens variab asphericity sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2410","description":"Lens variab asphericity sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74249","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA212","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0625T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total cortisol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82533","description":"Total cortisol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone mineral dual photon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78351","description":"Bone mineral dual photon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRA0","description":"ICD-PHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB130","description":"Special Care High _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair communication device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5336","description":"Repair communication device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair standard detach a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1140","description":"Wheelchair standard detach a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise temple bone implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69718","description":"Revise temple bone implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBA0","description":"ICD-AEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKC1","description":"ICD-OBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBA0","description":"ICD-BDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sildenafil citrate_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0090","description":"Sildenafil citrate_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc daily aspirin or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9277","description":"Doc daily aspirin or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC205","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRD0","description":"ICD-CCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped power wheelchair nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1239","description":"Ped power wheelchair nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA115","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEA0","description":"ICD-BBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMC1","description":"ICD-MJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELE1","description":"ICD-KELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPB0","description":"ICD-BAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc hand tum deep < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26116","description":"Exc hand tum deep < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKE1","description":"ICD-NEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWE1","description":"ICD-PIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27477","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPB0","description":"ICD-FDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETE0","description":"ICD-KETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXF1","description":"ICD-NFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA35","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01220","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","description":"CPT-01220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biofeedback train any meth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90901","description":"Biofeedback train any meth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGC0","description":"ICD-CIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIA1","description":"ICD-JBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAF0","description":"ICD-AEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited autopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88036","description":"Limited autopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFB1","description":"ICD-GBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUB0","description":"ICD-CHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin intermed 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5552","description":"Insulin intermed 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parkinsons disease mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8903","description":"Parkinsons disease mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9803","description":"Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64468","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","description":"CPT-64468","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corneal tissue processing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2785","description":"Corneal tissue processing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA23","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILF1","description":"ICD-GILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXB0","description":"ICD-NDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extrnl counterpulse_ per tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0166","description":"Extrnl counterpulse_ per tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWD0","description":"ICD-LDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg vein fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34530","description":"Leg vein fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDD1","description":"ICD-MIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHC1","description":"ICD-IDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0703","description":"HCPCS-A0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECC1","description":"ICD-IECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med reas pt_ pn_ not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8722","description":"Med reas pt_ pn_ not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNB1","description":"ICD-CGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mohs addl stage t/a/l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17314","description":"Mohs addl stage t/a/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27720","description":"Repair of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Multiple Trajectories For","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61737","description":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Multiple Trajectories For","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQA1","description":"ICD-GFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37281","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","description":"CPT-37281","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/biopsy eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67450","description":"Explore/biopsy eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst including t/o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58262","description":"Vag hyst including t/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth bladder stone surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87051","description":"Anesth bladder stone surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0621U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","description":"CPT-0621U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28496","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKB0","description":"ICD-OBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBE1","description":"ICD-EHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methadone oral 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0109","description":"Methadone oral 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4C","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWD1","description":"ICD-OFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVC0","description":"ICD-KGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXB0","description":"ICD-JHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADB0","description":"ICD-EADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABA0","description":"ICD-IABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLF0","description":"ICD-CGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYF1","description":"ICD-LHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMB1","description":"ICD-FHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTB1","description":"ICD-FHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44625","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laps impltj nstim vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0312T","description":"Laps impltj nstim vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOB0","description":"ICD-KFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELB0","description":"ICD-FELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTD1","description":"ICD-GGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15B","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXE0","description":"ICD-JIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"U/s trtmt_ not leiomyomata","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9734","description":"U/s trtmt_ not leiomyomata","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL06","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/treat lung lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32141","description":"Remove/treat lung lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQD0","description":"ICD-GFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDD0","description":"ICD-JHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTE1","description":"ICD-AHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSC1","description":"ICD-OBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgicord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4218","description":"Surgicord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHC0","description":"ICD-ACHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27086","description":"Remove hip foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28400","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUB0","description":"ICD-BHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMC0","description":"ICD-CBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB105","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavior identification assessment_ administered by a physician or other qualified health care professional_ each 15 minutes of the physician_s or other qualified health care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97151","description":"Behavior identification assessment_ administered by a physician or other qualified health care professional_ each 15 minutes of the physician_s or other qualified health care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25526","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPA1","description":"ICD-GGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Long-acting inhaled bronchodilator not prescribed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9699","description":"Long-acting inhaled bronchodilator not prescribed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antibody testing for a public health related pathogen_ including coronavirus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0605","description":"Antibody testing for a public health related pathogen_ including coronavirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental gold foil one surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2410","description":"Dental gold foil one surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRE0","description":"ICD-PDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC13","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Induced abortion 17-24 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2260","description":"Induced abortion 17-24 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHA0","description":"ICD-CAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esketamine_ nasal spray_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0013","description":"Esketamine_ nasal spray_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap colectomy w/proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44211","description":"Lap colectomy w/proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTB0","description":"ICD-NDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHME0","description":"ICD-JHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiography head w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70545","description":"Mr angiography head w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJA1","description":"ICD-GIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); open femoral vein approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0806T","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); open femoral vein approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTF1","description":"ICD-FDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31230","description":"Removal of upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apligraf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4101","description":"Apligraf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYA0","description":"ICD-CGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise ovarian tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58752","description":"Revise ovarian tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVA0","description":"ICD-GHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDE1","description":"ICD-JIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKE1","description":"ICD-FBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB112","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion And Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual An","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2072","description":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion And Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAC0","description":"ICD-CIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANF1","description":"ICD-GANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20C","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Toilet rail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0243","description":"Toilet rail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHB1","description":"ICD-KGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIC1","description":"ICD-JDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTB0","description":"ICD-OCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJF0","description":"ICD-NLJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCA1","description":"ICD-IHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRE1","description":"ICD-PIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWB0","description":"ICD-OCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of donor heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33940","description":"Removal of donor heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Swallow goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8997","description":"Swallow goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC244","description":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TB screening not performed or results not interpreted_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1005","description":"TB screening not performed or results not interpreted_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXE0","description":"ICD-OGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNB0","description":"ICD-JHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDA0","description":"ICD-ABDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of b hexosaminidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83080","description":"Assay of b hexosaminidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSE0","description":"ICD-HBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0564U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","description":"CPT-0564U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0993T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","description":"CPT-0993T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methyl aminolevulinate_ top","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7309","description":"Methyl aminolevulinate_ top","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCA0","description":"ICD-MHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNA1","description":"ICD-OJNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00932","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","description":"CPT-00932","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress forearm 2 spaces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25024","description":"Decompress forearm 2 spaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELE0","description":"ICD-KELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gene test sickle cell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3850","description":"Gene test sickle cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33363","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJE1","description":"ICD-NHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","description":"HCPCS-L6033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDE1","description":"ICD-GFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASF0","description":"ICD-HASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQD1","description":"ICD-PBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQE0","description":"ICD-PHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3A","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36625","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA CHLAMYDIA TRACHOMATIS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87320","description":"IAAD IA CHLAMYDIA TRACHOMATIS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Card output measure subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93562","description":"Card output measure subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy swallow tst (fees)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92613","description":"Endoscopy swallow tst (fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHE1","description":"ICD-BIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJA0","description":"ICD-OKJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWF0","description":"ICD-HHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryoprecipitatereducedplasma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9044","description":"Cryoprecipitatereducedplasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ caplacizumab-yhdp_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9047","description":"Injection_ caplacizumab-yhdp_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75840","description":"Vein x-ray adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISA0","description":"ICD-DISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUE0","description":"ICD-MAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSD1","description":"ICD-GFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRB1","description":"ICD-LDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHC1","description":"ICD-MDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDD0","description":"ICD-KIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEA1","description":"ICD-CEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTE1","description":"ICD-FGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43810","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress optic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67570","description":"Decompress optic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC254","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMF0","description":"ICD-MGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARE0","description":"ICD-LARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy stent add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31637","description":"Bronchoscopy stent add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1394","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","description":"HCPCS-M1394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01968","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","description":"CPT-01968","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPC0","description":"ICD-NEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWB1","description":"ICD-HIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGF1","description":"ICD-FEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50555","description":"Kidney endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXE0","description":"ICD-JEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair stern/nuss w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21742","description":"Repair stern/nuss w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFE1","description":"ICD-BEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMC1","description":"ICD-AAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMB1","description":"ICD-MIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients on active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1268","description":"Patients on active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTF0","description":"ICD-MJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUD0","description":"ICD-CIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57270","description":"Repair of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYE1","description":"ICD-LGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSC0","description":"ICD-CCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enterectomy cadaver donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44132","description":"Enterectomy cadaver donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40843","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Direct immunofluorescence","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0482","description":"Direct immunofluorescence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA11","description":"ICD-2LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1194","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient achieved a PDC of at least 75% for their asthma controller medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9810","description":"Patient achieved a PDC of at least 75% for their asthma controller medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Image cath fluid peri/retro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49406","description":"Image cath fluid peri/retro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of total replacement heart system (artificial heart)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33928","description":"Removal and replacement of total replacement heart system (artificial heart)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTB1","description":"ICD-GGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Na ferric gluconate complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2916","description":"Na ferric gluconate complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0138","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","description":"HCPCS-J0138","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC11","description":"ICD-4KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of nail fold toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11765","description":"Excision of nail fold toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPE0","description":"ICD-CIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICD0","description":"ICD-NICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARC0","description":"ICD-PARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15935","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA234","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJF0","description":"ICD-JEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPB0","description":"ICD-GEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation medicine (kidney allograft rejection)_ microarray gene expression profiling of 1494 genes_ utilizing transplant biopsy tissue_ algorithm reported as a probabil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0088U","description":"Transplantation medicine (kidney allograft rejection)_ microarray gene expression profiling of 1494 genes_ utilizing transplant biopsy tissue_ algorithm reported as a probabil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continuous Home Care - A flat per hourly rate before area wage adjustment for intensive home nursing care delivered by personnel when the need for such care exceeds 8 hours","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0603","description":"Continuous Home Care - A flat per hourly rate before area wage adjustment for intensive home nursing care delivered by personnel when the need for such care exceeds 8 hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWF1","description":"ICD-DEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bilateral hip_ knee_ ankle_ foot device_ powered_ includes pelvic component_ single or double upright(s)_ knee joints any type_ with or without ankle joints any type_ includes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1007","description":"Bilateral hip_ knee_ ankle_ foot device_ powered_ includes pelvic component_ single or double upright(s)_ knee joints any type_ with or without ankle joints any type_ includes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEC0","description":"ICD-OCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; qualitative_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82541","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; qualitative_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOC1","description":"ICD-LFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sc r pos/lat pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0633","description":"Lso sc r pos/lat pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flowcytometry/read 16 & >","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88189","description":"Flowcytometry/read 16 & >","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13D","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lyme disease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86618","description":"Lyme disease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure for cholangiography through an existing catheter(eg_ percutaneous transhepatic or t-tube)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47505","description":"Injection procedure for cholangiography through an existing catheter(eg_ percutaneous transhepatic or t-tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWD0","description":"ICD-CAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99205","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13120","description":"Cmplx rpr s/a/l 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Delay flap trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15600","description":"Delay flap trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXF0","description":"ICD-OIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are identified as having an intolerance or allergy to beta-blocker therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9800","description":"Patients who are identified as having an intolerance or allergy to beta-blocker therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMA0","description":"ICD-CHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJD0","description":"ICD-FFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Polysom any age 1-3> param","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95808","description":"Polysom any age 1-3> param","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJA0","description":"ICD-JAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOA1","description":"ICD-OKOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQF0","description":"ICD-PEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJA1","description":"ICD-OAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVC1","description":"ICD-BAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB12","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIA1","description":"ICD-IHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUD1","description":"ICD-JDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYB0","description":"ICD-CBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part pulp for apexogenesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3222","description":"Part pulp for apexogenesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC31","description":"ICD-1GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHC0","description":"ICD-BHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOF1","description":"ICD-DCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14A","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAB1","description":"ICD-AFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESA0","description":"ICD-KESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0665","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","description":"HCPCS-G0665","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQC0","description":"ICD-DCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSC0","description":"ICD-HHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMA1","description":"ICD-FDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCD0","description":"ICD-AFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSE0","description":"ICD-DGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25400","description":"Repair radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; With Mediastinal Lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21603","description":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; With Mediastinal Lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAC1","description":"ICD-MJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVB0","description":"ICD-JAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test_ or patient has a reactive hcv antibody test and has a follow up hcv viral test that dete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1230","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test_ or patient has a reactive hcv antibody test and has a follow up hcv viral test that dete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC221","description":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNA1","description":"ICD-CHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tumor imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78804","description":"Tumor imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILE0","description":"ICD-AILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEF0","description":"ICD-CHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFA1","description":"ICD-GDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd trach dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87490","description":"Chylmd trach dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIF0","description":"ICD-NJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIA1","description":"ICD-KDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHE1","description":"ICD-EHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External receiver_ cgm sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9278","description":"External receiver_ cgm sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB30","description":"High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1402","description":"HCPCS-A1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCB1","description":"ICD-OHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1043","description":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31529","description":"Laryngoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYC1","description":"ICD-LFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXD0","description":"ICD-OBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ob us < 14 wks addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76802","description":"Ob us < 14 wks addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92652","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/sac fb remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32658","description":"Thoracoscopy w/sac fb remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prostatic microwave thermotx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53850","description":"Prostatic microwave thermotx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFF1","description":"ICD-JBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXB1","description":"ICD-FAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQE1","description":"ICD-HHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0231T","description":"Njx tfrml eprl w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPC1","description":"ICD-NEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath eval fna report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88173","description":"Cytopath eval fna report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 21 targets (adenovirus_ coronavirus 229E_ coronaviru","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0100U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 21 targets (adenovirus_ coronavirus 229E_ coronaviru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGC0","description":"ICD-OIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optimal care for kidney health mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0002","description":"Optimal care for kidney health mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient has documented immunity to hepatitis B and initiating anti-TNF therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8869","description":"Patient has documented immunity to hepatitis B and initiating anti-TNF therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWC1","description":"ICD-HIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYE0","description":"ICD-PAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0516U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","description":"CPT-0516U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBD0","description":"ICD-ECBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLB1","description":"ICD-GFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ An","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2069","description":"Medication Assisted Treatment_ Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLB1","description":"ICD-JBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (non-small cell lung cancer)_ cell-free DNA from plasma_ targeted sequence analysis of at least 109 genes_ including sequence variants_ substitutions_ insertions_ del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0397U","description":"Oncology (non-small cell lung cancer)_ cell-free DNA from plasma_ targeted sequence analysis of at least 109 genes_ including sequence variants_ substitutions_ insertions_ del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTB1","description":"ICD-FFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3d render w/intrp postproces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76377","description":"3d render w/intrp postproces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXA1","description":"ICD-ODXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYA1","description":"ICD-GBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95708","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGND1","description":"ICD-OGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUD0","description":"ICD-MCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC121","description":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAD0","description":"ICD-OBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELD1","description":"ICD-OELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"<50% of total number of a patient_s outpatient RA encounters assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1008","description":"<50% of total number of a patient_s outpatient RA encounters assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0205","description":"HCPCS-A0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev cardrehab qualcardevent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4510F","description":"Prev cardrehab qualcardevent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFB0","description":"ICD-BDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2209","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso flex custom fab thoraci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0452","description":"Tlso flex custom fab thoraci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA11","description":"ICD-3CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAB0","description":"ICD-OJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FlowerAmnioPatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4178","description":"FlowerAmnioPatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBC1","description":"ICD-ECBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETF1","description":"ICD-CETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMB0","description":"ICD-GGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA212","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUD0","description":"ICD-CAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJF0","description":"ICD-BIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENA1","description":"ICD-KENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUE0","description":"ICD-OKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; Birth Through 5 Years Of Age Or Any","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33018","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; Birth Through 5 Years Of Age Or Any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLB1","description":"ICD-BHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11470","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC125","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFB1","description":"ICD-GAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB11","description":"ICD-1LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35371","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CT scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9348","description":"CT scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Localized delivery antimicro","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4381","description":"Localized delivery antimicro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTE0","description":"ICD-IGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSD1","description":"ICD-DHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-15014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","description":"CPT-15014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1356","description":"Patients who died during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26746","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9304","description":"HCPCS-C9304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFA1","description":"ICD-NIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBF1","description":"ICD-IBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bundle of his recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93600","description":"Bundle of his recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complex cystometrogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51726","description":"Complex cystometrogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert uteri tandem/ovoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57155","description":"Insert uteri tandem/ovoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1110T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1110T","description":"CPT-1110T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flurazepam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6051","description":"Flurazepam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGF1","description":"ICD-OJGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21280","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0701","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0701","description":"CDT-D0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSB1","description":"ICD-HBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect thigh/knee tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27364","description":"Resect thigh/knee tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOD1","description":"ICD-GBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1806","description":"Injection_ esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMC1","description":"ICD-OJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0124A","description":"IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20B","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Search for prior patient completed dicom format images not completed due to medical reasons(eg_CT studies performed for radiation treatment planning or image-guided radiation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9343","description":"Search for prior patient completed dicom format images not completed due to medical reasons(eg_CT studies performed for radiation treatment planning or image-guided radiation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPD1","description":"ICD-GBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plnning pt spec fenest graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34839","description":"Plnning pt spec fenest graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJA1","description":"ICD-JIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flex/ext/rotation wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6624","description":"Flex/ext/rotation wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFC1","description":"ICD-GDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic endoscopic retrograde cholangiopancreatography (ercp)_ including collection of specimen(s) by brushing or washing_ when performed_ with endoscopic cannulation of pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7541","description":"Diagnostic endoscopic retrograde cholangiopancreatography (ercp)_ including collection of specimen(s) by brushing or washing_ when performed_ with endoscopic cannulation of pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMB1","description":"ICD-CIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ belinostat_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9032","description":"Injection_ belinostat_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIB0","description":"ICD-OFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAF1","description":"ICD-IGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHB0","description":"ICD-CIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of System Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Unable To Locate Previous Colonoscopy Report_ Previous Colonoscopy Rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9999","description":"Documentation Of System Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Unable To Locate Previous Colonoscopy Report_ Previous Colonoscopy Rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injecte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1322","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injecte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB11","description":"ICD-3HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strep a dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87651","description":"Strep a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEC1","description":"ICD-KAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPE1","description":"ICD-OFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUB1","description":"ICD-EDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC25","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYF1","description":"ICD-LDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDD0","description":"ICD-CCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26350","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62305","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnosticmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0204","description":"Diagnosticmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVD1","description":"ICD-NKVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE240","description":"Reduced Physical Function _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIND1","description":"ICD-GIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISE0","description":"ICD-CISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77771","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADB1","description":"ICD-OADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLB1","description":"ICD-AGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of salivary cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42408","description":"Excision of salivary cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microsomal antibody each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86376","description":"Microsomal antibody each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ respiratory tract infection_ 17 bacteria_ 8 fungus_ 13 virus_ and 16 antibiotic-resistance genes_ multiplex amplified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0373U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ respiratory tract infection_ 17 bacteria_ 8 fungus_ 13 virus_ and 16 antibiotic-resistance genes_ multiplex amplified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1272","description":"Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0562T","description":"Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOC0","description":"ICD-PEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg artery-vein three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33519","description":"Cabg artery-vein three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBA0","description":"ICD-NHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic salivary reflex s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0755","description":"Electronic salivary reflex s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACA0","description":"ICD-OACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLE0","description":"ICD-JFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLD0","description":"ICD-ADLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC135","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelets leukoreduced irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9033","description":"Platelets leukoreduced irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46615","description":"Anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFF1","description":"ICD-JDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter placement of intravascular stent(s)_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36908","description":"Transcatheter placement of intravascular stent(s)_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECE1","description":"ICD-GECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDA1","description":"ICD-KHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQB1","description":"ICD-KFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exchange lens prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66986","description":"Exchange lens prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJA0","description":"ICD-FEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUC1","description":"ICD-EEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMA1","description":"ICD-ECMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cesarean delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59510","description":"Cesarean delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELA0","description":"ICD-NELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVB0","description":"ICD-KIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICD0","description":"ICD-JICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1301","description":"HCPCS-A1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOC1","description":"ICD-HGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOC0","description":"ICD-PBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDE1","description":"ICD-FFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVC0","description":"ICD-FDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69610","description":"Repair of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteogen ultrasound stimltor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0760","description":"Osteogen ultrasound stimltor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAB1","description":"ICD-GFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed total electr w/ mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0265","description":"Hosp bed total electr w/ mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove fix space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1555","description":"Remove fix space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAA1","description":"ICD-FFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NFCT DS BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0202U","description":"NFCT DS BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSD0","description":"ICD-PKSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic sheepskin pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0188","description":"Synthetic sheepskin pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYA1","description":"ICD-DBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35475","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACB1","description":"ICD-KACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXE1","description":"ICD-GEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmi is documented above normal parameters and a follow-up plan is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1293","description":"Bmi is documented above normal parameters and a follow-up plan is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUA0","description":"ICD-ECUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1030","description":"Patients with clinical indications for imaging of the head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O shoe add horseshoe toe tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3560","description":"O shoe add horseshoe toe tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB151","description":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLB1","description":"ICD-IFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0501","description":"HCPCS-B0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFF1","description":"ICD-OHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscope_ single-use (i.e. disposable)_ urinary tract_ imaging/illumination device (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1747","description":"Endoscope_ single-use (i.e. disposable)_ urinary tract_ imaging/illumination device (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOE1","description":"ICD-CAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFB1","description":"ICD-GHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86850","description":"Rbc antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE134","description":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx esophageal unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9099","description":"Onc dx esophageal unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCC0","description":"ICD-KGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4378","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","description":"HCPCS-Q4378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incobotulinumtoxin a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0588","description":"Incobotulinumtoxin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01758","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","description":"CPT-01758","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB11","description":"ICD-3DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMC0","description":"ICD-AGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit cont pain per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9326","description":"Hit cont pain per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYD0","description":"ICD-HDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial mastectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19301","description":"Partial mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYA0","description":"ICD-PCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of serum albumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82040","description":"Assay of serum albumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cult skin graft t/a/l +%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15152","description":"Cult skin graft t/a/l +%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rabies Immune Globulin_ Heat- And Solvent/Detergent-Treated (Rig-Ht S/D)_ Human_ For Intramuscular And/Or Subcutaneous Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90377","description":"Rabies Immune Globulin_ Heat- And Solvent/Detergent-Treated (Rig-Ht S/D)_ Human_ For Intramuscular And/Or Subcutaneous Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVE1","description":"ICD-OGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood pressure measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2000F","description":"Blood pressure measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWE1","description":"ICD-KDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tongue mouth neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41153","description":"Tongue mouth neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTB1","description":"ICD-AHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disconnect locking wrist uni","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6615","description":"Disconnect locking wrist uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWA1","description":"ICD-KAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transurethral Ablation Of Malignant Prostate Tissue By High-Energy Water Vapor Thermotherapy_ Including Intraoperative Imaging And Needle Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0582T","description":"Transurethral Ablation Of Malignant Prostate Tissue By High-Energy Water Vapor Thermotherapy_ Including Intraoperative Imaging And Needle Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTF1","description":"ICD-CHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ elastic medium stretch_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6598","description":"Gradient compression bandage roll_ elastic medium stretch_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of orbit (transcranial approach); with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61332","description":"Exploration of orbit (transcranial approach); with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEA0","description":"ICD-IEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICA1","description":"ICD-FICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice in ltch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5007","description":"Hospice in ltch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJB1","description":"ICD-JBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supported employ_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2024","description":"Supported employ_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPD0","description":"ICD-JAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test nonparaspinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95870","description":"Muscle test nonparaspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUB1","description":"ICD-NIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHF1","description":"ICD-CHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21267","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDF0","description":"ICD-NIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYD0","description":"ICD-HBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sterile needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4215","description":"Sterile needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAB0","description":"ICD-GAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHA1","description":"ICD-OFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1952","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","description":"HCPCS-L1952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjust bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20693","description":"Adjust bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPE0","description":"ICD-FHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBA0","description":"ICD-MBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture othr specimn aerobic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87070","description":"Culture othr specimn aerobic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification_ methylated DNA markers_ including LASS4_ LRRC4 and PPP2R5C_ a reference marker ZDHHC1_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0464U","description":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification_ methylated DNA markers_ including LASS4_ LRRC4 and PPP2R5C_ a reference marker ZDHHC1_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20D","description":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDC0","description":"ICD-EEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISB1","description":"ICD-DISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGA0","description":"ICD-NHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWA0","description":"ICD-HCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPE0","description":"ICD-BDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absorp drg >16<=48 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0745","description":"Absorp drg >16<=48 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ex h rate for sz ovr 30 day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0385T","description":"Ex h rate for sz ovr 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00811","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","description":"CPT-00811","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of corneal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65450","description":"Treatment of corneal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intrnl bleaching per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9974","description":"Intrnl bleaching per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adm Tocilizu COVID-19 2nd dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0250","description":"Adm Tocilizu COVID-19 2nd dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFD0","description":"ICD-GAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E2513","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","description":"HCPCS-E2513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Larynx surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31599","description":"Larynx surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJE0","description":"ICD-FIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBE1","description":"ICD-FEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKD1","description":"ICD-NBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEC1","description":"ICD-NEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJF0","description":"ICD-JHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIE1","description":"ICD-OKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wellness assessment by nonph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5190","description":"Wellness assessment by nonph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEE1","description":"ICD-BHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQE0","description":"ICD-DIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0962T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","description":"CPT-0962T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intraoral procedures_ including biopsy; radical surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0126U","description":"Anesthesia for intraoral procedures_ including biopsy; radical surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISA0","description":"ICD-HISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOA0","description":"ICD-GFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKD0","description":"ICD-JBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYF1","description":"ICD-OJYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDD1","description":"ICD-MFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFA1","description":"ICD-OCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Singlay_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4329","description":"Singlay_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psych hlth fac svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2013","description":"Psych hlth fac svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEC1","description":"ICD-NKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHA1","description":"ICD-NDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat neck spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22326","description":"Treat neck spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHA1","description":"ICD-ICHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fludarabine phosphate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9185","description":"Fludarabine phosphate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0870","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","description":"HCPCS-J0870","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOB0","description":"ICD-KCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5146","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","description":"HCPCS-Q5146","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conform band n/s w<3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6442","description":"Conform band n/s w<3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNB0","description":"ICD-KHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No admit req surg rev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9413","description":"No admit req surg rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1019T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","description":"CPT-1019T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of urinary leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53080","description":"Drainage of urinary leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD120","description":"Special Care High _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial preventive exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0402","description":"Initial preventive exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemical peel face dermal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15789","description":"Chemical peel face dermal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert non-tunnel cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36555","description":"Insert non-tunnel cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe lift elev heel/sole cor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3320","description":"Shoe lift elev heel/sole cor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"2019-nCoV Coronavirus_ SARS-CoV-2/2019-nCoV (COVID-19)_ any technique_ multiple types or subtypes (includes all targets)_ non-CDC_ making use of high throughput technologies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0004","description":"2019-nCoV Coronavirus_ SARS-CoV-2/2019-nCoV (COVID-19)_ any technique_ multiple types or subtypes (includes all targets)_ non-CDC_ making use of high throughput technologies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBB1","description":"ICD-JIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLC0","description":"ICD-BFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATA0","description":"ICD-OATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Round caliper and plate atta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2240","description":"Round caliper and plate atta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVD1","description":"ICD-JEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTE0","description":"ICD-ACTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXF1","description":"ICD-JCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cap bld skin piercing laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0620","description":"Cap bld skin piercing laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wedge biopsy of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47100","description":"Wedge biopsy of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDB0","description":"ICD-CFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor xiii anti-hem factor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7180","description":"Factor xiii anti-hem factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMD1","description":"ICD-GFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hist type doc on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9283","description":"Hist type doc on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0A","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q8h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9502","description":"Hit antibiotic q8h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with dilation of frontal and sphenoid sinus ostia (eg_ balloon dilation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31298","description":"Nasal/sinus endoscopy_ surgical; with dilation of frontal and sphenoid sinus ostia (eg_ balloon dilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJB1","description":"ICD-FIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJB1","description":"ICD-OJJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33641","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSA1","description":"ICD-ODSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDA0","description":"ICD-KIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLID0","description":"ICD-MLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ arm_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6523","description":"Gradient compression garment_ arm_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of neck cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42810","description":"Excision of neck cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLD1","description":"ICD-MFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device_ mechano-electrical skin interface and electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0459T","description":"Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device_ mechano-electrical skin interface and electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digital sub 2 or more images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0394","description":"Digital sub 2 or more images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASF0","description":"ICD-DASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reoperation bypass graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35700","description":"Reoperation bypass graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92285","description":"Eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration behind upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31040","description":"Exploration behind upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1140","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"On Date Of Encounter_ Patient Is Not Able To Participate In Assessment Or Screening_ Including Non-Verbal Patients_ Delirious_ Severely Aphasic_ Severely Developmentally Delay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0037","description":"On Date Of Encounter_ Patient Is Not Able To Participate In Assessment Or Screening_ Including Non-Verbal Patients_ Delirious_ Severely Aphasic_ Severely Developmentally Delay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA_ gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0047U","description":"Oncology (prostate)_ mRNA_ gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Endoscopic Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0616","description":"Hospital Special Treatment Room Support Component (Hstrsc) Endoscopic Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJC0","description":"ICD-BCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPE1","description":"ICD-JAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINB0","description":"ICD-JINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAA1","description":"ICD-NBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6014","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHB1","description":"ICD-IDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microbe susceptible mlc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87187","description":"Microbe susceptible mlc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2C","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAED1","description":"ICD-BAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIE1","description":"ICD-BHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB250","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBC0","description":"ICD-GDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afluria vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2035","description":"Afluria vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHD1","description":"ICD-FBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGED0","description":"ICD-JGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orchiectomy partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54522","description":"Orchiectomy partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place cath carotd art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36224","description":"Place cath carotd art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEB1","description":"ICD-IFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPF1","description":"ICD-NJPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag r an/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0631","description":"Lso sag r an/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01173","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","description":"CPT-01173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50436","description":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Benzodiazepines","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6031","description":"Benzodiazepines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXF1","description":"ICD-KIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGA1","description":"ICD-OGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGME1","description":"ICD-CGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55865","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visc & infraren abd 3 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34847","description":"Visc & infraren abd 3 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Portable oxygen contents_ liquid_ 1 month_s supply = 1 unit_ prescribed amount at rest or nighttime exceeds 4 liters per minute","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0447","description":"Portable oxygen contents_ liquid_ 1 month_s supply = 1 unit_ prescribed amount at rest or nighttime exceeds 4 liters per minute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSE0","description":"ICD-GGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pediatrics (congenital epigenetic disorders)_ whole genome methylation analysis by microarray for 50 or more genes_ blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0318U","description":"Pediatrics (congenital epigenetic disorders)_ whole genome methylation analysis by microarray for 50 or more genes_ blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEF1","description":"ICD-NLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIB1","description":"ICD-KFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom gradient sleev/glov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8420","description":"Custom gradient sleev/glov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISB0","description":"ICD-CISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWE0","description":"ICD-DIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mouth surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40899","description":"Mouth surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE215","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPF0","description":"ICD-KGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC11","description":"ICD-3LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31785","description":"Remove windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1972","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1972","description":"HCPCS-L1972","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRA0","description":"ICD-PFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCD1","description":"ICD-OLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXD1","description":"ICD-OAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46601","description":"Diagnostic anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMD1","description":"ICD-FHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCB0","description":"ICD-OBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIC1","description":"ICD-AEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUF0","description":"ICD-KAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARD0","description":"ICD-LARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFME1","description":"ICD-JFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9696","description":"Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transthor diaphrag hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43335","description":"Transthor diaphrag hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46761","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSC0","description":"ICD-DCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18G","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroretinography with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92275","description":"Electroretinography with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB213","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVE0","description":"ICD-OGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHA1","description":"ICD-GGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAF1","description":"ICD-NGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj facial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64402","description":"N block inj facial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multi-position stnd fram sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0641","description":"Multi-position stnd fram sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQB1","description":"ICD-PHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEC0","description":"ICD-KIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27828","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTB0","description":"ICD-EHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 4 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3390F","description":"Ajcc cln cncr stage 4 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFE0","description":"ICD-JCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Polysom <6 yrs cpap/bilvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95783","description":"Polysom <6 yrs cpap/bilvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCB1","description":"ICD-MFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLF0","description":"ICD-GCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Employment Career Assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1732","description":"Employment Career Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCF1","description":"ICD-OFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE120","description":"Special Care High _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETC1","description":"ICD-GETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEF0","description":"ICD-FDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWF1","description":"ICD-GHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGF0","description":"ICD-GGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2037","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","description":"HCPCS-A2037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOC0","description":"ICD-DGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAF1","description":"ICD-OAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYD1","description":"ICD-LFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78258","description":"Esophageal motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAB0","description":"ICD-NCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTE0","description":"ICD-KHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFE1","description":"ICD-FGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj brachial plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64415","description":"N block inj brachial plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subtalar arthro w/fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29907","description":"Subtalar arthro w/fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWF0","description":"ICD-KFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0524U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","description":"CPT-0524U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKF0","description":"ICD-BBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPF1","description":"ICD-FFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTC0","description":"ICD-NGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA220","description":"Clinically Complex _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health  or substance use disorder_   initial 15-29 minutes_ provided remotely by hospital staff who are licensed to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7900","description":"Service for diagnosis_ evaluation_ or treatment of a mental health  or substance use disorder_   initial 15-29 minutes_ provided remotely by hospital staff who are licensed to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arch supp att to shoe long/m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3090","description":"Arch supp att to shoe long/m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Prescribed Or Currently Being T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2092","description":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Prescribed Or Currently Being T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC10","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIF0","description":"ICD-JCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0771T","description":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29881","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXE0","description":"ICD-JHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE251","description":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair Of Orthodontic Appliance - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8696","description":"Repair Of Orthodontic Appliance - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJF1","description":"ICD-NHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDB1","description":"ICD-ICDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJC0","description":"ICD-NGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCD0","description":"ICD-MKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHE1","description":"ICD-KDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application lower leg splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29515","description":"Application lower leg splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abduction rotation bar shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3140","description":"Abduction rotation bar shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture screen only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87081","description":"Culture screen only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo total proctocolectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44212","description":"Laparo total proctocolectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUE0","description":"ICD-MGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penicillin g potassium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2540","description":"Penicillin g potassium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCF1","description":"ICD-ACCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX14","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14D","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUD0","description":"ICD-IDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligate oviduct(s) add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58611","description":"Ligate oviduct(s) add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBC0","description":"ICD-NLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20704","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLF0","description":"ICD-FFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92511","description":"Nasopharyngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap paraesoph her rpr w/mesh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43282","description":"Lap paraesoph her rpr w/mesh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSE1","description":"ICD-LFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEME0","description":"ICD-AEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLA1","description":"ICD-FDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Double transfer toe-hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26554","description":"Double transfer toe-hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTA0","description":"ICD-ADTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand/chin ctrl std joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2374","description":"Hand/chin ctrl std joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18C","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0943T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","description":"CPT-0943T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHB1","description":"ICD-BEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy w/rf delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0288T","description":"Anoscopy w/rf delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Growth hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80430","description":"Growth hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCB0","description":"ICD-BHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCF0","description":"ICD-NGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFA1","description":"ICD-GIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICC0","description":"ICD-MICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med rsn no scr etoh use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9623","description":"Doc med rsn no scr etoh use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0612U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","description":"CPT-0612U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES150","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inlay composite/resin one su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2650","description":"Inlay composite/resin one su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOB0","description":"ICD-CCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9278","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","description":"HCPCS-J9278","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX01","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Habil ed waiver per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2013","description":"Habil ed waiver per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGC0","description":"ICD-NKGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 2-3 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72040","description":"X-ray exam neck spine 2-3 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEE1","description":"ICD-KGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of astigmatism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65775","description":"Correction of astigmatism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ granisetron extended release_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9486","description":"Injection_ granisetron extended release_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAA1","description":"ICD-KDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Harvest allogeneic stem cell","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38205","description":"Harvest allogeneic stem cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sewho cap design w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3961","description":"Sewho cap design w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25130","description":"Removal of wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL03","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext h rate epi sz 14 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0381T","description":"Ext h rate epi sz 14 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHD1","description":"ICD-GEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHA1","description":"ICD-MLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMB1","description":"ICD-MJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOE1","description":"ICD-DCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEED1","description":"ICD-JEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYA1","description":"ICD-ODYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILD1","description":"ICD-NILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARF1","description":"ICD-DARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPE0","description":"ICD-GGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLC0","description":"ICD-NCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiological Evaluation Of Implantable Cardioverter-Defibrillator System With Substernal Electrode (Includes Defibrillation Threshold Evaluation_ Induction Of Arrhythm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0577T","description":"Electrophysiological Evaluation Of Implantable Cardioverter-Defibrillator System With Substernal Electrode (Includes Defibrillation Threshold Evaluation_ Induction Of Arrhythm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay porc 3/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2630","description":"Dental onlay porc 3/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25C","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37280","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","description":"CPT-37280","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; cranioplasty or elevation of depres","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0132U","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1101","description":"HCPCS-A1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCE1","description":"ICD-ECCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extension drainage tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4331","description":"Extension drainage tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Outpt iv insulin tx any mea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9147","description":"Outpt iv insulin tx any mea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tooth root removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7250","description":"Tooth root removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34705","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of scrotum abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55100","description":"Drainage of scrotum abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHC1","description":"ICD-KEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pul art balloon repr percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92997","description":"Pul art balloon repr percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMF1","description":"ICD-NKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Placement of drain pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48001","description":"Placement of drain pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPB0","description":"ICD-OAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUA0","description":"ICD-FHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBA1","description":"ICD-MIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUC0","description":"ICD-NBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score knee >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8647","description":"Fun stat score knee >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB31","description":"ICD-1EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9192","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9192","description":"HCPCS-J9192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINF0","description":"ICD-CINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJD1","description":"ICD-KFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDF0","description":"ICD-CHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ avelumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9023","description":"Injection_ avelumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFA1","description":"ICD-OIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEC0","description":"ICD-OEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOA1","description":"ICD-CEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67107","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telehealth transmit_ per min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1014","description":"Telehealth transmit_ per min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD117","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFE1","description":"ICD-KAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA01","description":"Default_ /Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFC1","description":"ICD-CDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKE0","description":"ICD-JHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXA0","description":"ICD-OCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJD1","description":"ICD-GAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJD1","description":"ICD-BDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIB1","description":"ICD-KEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrogastrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91132","description":"Electrogastrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93225","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAF0","description":"ICD-CAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFC1","description":"ICD-FAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tacrolimus imme rel oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7507","description":"Tacrolimus imme rel oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable with carotid sinus baroreceptor stimulation lead(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1825","description":"Generator_ neurostimulator (implantable)_ non-rechargeable with carotid sinus baroreceptor stimulation lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLA0","description":"ICD-BHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMC0","description":"ICD-FAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXD1","description":"ICD-NJXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lysis + lavage w catheters","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7871","description":"Lysis + lavage w catheters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TB screening performed and results interpreted within 12 months prior to initiation of first-time biologic disease modifying an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1003","description":"TB screening performed and results interpreted within 12 months prior to initiation of first-time biologic disease modifying an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28D","description":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; initial wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0512T","description":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; initial wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMB1","description":"ICD-NGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy lower leg soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27613","description":"Biopsy lower leg soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUC0","description":"ICD-KGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES117","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAC0","description":"ICD-EDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","description":"HCPCS-J3404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc advncd dis cmfrt not 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1153F","description":"Doc advncd dis cmfrt not 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTA1","description":"ICD-ABTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infusion insulin pump needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4231","description":"Infusion insulin pump needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGB0","description":"ICD-BAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFF0","description":"ICD-JFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHA1","description":"ICD-GBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELE0","description":"ICD-BELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37249","description":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shoulder cast plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4003","description":"Cast sup shoulder cast plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral infus pump portab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9004","description":"Parenteral infus pump portab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUF0","description":"ICD-NIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFE1","description":"ICD-NDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Missed appointment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9986","description":"Missed appointment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20C","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB54","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1016T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","description":"CPT-1016T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD134","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUD0","description":"ICD-GDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient is not dysarthric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3763F","description":"Patient is not dysarthric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUC1","description":"ICD-MAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28H","description":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKD0","description":"ICD-CEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRF0","description":"ICD-OIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTD0","description":"ICD-BCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHE0","description":"ICD-OJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCF1","description":"ICD-BBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXE0","description":"ICD-CDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETA1","description":"ICD-FETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHB1","description":"ICD-FFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADC0","description":"ICD-JADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cholera vaccine live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90625","description":"Cholera vaccine live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOF0","description":"ICD-LEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pne scrn done doc vac done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9279","description":"Pne scrn done doc vac done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBF0","description":"ICD-GFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMA1","description":"ICD-FIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPC0","description":"ICD-GGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer not used w oxygen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7017","description":"Nebulizer not used w oxygen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKE1","description":"ICD-NFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGF0","description":"ICD-NHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWC0","description":"ICD-GCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVC0","description":"ICD-CGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Norsn for gc chl syp test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9230","description":"Norsn for gc chl syp test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB255","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJF0","description":"ICD-OCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXF1","description":"ICD-OCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVE1","description":"ICD-NCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phenobarbital sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2560","description":"Phenobarbital sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWD1","description":"ICD-ODWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29880","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Nasal Naloxone; 2-Pack Of 8Mg Per 0.1 Ml Nasal Spray (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1028","description":"Take-Home Supply Of Nasal Naloxone; 2-Pack Of 8Mg Per 0.1 Ml Nasal Spray (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYB0","description":"ICD-LBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKF0","description":"ICD-FFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBC0","description":"ICD-FBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFE1","description":"ICD-FBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2035","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","description":"HCPCS-A2035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAD0","description":"ICD-MIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTF0","description":"ICD-AFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHD0","description":"ICD-KFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4364","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","description":"HCPCS-Q4364","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29345","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHD0","description":"ICD-CEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHE1","description":"ICD-JGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8B","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc hip pelvis les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27043","description":"Exc hip pelvis les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup hip spica ped fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4028","description":"Cast sup hip spica ped fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOF1","description":"ICD-CIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKB0","description":"ICD-OIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFD1","description":"ICD-BCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXF0","description":"ICD-NEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1096T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1096T","description":"CPT-1096T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97552","description":"Group caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHA1","description":"ICD-KGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCC1","description":"ICD-OLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCF1","description":"ICD-NDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELA1","description":"ICD-IELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOC1","description":"ICD-PKOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDF1","description":"ICD-AIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSE1","description":"ICD-PKSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mastoidectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69502","description":"Mastoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRF1","description":"ICD-HFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFF1","description":"ICD-CBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEB1","description":"ICD-OJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA32","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor viia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7189","description":"Factor viia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caster pin lock each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0073","description":"Caster pin lock each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAD0","description":"ICD-AGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQD1","description":"ICD-LAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQF0","description":"ICD-OEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA21","description":"ICD-2DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release palm & finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26442","description":"Release palm & finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWB0","description":"ICD-DFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTE1","description":"ICD-MBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy w/bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45305","description":"Proctosigmoidoscopy w/bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening proctoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0601","description":"Screening proctoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQE1","description":"ICD-GCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEA1","description":"ICD-EHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak sleeve susp neoprene/equa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5695","description":"Ak sleeve susp neoprene/equa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUD0","description":"ICD-JHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYC0","description":"ICD-KEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCC1","description":"ICD-CBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43887","description":"Remove gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0555","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","description":"HCPCS-G0555","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0371T","description":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Botulinum antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90287","description":"Botulinum antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCED1","description":"ICD-KCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Power adapter_ combo vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0478","description":"Power adapter_ combo vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAC1","description":"ICD-BFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22C","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRA1","description":"ICD-PJRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18A","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPE1","description":"ICD-CFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEE1","description":"ICD-KIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/o coronary artery stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4562F","description":"Pt w/o coronary artery stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychi sympt 1+present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1182F","description":"Neuropsychi sympt 1+present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA241","description":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEA1","description":"ICD-OFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOB1","description":"ICD-GFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEB1","description":"ICD-GCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"20+ cc syringe only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4213","description":"20+ cc syringe only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7569","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7569","description":"HCPCS-C7569","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPF1","description":"ICD-OKPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUF1","description":"ICD-OHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast bath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97034","description":"Contrast bath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incontinence product_ disposable_ penile wrap_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4545","description":"Incontinence product_ disposable_ penile wrap_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCC1","description":"ICD-MKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1205","description":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of more than","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1034","description":"Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of more than","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJB0","description":"ICD-GCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCA1","description":"ICD-KDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Same day nb discharge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99463","description":"Same day nb discharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAA1","description":"ICD-NJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome count additional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88285","description":"Chromosome count additional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIC1","description":"ICD-MFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Head/extremity control inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2328","description":"Head/extremity control inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75710","description":"Artery x-rays arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMA0","description":"ICD-KIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj perflutren lip micros_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9957","description":"Inj perflutren lip micros_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient not screened for future fall risk_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1070","description":"Patient not screened for future fall risk_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Norsn no pros info op rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9303","description":"Norsn no pros info op rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27823","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA46","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPA0","description":"ICD-CGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUC1","description":"ICD-BBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB22","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Composite byp grft 3/> segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35683","description":"Composite byp grft 3/> segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Single pivot hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6605","description":"Single pivot hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEE0","description":"ICD-FFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge resin w/noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6252","description":"Bridge resin w/noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28G","description":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJD1","description":"ICD-CGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37294","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","description":"CPT-37294","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX23","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient lift sling or seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0621","description":"Patient lift sling or seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLE1","description":"ICD-FBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIE1","description":"ICD-NKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEA0","description":"ICD-JHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMB1","description":"ICD-KEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGID0","description":"ICD-NGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chiropract manj xtrspinl 1/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98943","description":"Chiropract manj xtrspinl 1/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBE1","description":"ICD-JDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJA1","description":"ICD-CFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99324","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPC1","description":"ICD-BCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLF1","description":"ICD-BFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICD1","description":"ICD-JICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18I","description":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery of pancreatic cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48500","description":"Surgery of pancreatic cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUE0","description":"ICD-ICUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINB0","description":"ICD-GINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFF1","description":"ICD-GHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGC0","description":"ICD-NHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99245","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB111","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERA1","description":"ICD-PERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQB1","description":"ICD-KHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQC0","description":"ICD-PLQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99493","description":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5167","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5167","description":"HCPCS-Q5167","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hinge ext/flex wrist finger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3901","description":"Hinge ext/flex wrist finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIC1","description":"ICD-MIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC11","description":"ICD-1JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHB0","description":"ICD-KGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostectomy_ partial_ exostectomy or condylectomy_ metatarsal head_ each meta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3052F","description":"Ostectomy_ partial_ exostectomy or condylectomy_ metatarsal head_ each meta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOC1","description":"ICD-ODOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ heparin sodium (pfizer)_ not therapeutically equivalent to j1644_ per 1000 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1643","description":"Injection_ heparin sodium (pfizer)_ not therapeutically equivalent to j1644_ per 1000 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12A","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4047F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28140","description":"Removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted molecular pathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81479","description":"Unlisted molecular pathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJB1","description":"ICD-JEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx l/r atrial fib addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93657","description":"Tx l/r atrial fib addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGF0","description":"ICD-CCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOE0","description":"ICD-HAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINB0","description":"ICD-BINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLA1","description":"ICD-BDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3C","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSB1","description":"ICD-KCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Synvisc or synvisc-one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7325","description":"Synvisc or synvisc-one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHE1","description":"ICD-IEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMC1","description":"ICD-NCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Warfarin or another FDA-approved anticoagulant not prescribed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9928","description":"Warfarin or another FDA-approved anticoagulant not prescribed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKF0","description":"ICD-JBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBND0","description":"ICD-CBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADE1","description":"ICD-NADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGC0","description":"ICD-FGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow fair lead cable dir fo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6586","description":"Elbow fair lead cable dir fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe lifts tapered to one-ha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3332","description":"Shoe lifts tapered to one-ha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTA1","description":"ICD-OHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"INJECTION_ OCRELIZUMAB_ 1 MG (OCREVUS)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9494","description":"INJECTION_ OCRELIZUMAB_ 1 MG (OCREVUS)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit chelation diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9355","description":"Hit chelation diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit est age 12-17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99394","description":"Prev visit est age 12-17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOA1","description":"ICD-LEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Terbutaline sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3105","description":"Terbutaline sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk molded supracondylar susp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5670","description":"Bk molded supracondylar susp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYF1","description":"ICD-KEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak/knee disartic pelvic join","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5696","description":"Ak/knee disartic pelvic join","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair single ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33619","description":"Repair single ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco Screening Not Performed Or Tobacco Cessation Intervention Not Provided On The Date Of The Encounter Or Within The Previous 12 Months_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0029","description":"Tobacco Screening Not Performed Or Tobacco Cessation Intervention Not Provided On The Date Of The Encounter Or Within The Previous 12 Months_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted ambulance service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0999","description":"Unlisted ambulance service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETC0","description":"ICD-IETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCF1","description":"ICD-MDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTB1","description":"ICD-JFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMD1","description":"ICD-OBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9896","description":"Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93314","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMB0","description":"ICD-FGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOF0","description":"ICD-GIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYC0","description":"ICD-HGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD130","description":"Reduced Physical Function _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abl1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81170","description":"Abl1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5D","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGA0","description":"ICD-KGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPA0","description":"ICD-NEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCC1","description":"ICD-OCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemostats for dialysis_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1637","description":"Hemostats for dialysis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKE1","description":"ICD-JIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEC1","description":"ICD-BCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSD0","description":"ICD-CFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWD0","description":"ICD-PIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFD0","description":"ICD-OHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGND1","description":"ICD-GGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOA1","description":"ICD-PCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCB1","description":"ICD-AFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81166","description":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRC1","description":"ICD-PDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWD0","description":"ICD-GFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGD1","description":"ICD-OAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18E","description":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTA1","description":"ICD-BFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDF1","description":"ICD-JGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTA1","description":"ICD-JDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00300","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","description":"CPT-00300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0646U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0646U","description":"CPT-0646U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit postnatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99501","description":"Home visit postnatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDC0","description":"ICD-JDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"A/d tx program_ per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2035","description":"A/d tx program_ per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBA1","description":"ICD-EIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIC1","description":"ICD-IBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWD1","description":"ICD-LIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBB0","description":"ICD-OIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDE0","description":"ICD-FCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0574U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","description":"CPT-0574U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFME0","description":"ICD-GFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDF0","description":"ICD-IDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures immediat maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5130","description":"Dentures immediat maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOB0","description":"ICD-CHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRE1","description":"ICD-ODRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFA1","description":"ICD-OEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of quinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84228","description":"Assay of quinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of digoxin free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80163","description":"Assay of digoxin free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSC1","description":"ICD-KCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCD0","description":"ICD-AGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYF1","description":"ICD-ODYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUA1","description":"ICD-EHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Val rsn hd ct ord reg indic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9595","description":"Val rsn hd ct ord reg indic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDC0","description":"ICD-JCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00820","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","description":"CPT-00820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01710","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","description":"CPT-01710","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIE0","description":"ICD-IDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2C","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAE0","description":"ICD-AEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy submucous njx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45381","description":"Colonoscopy submucous njx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0613U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","description":"CPT-0613U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIC0","description":"ICD-BBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4B","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16371","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16371","description":"CPT-16371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"So 8 ab rstr can/web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3660","description":"So 8 ab rstr can/web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKE1","description":"ICD-KEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYB0","description":"ICD-LCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJF0","description":"ICD-NFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1608","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1608","description":"HCPCS-C1608","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYF0","description":"ICD-PIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAB0","description":"ICD-NKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pain Management_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 36 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0290U","description":"Pain Management_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 36 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPF1","description":"ICD-BGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUE1","description":"ICD-EBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAE0","description":"ICD-KHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28X","description":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plas shoe insert w ank joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2180","description":"Plas shoe insert w ank joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKB1","description":"ICD-KIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC07","description":"Ultra High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair humerus with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24435","description":"Repair humerus with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Position wc cush wdth <22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2605","description":"Position wc cush wdth <22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Current percep threshold tst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0255","description":"Current percep threshold tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7558","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1275","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18F","description":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance (eg_ vibration) elastography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76391","description":"Magnetic resonance (eg_ vibration) elastography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUF0","description":"ICD-MFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply forearm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29125","description":"Apply forearm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ATXN1 (ataxin 1) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81178","description":"ATXN1 (ataxin 1) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngography_ contrast_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70373","description":"Laryngography_ contrast_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect face/scalp tum 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21016","description":"Resect face/scalp tum 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11423","description":"Exc h-f-nk-sp b9+marg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Ocular (Ovemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92518","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Ocular (Ovemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUA0","description":"ICD-MDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYF0","description":"ICD-DAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMC1","description":"ICD-GGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA17","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEE1","description":"ICD-NIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31755","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRE1","description":"ICD-HGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBD1","description":"ICD-OGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flex foot system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5980","description":"Flex foot system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXA0","description":"ICD-NCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXF0","description":"ICD-CFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9170","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9170","description":"HCPCS-C9170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLA1","description":"ICD-MFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56800","description":"Repair of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64891","description":"Nerve graft hand/foot >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFB0","description":"ICD-CCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ADAMTS13_ recombinant-krhn_ 10 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7171","description":"Injection_ ADAMTS13_ recombinant-krhn_ 10 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic pneumothorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32960","description":"Therapeutic pneumothorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric bypass for obesity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43846","description":"Gastric bypass for obesity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC46","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values_ with analysis_ review_ and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0528T","description":"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values_ with analysis_ review_ and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRD0","description":"ICD-PCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High inten beh couns std 30m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0445","description":"High inten beh couns std 30m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGC1","description":"ICD-CAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5159","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","description":"HCPCS-Q5159","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTC0","description":"ICD-MJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15221","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWA1","description":"ICD-OEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brief emotional/behav assmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96127","description":"Brief emotional/behav assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBA0","description":"ICD-JCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQC1","description":"ICD-DAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNC0","description":"ICD-OKNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of wrist bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25215","description":"Removal of wrist bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg </4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64897","description":"Nerve graft arm/leg </4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCE0","description":"ICD-OGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRF0","description":"ICD-KIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23B","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7638","description":"Dexamethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEME0","description":"ICD-CEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUF0","description":"ICD-BFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (acute myelogenous leukemia)_ DNA_ whole genome next-generation sequencing to detect gene rearrangement(s)_ blood or bone marrow_ report of specific gene rearrangem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0056U","description":"Hematology (acute myelogenous leukemia)_ DNA_ whole genome next-generation sequencing to detect gene rearrangement(s)_ blood or bone marrow_ report of specific gene rearrangem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPB1","description":"ICD-GHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALD1","description":"ICD-GALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUC0","description":"ICD-MKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glucose blood test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82962","description":"Glucose blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRB0","description":"ICD-KCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cysto/uretero w/up stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52345","description":"Cysto/uretero w/up stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA42","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLF0","description":"ICD-JFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iodine I-131 iobenguane_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9407","description":"Iodine I-131 iobenguane_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITB0","description":"ICD-OITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFC0","description":"ICD-ODFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBF0","description":"ICD-KEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJD0","description":"ICD-NBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYD1","description":"ICD-PFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drsg gel filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6248","description":"Hydrogel drsg gel filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEE1","description":"ICD-MAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIF1","description":"ICD-BHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCA1","description":"ICD-BGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open/perq place stent same","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37238","description":"Open/perq place stent same","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTF0","description":"ICD-GDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAE1","description":"ICD-EBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAE0","description":"ICD-OLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXE0","description":"ICD-JFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOC1","description":"ICD-GEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPF1","description":"ICD-KGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0406","description":"HCPCS-C0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin substitute_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4100","description":"Skin substitute_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBF1","description":"ICD-ECBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0856","description":"Pwc gp3 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARA0","description":"ICD-LARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunohisto antb 1st stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88342","description":"Immunohisto antb 1st stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp ilio-mesenteric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35633","description":"Art byp ilio-mesenteric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLB0","description":"ICD-KFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CO GNOTYP AQP1 EXON 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0181U","description":"CO GNOTYP AQP1 EXON 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCC0","description":"ICD-BGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKB0","description":"ICD-GAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOF1","description":"ICD-DAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25535","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOA0","description":"ICD-DHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODED0","description":"ICD-ODED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methotrexate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80204","description":"Methotrexate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammogram screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77057","description":"Mammogram screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01716","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","description":"CPT-01716","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSD1","description":"ICD-OGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA03","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tee w or w/o fol w/cont_cong","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8926","description":"Tee w or w/o fol w/cont_cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICED0","description":"ICD-ICED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUE1","description":"ICD-OIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1183","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKB0","description":"ICD-GBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHB0","description":"ICD-MBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLF0","description":"ICD-OHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICA0","description":"ICD-OICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKD1","description":"ICD-OHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of reason(s) sentinel lymph node biopsy not performed (e.g._ reasons could include but not limited to; non-invasive cancer_ incidental discovery of breast cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8880","description":"Documentation of reason(s) sentinel lymph node biopsy not performed (e.g._ reasons could include but not limited to; non-invasive cancer_ incidental discovery of breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20B","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAC1","description":"ICD-KIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFE1","description":"ICD-KFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEB0","description":"ICD-GAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBB1","description":"ICD-NBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2133","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCF0","description":"ICD-FGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88364","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQD1","description":"ICD-GCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHE0","description":"ICD-KAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKD1","description":"ICD-KIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDF0","description":"ICD-CIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; Each Additional 25 Cc Injectate_ Or P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15774","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; Each Additional 25 Cc Injectate_ Or P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXB1","description":"ICD-KAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"2d tee w or w/o fol w/con_in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8925","description":"2d tee w or w/o fol w/con_in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antepartum care only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59425","description":"Antepartum care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHD1","description":"ICD-IFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Facial nerve function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92516","description":"Facial nerve function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVD0","description":"ICD-OIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"12-lead ecg performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3120F","description":"12-lead ecg performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay everolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80169","description":"Drug assay everolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg <=16 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6234","description":"Hydrocolld drg <=16 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair throat esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42953","description":"Repair throat esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESB1","description":"ICD-DESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENC0","description":"ICD-OENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp multidisipln evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2000","description":"Comp multidisipln evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temporal artery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37609","description":"Temporal artery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1000T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","description":"CPT-1000T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXD1","description":"ICD-OEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Th/wght bear nar m-l brim mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2525","description":"Th/wght bear nar m-l brim mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWD0","description":"ICD-CHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crisis interven waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2034","description":"Crisis interven waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESA0","description":"ICD-GESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETF0","description":"ICD-EETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1049","description":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants_ Low-Pass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81349","description":"Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants_ Low-Pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJA1","description":"ICD-CBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hair removal by electrolysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17380","description":"Hair removal by electrolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped fluid and electrolyte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4103","description":"Ef ped fluid and electrolyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASD1","description":"ICD-HASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cam relese assem ftrst/lgrst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0051","description":"Cam relese assem ftrst/lgrst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKD1","description":"ICD-OIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screen cerv/vag thin layer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0123","description":"Screen cerv/vag thin layer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9975","description":"Documentation of medical reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX33","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIF1","description":"ICD-FDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAF0","description":"ICD-IDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSB1","description":"ICD-CHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQE0","description":"ICD-CHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (genetic platelet disorders)_ genomic sequence analysis of 43 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Comprehensive Platelet Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0274U","description":"Hematology (genetic platelet disorders)_ genomic sequence analysis of 43 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Comprehensive Platelet Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIF0","description":"ICD-AEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device_ requiring flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7299","description":"Removal of temporary anchorage device_ requiring flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rb82 rubidium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9555","description":"Rb82 rubidium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial exchange transfusion_ blood_ plasma or crystalloid necessitating the skill of a physician or other qualified health care professional_ newborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36456","description":"Partial exchange transfusion_ blood_ plasma or crystalloid necessitating the skill of a physician or other qualified health care professional_ newborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4D","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDF0","description":"ICD-NJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMF1","description":"ICD-EBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUA0","description":"ICD-IGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21B","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSC0","description":"ICD-KDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1377","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","description":"HCPCS-M1377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXD0","description":"ICD-JCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOA1","description":"ICD-CIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCB0","description":"ICD-NLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w iv ab not given on time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8917","description":"Pt w iv ab not given on time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/con_stres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8928","description":"Tte w or w/o fol w/con_stres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGID0","description":"ICD-KGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEC0","description":"ICD-FEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFID1","description":"ICD-IFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVB0","description":"ICD-KBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMD0","description":"ICD-FAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYD0","description":"ICD-LEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFA1","description":"ICD-NHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ pmkr_ other than trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1898","description":"Lead_ pmkr_ other than trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGA1","description":"ICD-GIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENF0","description":"ICD-NENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXC0","description":"ICD-FBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/repair hearing aid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69711","description":"Remove/repair hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Io anal gast n-stim subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95981","description":"Io anal gast n-stim subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27742","description":"Repair of leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYE1","description":"ICD-GIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cad cxr with interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174T","description":"Cad cxr with interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJD0","description":"ICD-CEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHE0","description":"ICD-FAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDF0","description":"ICD-GHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Create eardrum opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69433","description":"Create eardrum opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJE1","description":"ICD-NFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","description":"HCPCS-Q4386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJID1","description":"ICD-OJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIE1","description":"ICD-OAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-rays bone length studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77073","description":"X-rays bone length studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIE0","description":"ICD-BBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRB0","description":"ICD-CCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECA1","description":"ICD-GECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt no doc hear loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8567","description":"Pt no doc hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNC1","description":"ICD-BBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Oncology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4031","description":"Radiation Oncology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis_ male_ including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52284","description":"Cystourethroscopy_ with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis_ male_ including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJA0","description":"ICD-FCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFF0","description":"ICD-OBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKF1","description":"ICD-KDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCE1","description":"ICD-BCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23145","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQC1","description":"ICD-PEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tympanometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92567","description":"Tympanometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTF0","description":"ICD-CCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUF1","description":"ICD-NLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aud osseo dev_ int/ext comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8690","description":"Aud osseo dev_ int/ext comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9494","description":"Hit antibiotic total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB15","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQF0","description":"ICD-OIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHC0","description":"ICD-FFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE114","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGB0","description":"ICD-GFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72148","description":"MRI lumbar spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC33","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBB0","description":"ICD-EFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1704","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1704","description":"CDT-D1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGF1","description":"ICD-OBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSF1","description":"ICD-DBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (coronary artery disease [CAD])_ DNA_ genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs]_ targeted variant genotyping)_ patient lifestyl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0466U","description":"Cardiology (coronary artery disease [CAD])_ DNA_ genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs]_ targeted variant genotyping)_ patient lifestyl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occult blood other sources","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82271","description":"Occult blood other sources","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHC1","description":"ICD-IHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","description":"CPT-55882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens aniseikonic bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2218","description":"Lens aniseikonic bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDC0","description":"ICD-CEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGF1","description":"ICD-CIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAD0","description":"ICD-GEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01730","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","description":"CPT-01730","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOB0","description":"ICD-DHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No f/u eval q3mo opiod tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9563","description":"No f/u eval q3mo opiod tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC246","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMA1","description":"ICD-ADMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neck spine fuse&remov bel c2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22551","description":"Neck spine fuse&remov bel c2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Etoposide oral 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8560","description":"Etoposide oral 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2124","description":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9725","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHB0","description":"ICD-CEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEE0","description":"ICD-AGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEID1","description":"ICD-CEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of non-biodegradable drug delivery implants_ 4 or more (services for subdermal rod implant)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0516","description":"Insertion of non-biodegradable drug delivery implants_ 4 or more (services for subdermal rod implant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWA1","description":"ICD-KEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEF1","description":"ICD-AIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIME0","description":"ICD-KIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMD0","description":"ICD-MCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB60","description":"Ultra High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ avacincaptad pegol_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2782","description":"Injection_ avacincaptad pegol_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flu immunize no admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8484","description":"Flu immunize no admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7525","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGD0","description":"ICD-BBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQE1","description":"ICD-KCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFME1","description":"ICD-EFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKF1","description":"ICD-OLKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Functionality And Deformity As A Function Of Shear Stress_ Whole Blood_ Reported As A Maximum Elongation Index","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0305U","description":"Hematology_ Red Blood Cell (Rbc) Functionality And Deformity As A Function Of Shear Stress_ Whole Blood_ Reported As A Maximum Elongation Index","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl met band kafo-afo prox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4080","description":"Repl met band kafo-afo prox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLD1","description":"ICD-OCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC224","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rh ig full-dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90384","description":"Rh ig full-dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures repair resin base","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5610","description":"Dentures repair resin base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQF1","description":"ICD-PFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQD1","description":"ICD-KIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSB1","description":"ICD-KDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIB0","description":"ICD-IEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLC0","description":"ICD-NKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMD0","description":"ICD-BCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eptifibatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1327","description":"Eptifibatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Off assis eol iss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9380","description":"Off assis eol iss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice in hospice facility","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5006","description":"Hospice in hospice facility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDME1","description":"ICD-BDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8012","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8012","description":"HCPCS-C8012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCC1","description":"ICD-JGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1116","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC110","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQB0","description":"ICD-CGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBC1","description":"ICD-KEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc w ami s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9606","description":"Perc d-e cor revasc w ami s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIA1","description":"ICD-KBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDA0","description":"ICD-JFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder joint surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23101","description":"Shoulder joint surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBND1","description":"ICD-KBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCE1","description":"ICD-GHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHB0","description":"ICD-GEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx cml remission","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9126","description":"Onc dx cml remission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13A","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBE0","description":"ICD-JFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRC0","description":"ICD-CFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMD0","description":"ICD-OKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87564","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","description":"CPT-87564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screening propoxyphene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80367","description":"Drug screening propoxyphene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXD0","description":"ICD-KFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEE1","description":"ICD-JEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB46","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seg pneum int legs/trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0670","description":"Seg pneum int legs/trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"C motor evoked uppr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95928","description":"C motor evoked uppr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXC0","description":"ICD-NHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sinusoidal rotational test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92546","description":"Sinusoidal rotational test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Actigraphy testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95803","description":"Actigraphy testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACA0","description":"ICD-BACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mast subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19304","description":"Mast subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast exam thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75600","description":"Contrast exam thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE124","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA144","description":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTA0","description":"ICD-NJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Received An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2163","description":"Patient Received An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1704","description":"HCPCS-A1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"So hard plas stabili pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3678","description":"So hard plas stabili pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYE1","description":"ICD-GFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAE1","description":"ICD-IGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v thin layer redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88143","description":"Cytopath c/v thin layer redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTB0","description":"ICD-ICTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDD1","description":"ICD-CEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97710","description":"","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cros hearing aid dispens fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5200","description":"Cros hearing aid dispens fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10A","description":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total disc arthrp ant appr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0375T","description":"Total disc arthrp ant appr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx esophag t1-t3 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9096","description":"Onc dx esophag t1-t3 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue in-situ hybridization","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0479","description":"Tissue in-situ hybridization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Administration of patient-focused health risk assessment instrument (eg_ health hazard appraisal) with scoring and documentation_ per standardized instrument","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96160","description":"Administration of patient-focused health risk assessment instrument (eg_ health hazard appraisal) with scoring and documentation_ per standardized instrument","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMA1","description":"ICD-EHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAB1","description":"ICD-OFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLD1","description":"ICD-MHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Uvl sys panel 4 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0692","description":"Uvl sys panel 4 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC126","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGME0","description":"ICD-OGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBE0","description":"ICD-GDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELF0","description":"ICD-EELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35002","description":"Repair artery rupture neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxford w supinat/pronat inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3201","description":"Oxford w supinat/pronat inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sphenoid sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31051","description":"Sphenoid sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBE0","description":"ICD-IEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCD0","description":"ICD-CBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove uterus after cesarean","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59525","description":"Remove uterus after cesarean","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXC1","description":"ICD-KFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ oritavancin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2407","description":"Injection_ oritavancin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8A","description":"Low Rehab_ ADL Index 0-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIE0","description":"ICD-JIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLD1","description":"ICD-KCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epidrm a-grft face/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15115","description":"Epidrm a-grft face/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51525","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of porphobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84110","description":"Assay of porphobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0238","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","description":"HCPCS-Q0238","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score shdl pt no el","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8665","description":"Fun stat score shdl pt no el","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGC1","description":"ICD-JDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETA1","description":"ICD-JETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEA1","description":"ICD-AHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens aniseikonic single","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2118","description":"Lens aniseikonic single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-82233","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","description":"CPT-82233","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ovine_ up to 999 usp units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3471","description":"Ovine_ up to 999 usp units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice general care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2045","description":"Hospice general care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCC0","description":"ICD-OCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSE1","description":"ICD-LHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No hcv infect srn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9454","description":"No hcv infect srn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAA0","description":"ICD-JDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRE0","description":"ICD-KBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIE1","description":"ICD-ODIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPF0","description":"ICD-OBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronch thermoplsty 2/> lobes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31661","description":"Bronch thermoplsty 2/> lobes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ferric pyrophosphate citrate solution (TrifericAVNU)_ 0.1 mg of iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1445","description":"Injection_ ferric pyrophosphate citrate solution (TrifericAVNU)_ 0.1 mg of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2208","description":"Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63047","description":"Remove spine lamina 1 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFD0","description":"ICD-NDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0932T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","description":"CPT-0932T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX06","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast prosthesis w adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8031","description":"Breast prosthesis w adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct bone density axial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77078","description":"Ct bone density axial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOD1","description":"ICD-CFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD136","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99244","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBD0","description":"ICD-KHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 21 bacterial and fungal organisms and identification of 21 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0374U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 21 bacterial and fungal organisms and identification of 21 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ C-1 Esterase Inhibitor (Recombinant) Ruconest_ 10 Units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9445","description":"Injection_ C-1 Esterase Inhibitor (Recombinant) Ruconest_ 10 Units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1603","description":"HCPCS-A1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIF0","description":"ICD-BHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rn home care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1030","description":"Rn home care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt post facet implt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0222T","description":"Plmt post facet implt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1025","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXC1","description":"ICD-FCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC31","description":"ICD-4FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNE0","description":"ICD-NKNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFD0","description":"ICD-OIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15C","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNC1","description":"ICD-OGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJF1","description":"ICD-CIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIB1","description":"ICD-FDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASD1","description":"ICD-CASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMC0","description":"ICD-MJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCB1","description":"ICD-MKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap inc hern repair comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49655","description":"Lap inc hern repair comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIB0","description":"ICD-FEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAD0","description":"ICD-EIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Freeing of bowel adhesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44005","description":"Freeing of bowel adhesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDA0","description":"ICD-NHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAC1","description":"ICD-FHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX07","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIE1","description":"ICD-AAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYF1","description":"ICD-PJYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDE1","description":"ICD-MJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31582","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANF0","description":"ICD-NANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJF1","description":"ICD-GIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCID0","description":"ICD-KCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit7.6-12.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12044","description":"Intmd rpr n-hf/genit7.6-12.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arm supp att to wc rancho ty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2627","description":"Arm supp att to wc rancho ty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSB1","description":"ICD-CDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection anistreplase 30 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0350","description":"Injection anistreplase 30 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXB1","description":"ICD-CDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABB1","description":"ICD-MABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63308","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARF1","description":"ICD-OARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJE0","description":"ICD-JIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTE1","description":"ICD-OKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral antiplat thx rx dischrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4073F","description":"Oral antiplat thx rx dischrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGF0","description":"ICD-BIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGE0","description":"ICD-FCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with guided transhepatic cholangiography_ without biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47560","description":"Laparoscopy_ surgical; with guided transhepatic cholangiography_ without biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQC1","description":"ICD-OEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcondylar approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61597","description":"Transcondylar approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext amb infusn pump insulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0784","description":"Ext amb infusn pump insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Division of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58600","description":"Division of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac rehab/monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93798","description":"Cardiac rehab/monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv musc neck dyston","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64616","description":"Chemodenerv musc neck dyston","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSF0","description":"ICD-HCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERE0","description":"ICD-GERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bile duct tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47712","description":"Excision of bile duct tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diab shoe for density insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5500","description":"Diab shoe for density insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin sys stance flexion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5845","description":"Knee-shin sys stance flexion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1240","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of interbody biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performed_ to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22853","description":"Insertion of interbody biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performed_ to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Op rad mg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9236","description":"Op rad mg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Refitting of obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5933","description":"Refitting of obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWA0","description":"ICD-OAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMA0","description":"ICD-IFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJE1","description":"ICD-BHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILB1","description":"ICD-IILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC113","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLD0","description":"ICD-AGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc advncd dis comfort 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1152F","description":"Doc advncd dis comfort 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJE0","description":"ICD-GDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUB1","description":"ICD-GGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYE0","description":"ICD-KAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33015","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBF0","description":"ICD-EBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cult epiderm grft f/n/hfg +%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15157","description":"Cult epiderm grft f/n/hfg +%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45341","description":"Sigmoidoscopy w/ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABD0","description":"ICD-AABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKB1","description":"ICD-OBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEID1","description":"ICD-GEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ pmkr_ transvenous vdd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1779","description":"Lead_ pmkr_ transvenous vdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNC0","description":"ICD-KFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10A","description":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAA0","description":"ICD-CAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIF1","description":"ICD-NCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine incon plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0509F","description":"Urine incon plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOB0","description":"ICD-CDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIA1","description":"ICD-AGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2194","description":"Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5152","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","description":"HCPCS-Q5152","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD251","description":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCC0","description":"ICD-MBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBA0","description":"ICD-OFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of jaw nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64738","description":"Incision of jaw nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBF0","description":"ICD-OJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2030","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","description":"HCPCS-A2030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Swivel adaptor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8186","description":"Swivel adaptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMB0","description":"ICD-FHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lung extrapleural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32445","description":"Removal of lung extrapleural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHA1","description":"ICD-BCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42510","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2_ 3_ 4)_ formalin-fixed paraffin-embedded (FFPE)_ predictive_ identificat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0471U","description":"Oncology (colorectal cancer)_ qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2_ 3_ 4)_ formalin-fixed paraffin-embedded (FFPE)_ predictive_ identificat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNC0","description":"ICD-JGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAD1","description":"ICD-GDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB11","description":"ICD-2EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRD0","description":"ICD-GIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOA0","description":"ICD-PAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEB1","description":"ICD-BCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMC1","description":"ICD-NEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB31","description":"ICD-2JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSC0","description":"ICD-PKSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICID1","description":"ICD-ICID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVD1","description":"ICD-BEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGE0","description":"ICD-OKGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery_ including any type of measur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9741","description":"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery_ including any type of measur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0914T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","description":"CPT-0914T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQC1","description":"ICD-PAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUD1","description":"ICD-MEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAD0","description":"ICD-KAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWF1","description":"ICD-HEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKA0","description":"ICD-OFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFA1","description":"ICD-CFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla ii typing 1 locus lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81376","description":"Hla ii typing 1 locus lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB31","description":"ICD-4GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB21","description":"ICD-1EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTB0","description":"ICD-ODTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIE0","description":"ICD-CDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNA1","description":"ICD-FCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42835","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDE1","description":"ICD-EIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEF0","description":"ICD-MLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recement space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1550","description":"Recement space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1479","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","description":"HCPCS-M1479","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure for chemonucleolysis_ including discography_ intervertebral disc_ single or multiple levels_ lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62292","description":"Injection procedure for chemonucleolysis_ including discography_ intervertebral disc_ single or multiple levels_ lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Jak2 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81270","description":"Jak2 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1318","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESE0","description":"ICD-KESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNF1","description":"ICD-KBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVA1","description":"ICD-GHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHC0","description":"ICD-BEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Offset knee joint each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2390","description":"Offset knee joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v auto fluid redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88175","description":"Cytopath c/v auto fluid redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDE1","description":"ICD-KIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21348","description":"Opn tx nasomax fx w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METD1","description":"ICD-METD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHE0","description":"ICD-CCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPC0","description":"ICD-JGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNB1","description":"ICD-GHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trabeculostomy Ab Interno By Laser; With Use Of Ophthalmic Endoscope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0622T","description":"Trabeculostomy Ab Interno By Laser; With Use Of Ophthalmic Endoscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITD0","description":"ICD-BITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBB0","description":"ICD-KIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITB1","description":"ICD-CITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDE0","description":"ICD-GIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKC1","description":"ICD-CCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted for performance of elective carotid intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9689","description":"Patient admitted for performance of elective carotid intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup long arm ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4008","description":"Cast sup long arm ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB33","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81234","description":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTC1","description":"ICD-ABTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDC1","description":"ICD-OCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATE1","description":"ICD-NATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSF0","description":"ICD-OJSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEB0","description":"ICD-IFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXA1","description":"ICD-NHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis machine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1590","description":"Hemodialysis machine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRA1","description":"ICD-DIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXD0","description":"ICD-FCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKD0","description":"ICD-BIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGB1","description":"ICD-KGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Budesonide comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7634","description":"Budesonide comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0503","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0503","description":"CDT-D0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADC0","description":"ICD-OADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRC0","description":"ICD-KDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQE1","description":"ICD-CAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-META1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"META1","description":"ICD-META1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC42","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLD1","description":"ICD-NJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical splint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5988","description":"Surgical splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIE1","description":"ICD-JFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLA0","description":"ICD-NFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orth dev repair/repl minor p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4210","description":"Orth dev repair/repl minor p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACC1","description":"ICD-KACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9902","description":"Patient screened for tobacco use and identified as a tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHD0","description":"ICD-GAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung perfusion imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78580","description":"Lung perfusion imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCB1","description":"ICD-BFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44377","description":"Small bowel endoscopy/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB101","description":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8I","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27429","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEE1","description":"ICD-IAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate atria x10sv add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33258","description":"Ablate atria x10sv add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWE0","description":"ICD-OCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray for pancreas endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74329","description":"X-ray for pancreas endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHF0","description":"ICD-EBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle/tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24301","description":"Muscle/tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEF1","description":"ICD-OFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJA0","description":"ICD-JBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove int/ext hem 1 group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46255","description":"Remove int/ext hem 1 group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hdtrans bench w/wo comm open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0248","description":"Hdtrans bench w/wo comm open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37297","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","description":"CPT-37297","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLE1","description":"ICD-MHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Puncture drainage of lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10160","description":"Puncture drainage of lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGD0","description":"ICD-GBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE114","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14B","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELC1","description":"ICD-CELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDB0","description":"ICD-BBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Out of office emerg med serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99060","description":"Out of office emerg med serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQA1","description":"ICD-KBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDB1","description":"ICD-JDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYB1","description":"ICD-OFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Referred for an av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4051F","description":"Referred for an av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSB1","description":"ICD-CBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRC1","description":"ICD-OJRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9488","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methylprednisolone 20 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1020","description":"Methylprednisolone 20 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic compression device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0675","description":"Pneumatic compression device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYB0","description":"ICD-HDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECC0","description":"ICD-AECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee orth pos locking joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1831","description":"Knee orth pos locking joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of hematoma/fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10140","description":"Drainage of hematoma/fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay acid phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84060","description":"Assay acid phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNA0","description":"ICD-NLNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In morphine preservativ free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2274","description":"In morphine preservativ free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nephropathy doc tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3066F","description":"Nephropathy doc tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAE1","description":"ICD-OBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14C","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome banding study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88283","description":"Chromosome banding study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy remove adnexa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58661","description":"Laparoscopy remove adnexa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEC0","description":"ICD-OHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3204","description":"Hightop w/ supp/pronator inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFA0","description":"ICD-BAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNE1","description":"ICD-KDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIID1","description":"ICD-FIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPD0","description":"ICD-NHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of caries arresting medicament-per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1354","description":"Application of caries arresting medicament-per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External recharg sys intern","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8689","description":"External recharg sys intern","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAA0","description":"ICD-EBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYC0","description":"ICD-CCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transthor cath for stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33621","description":"Transthor cath for stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Report ckd measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8487","description":"Report ckd measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frenuloplasty","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7963","description":"Frenuloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAE1","description":"ICD-FCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Baclofen 10 mg injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0475","description":"Baclofen 10 mg injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone srgry cmptr fluor image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054T","description":"Bone srgry cmptr fluor image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2638","description":"Brachytx_ stranded_ i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITC1","description":"ICD-JITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVF0","description":"ICD-BIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy revise stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31638","description":"Bronchoscopy revise stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVB1","description":"ICD-OAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93616","description":"Esophageal recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITD0","description":"ICD-JITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPD0","description":"ICD-OAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXB1","description":"ICD-NGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECB0","description":"ICD-GECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHC0","description":"ICD-MFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFD1","description":"ICD-FFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unlisted procedure_ intestine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6021","description":"Unlisted procedure_ intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg >16<=48 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6255","description":"Absorpt drg >16<=48 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAME1","description":"ICD-AAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59410","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","description":"CPT-92635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68705","description":"Revise tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKED0","description":"ICD-NKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFC0","description":"ICD-NCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDE0","description":"ICD-IDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATB1","description":"ICD-AATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBF1","description":"ICD-AIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67015","description":"Release of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKC0","description":"ICD-ODKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJF0","description":"ICD-KAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDC1","description":"ICD-BCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Er/ip hosp =/>2 in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9522","description":"Er/ip hosp =/>2 in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal extent unknwn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9095","description":"Onc dx rectal extent unknwn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73580","description":"Contrast x-ray of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEE1","description":"ICD-EDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEB1","description":"ICD-AFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETF1","description":"ICD-IETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interphalangeal joint spacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8658","description":"Interphalangeal joint spacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"4-bar link above knee w/swng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5614","description":"4-bar link above knee w/swng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intercep dental tx primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8050","description":"Intercep dental tx primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLF1","description":"ICD-KDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB11","description":"ICD-2AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADB1","description":"ICD-JADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLA1","description":"ICD-NHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 1200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0244","description":"Injection_ casirivimab and imdevimab_ 1200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLF1","description":"ICD-GGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKC0","description":"ICD-KBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [HA]_ procollagen III amino terminal peptide [PIIINP]_ tissue inhibitor of metalloproteinase 1 [TIMP-1])_ using immuno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81517","description":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [HA]_ procollagen III amino terminal peptide [PIIINP]_ tissue inhibitor of metalloproteinase 1 [TIMP-1])_ using immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYF0","description":"ICD-CFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGA0","description":"ICD-KIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIC0","description":"ICD-NEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAA1","description":"ICD-BCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOF0","description":"ICD-HIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTC0","description":"ICD-JFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJB0","description":"ICD-CBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMF1","description":"ICD-CBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRA1","description":"ICD-GHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDB1","description":"ICD-BEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9855","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1080","description":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA11","description":"ICD-2BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA_ gene-expression profiling by real-time quantitative PCR of 5 genes (MDK_ HOXA13_ CDC2 [CDK1]_ IGFBP5_ and CXCR2)_ utilizing urine_ algorithm incor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0363U","description":"Oncology (urothelial)_ mRNA_ gene-expression profiling by real-time quantitative PCR of 5 genes (MDK_ HOXA13_ CDC2 [CDK1]_ IGFBP5_ and CXCR2)_ utilizing urine_ algorithm incor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Care plan hgb docd esa pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0514F","description":"Care plan hgb docd esa pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHE0","description":"ICD-EGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behind ear binaur hearing ai","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5140","description":"Behind ear binaur hearing ai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sgd spelling phys contact","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2508","description":"Sgd spelling phys contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRE0","description":"ICD-GGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-hypertensive or hypertensive blood pressure reading documented_ indicated follow-up not documented_ Patient not eligible/ not appropriate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8951","description":"Pre-hypertensive or hypertensive blood pressure reading documented_ indicated follow-up not documented_ Patient not eligible/ not appropriate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD111","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1289","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1289","description":"HCPCS-J1289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAC0","description":"ICD-MBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ omacetaxine mep_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9262","description":"Inj_ omacetaxine mep_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITD1","description":"ICD-KITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBB1","description":"ICD-KFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBC0","description":"ICD-GGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOC1","description":"ICD-OLOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasonic generator w svneb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0574","description":"Ultrasonic generator w svneb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUD1","description":"ICD-BEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of abdomen artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37617","description":"Ligation of abdomen artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEA0","description":"ICD-NGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pres/absn hmrhg/lesion docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3110F","description":"Pres/absn hmrhg/lesion docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15B","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59325","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALB1","description":"ICD-AALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVB1","description":"ICD-CCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCC0","description":"ICD-ADCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31085","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAD0","description":"ICD-FHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDB1","description":"ICD-AFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0782T","description":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIE0","description":"ICD-MAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12A","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4041","description":"Cast sup lng leg splnt plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDE1","description":"ICD-CEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMF0","description":"ICD-IGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88162","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMA1","description":"ICD-MBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGE1","description":"ICD-BGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-2 piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21142","description":"Lefort i-2 piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBC1","description":"ICD-MIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDA0","description":"ICD-JGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGA1","description":"ICD-NGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDC1","description":"ICD-FCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXC1","description":"ICD-KHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYB0","description":"ICD-HBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dna analysis apoe alzheimer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3852","description":"Dna analysis apoe alzheimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITC0","description":"ICD-EITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX15","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHC1","description":"ICD-GCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolysins screen i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85390","description":"Fibrinolysins screen i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKD0","description":"ICD-CAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ob us >/= 14 wks addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76810","description":"Ob us >/= 14 wks addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLA1","description":"ICD-NCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLF0","description":"ICD-EHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESF1","description":"ICD-KESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB10","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQD1","description":"ICD-HCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of nos vitamin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84591","description":"Assay of nos vitamin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYE0","description":"ICD-HEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQE1","description":"ICD-LFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6518","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","description":"HCPCS-A6518","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICB1","description":"ICD-MICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin beta esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0887","description":"Epoetin beta esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLB1","description":"ICD-OHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Redo endovas vena cava filtr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37192","description":"Redo endovas vena cava filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLA0","description":"ICD-ICLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefotetan disodiu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0074","description":"Injection_ cefotetan disodiu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin electrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83020","description":"Hemoglobin electrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Init nb em per day non-fac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99461","description":"Init nb em per day non-fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anastomosis/artery-aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33606","description":"Anastomosis/artery-aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Underarm springassist crutch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0117","description":"Underarm springassist crutch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTF0","description":"ICD-NKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair pail or pan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0167","description":"Commode chair pail or pan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICA0","description":"ICD-FICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFB0","description":"ICD-OHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4399","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","description":"HCPCS-Q4399","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Guide wire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1769","description":"Guide wire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96931","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUC1","description":"ICD-IGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBD1","description":"ICD-IEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9806","description":"HCPCS-C9806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWC1","description":"ICD-KEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAE0","description":"ICD-EGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSA1","description":"ICD-PJSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRF0","description":"ICD-PIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELE1","description":"ICD-NELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chloroprocaine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2400","description":"Chloroprocaine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy oocyte polar body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89290","description":"Biopsy oocyte polar body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit new age 5-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99383","description":"Prev visit new age 5-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCB1","description":"ICD-BDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYF1","description":"ICD-PEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA244","description":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITA1","description":"ICD-KITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cciiv3 vac im cult prsv free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90661","description":"Cciiv3 vac im cult prsv free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAF0","description":"ICD-OKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNE1","description":"ICD-CFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJA0","description":"ICD-NDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOB1","description":"ICD-OGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRE0","description":"ICD-OLRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of a chlamydia screening test with proper follow-up","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9820","description":"Documentation of a chlamydia screening test with proper follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTC1","description":"ICD-IHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOD0","description":"ICD-PBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLE0","description":"ICD-CHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCD1","description":"ICD-MCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGME0","description":"ICD-AGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnion bio or Axobiomembrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4211","description":"Amnion bio or Axobiomembrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1042T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1042T","description":"CPT-1042T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61642","description":"Dilate ic vasospasm add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59130","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEA0","description":"ICD-OKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMF1","description":"ICD-OHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBME0","description":"ICD-EBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOF0","description":"ICD-KAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEE0","description":"ICD-ABEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0946T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","description":"CPT-0946T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Tedizolid Phosphate_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9446","description":"Injection_ Tedizolid Phosphate_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEA0","description":"ICD-ADEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB134","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27265","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE126","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLB1","description":"ICD-BFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOA1","description":"ICD-GFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCF0","description":"ICD-OGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onlay cst hgh nbl mtl 2 srfc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6610","description":"Onlay cst hgh nbl mtl 2 srfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB145","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADC1","description":"ICD-BADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documented reason for not assessing hepatitis B virus (HBV) status (e.g._ patient not initiating anti-TNF therapy_ patient declined) prior to initiating anti-TNF therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9504","description":"Documented reason for not assessing hepatitis B virus (HBV) status (e.g._ patient not initiating anti-TNF therapy_ patient declined) prior to initiating anti-TNF therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTF0","description":"ICD-IGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMD0","description":"ICD-KIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJB0","description":"ICD-CEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFA1","description":"ICD-FHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHA1","description":"ICD-CBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Brexanolone_ 1Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9055","description":"Injection_ Brexanolone_ 1Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reusable underpad chair size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4540","description":"Reusable underpad chair size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61519","description":"Remove brain lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLB1","description":"ICD-GGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not consid poss risk fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3573F","description":"Pt not consid poss risk fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove femur lesion/bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27062","description":"Remove femur lesion/bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLF0","description":"ICD-FDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLB1","description":"ICD-NKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAE1","description":"ICD-AAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; With Continuous Oximetry Monitoring (Per Session)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94626","description":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; With Continuous Oximetry Monitoring (Per Session)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKND1","description":"ICD-OKND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD246","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGED0","description":"ICD-NGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEA1","description":"ICD-FCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJA0","description":"ICD-CCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pentamidine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2545","description":"Pentamidine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA10","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Max MRI capture & interprete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0369","description":"Max MRI capture & interprete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5170","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5170","description":"HCPCS-Q5170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDB0","description":"ICD-MEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Moving Expenses)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7333","description":"Community Transition Svcs (Moving Expenses)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0803","description":"HCPCS-B0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardioassist internal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92970","description":"Cardioassist internal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUD0","description":"ICD-NAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74415","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHA0","description":"ICD-EGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental recement crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2920","description":"Dental recement crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWC1","description":"ICD-PJWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX22","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traditional healing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0051","description":"Traditional healing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTF1","description":"ICD-FCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWD1","description":"ICD-LGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICME1","description":"ICD-ICME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lith ion non prosth recharge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4601","description":"Lith ion non prosth recharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Axillary crutch extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0978","description":"Axillary crutch extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGA0","description":"ICD-JHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28B","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCA0","description":"ICD-BDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELE0","description":"ICD-MELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2D","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dent appl desensitizing med","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9910","description":"Dent appl desensitizing med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA217","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGE1","description":"ICD-GGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTF0","description":"ICD-MLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo plas sing free knee mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2037","description":"Kafo plas sing free knee mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIF0","description":"ICD-EDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYF1","description":"ICD-GGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVA0","description":"ICD-JHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFED0","description":"ICD-EFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood split unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9011","description":"Blood split unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRD1","description":"ICD-PKRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of fascia for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20920","description":"Removal of fascia for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCA1","description":"ICD-GHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUC1","description":"ICD-NJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJB0","description":"ICD-CGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACC0","description":"ICD-IACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB214","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB11","description":"ICD-1BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLB0","description":"ICD-NKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FUT1 GNOTYP FUT1 EXON 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0185U","description":"FUT1 GNOTYP FUT1 EXON 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Surveillance Center Technical Support Including Data Transmission With Analysis_ With A Minimum Of 18 Training Hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0705T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Surveillance Center Technical Support Including Data Transmission With Analysis_ With A Minimum Of 18 Training Hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQC1","description":"ICD-GBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24635","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDA0","description":"ICD-CFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIID0","description":"ICD-GIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWD0","description":"ICD-LBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0554U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","description":"CPT-0554U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOD0","description":"ICD-OFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reremove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25112","description":"Reremove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTD1","description":"ICD-MHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEA0","description":"ICD-FIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"P2y inhib not presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9440","description":"P2y inhib not presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVC0","description":"ICD-OAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFB1","description":"ICD-JAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hh respiratory thrpy in eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5180","description":"Hh respiratory thrpy in eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cranio/maxillofacial surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21299","description":"Cranio/maxillofacial surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC260","description":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us bone density measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76977","description":"Us bone density measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01939","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","description":"CPT-01939","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKD0","description":"ICD-BGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJB1","description":"ICD-JDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMF1","description":"ICD-JBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laboratory processing of microbial specimen to include culture and sensitivity studies_ preparation and transmission of written report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0414","description":"Laboratory processing of microbial specimen to include culture and sensitivity studies_ preparation and transmission of written report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test cran nerv unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95867","description":"Muscle test cran nerv unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVF0","description":"ICD-GIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96133","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEC1","description":"ICD-GAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93975","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bl draw <3 yrs other vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36406","description":"Bl draw <3 yrs other vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Front castr compl pneum tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0071","description":"Front castr compl pneum tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNB1","description":"ICD-NBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERB0","description":"ICD-GERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMB1","description":"ICD-GGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24A","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1070T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1070T","description":"CPT-1070T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preop anes or proxy b/4 surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9497","description":"Preop anes or proxy b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAF0","description":"ICD-EHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYA0","description":"ICD-CCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroestradiol f 18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9591","description":"Fluoroestradiol f 18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMB0","description":"ICD-CGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKD0","description":"ICD-CDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj secretin synthetic human","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2850","description":"Inj secretin synthetic human","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOF0","description":"ICD-OLOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEA1","description":"ICD-ICEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB45","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCB1","description":"ICD-NBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTC0","description":"ICD-OHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemi-wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1083","description":"Hemi-wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient pregnancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1061","description":"Patient pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKF1","description":"ICD-NIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNB0","description":"ICD-BFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTC0","description":"ICD-FHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOE0","description":"ICD-CDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot/toes surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28899","description":"Foot/toes surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNF1","description":"ICD-BBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27665","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak/bk self-aligning unit ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5617","description":"Ak/bk self-aligning unit ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prenatal at risk education","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1003","description":"Prenatal at risk education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUE0","description":"ICD-NLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip disartic sach thermopls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5595","description":"Hip disartic sach thermopls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semen anal strict criteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89322","description":"Semen anal strict criteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9845","description":"Patient received anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise spinal cord tract(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63170","description":"Incise spinal cord tract(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYF1","description":"ICD-LBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKF1","description":"ICD-CFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB13","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJC0","description":"ICD-KDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTA0","description":"ICD-IFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20C","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENB0","description":"ICD-BENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ nivolumab and relatlimab-rmbw_ 3 mg/1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9298","description":"Injection_ nivolumab and relatlimab-rmbw_ 3 mg/1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLE1","description":"ICD-OFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of hand bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26230","description":"Partial removal of hand bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning_ utilizing first morni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0228U","description":"Oncology (prostate)_ multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning_ utilizing first morni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOC1","description":"ICD-DAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFE1","description":"ICD-KCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRC1","description":"ICD-KCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINF1","description":"ICD-KINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correct inverted nipple(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19355","description":"Correct inverted nipple(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ptnot rcvng anti-rhm thxpyra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4196F","description":"Ptnot rcvng anti-rhm thxpyra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doppler echo exam heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93321","description":"Doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGD1","description":"ICD-FAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33962","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPF1","description":"ICD-ODPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHE0","description":"ICD-JHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teprotumumab-trbw_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3241","description":"Injection_ teprotumumab-trbw_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXE0","description":"ICD-NJXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYC0","description":"ICD-LBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Discography cerv/thor spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72285","description":"Discography cerv/thor spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMC0","description":"ICD-FGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Case management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1016","description":"Case management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22A","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion palate prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42281","description":"Insertion palate prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUF1","description":"ICD-NFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNB1","description":"ICD-BGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHE1","description":"ICD-IIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28B","description":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEID0","description":"ICD-BEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUF1","description":"ICD-KCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24D","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurobehavioral status exam (clinical assessment of thinking_ reasoning and judgment_ [eg_ acquired knowledge_ attention_ language_ memory_ planning and problem solving_ and v","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96121","description":"Neurobehavioral status exam (clinical assessment of thinking_ reasoning and judgment_ [eg_ acquired knowledge_ attention_ language_ memory_ planning and problem solving_ and v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIA0","description":"ICD-JGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYE0","description":"ICD-DHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOA0","description":"ICD-CAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61690","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct sft tsue nck w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70492","description":"Ct sft tsue nck w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVC0","description":"ICD-FAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBC1","description":"ICD-FIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24D","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQB1","description":"ICD-GHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FY GNOTYP ACKR1 EXONS 1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0187U","description":"FY GNOTYP ACKR1 EXONS 1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMF0","description":"ICD-NBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB224","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair hallux rigidus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28289","description":"Repair hallux rigidus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKA1","description":"ICD-OKKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply spine prosth device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22851","description":"Apply spine prosth device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEC0","description":"ICD-FIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX42","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0959T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","description":"CPT-0959T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1901","description":"HCPCS-A1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEC1","description":"ICD-EFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluoroguide for vein device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77001","description":"Fluoroguide for vein device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00740","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00740","description":"CPT-00740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alglucosidase alfa injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0220","description":"Alglucosidase alfa injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENE0","description":"ICD-BENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCB1","description":"ICD-FBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIB1","description":"ICD-OKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos back post/lat wdth <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2615","description":"Pos back post/lat wdth <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJME1","description":"ICD-NJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEC1","description":"ICD-GEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMD0","description":"ICD-FHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cancelled appointment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9987","description":"Cancelled appointment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX23","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYD0","description":"ICD-LDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20A","description":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mcp joint repl 2 pc or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8631","description":"Mcp joint repl 2 pc or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIE1","description":"ICD-NFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCND1","description":"ICD-OCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD204","description":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUA0","description":"ICD-KIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (Cuvitru)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1555","description":"Injection_ immune globulin (Cuvitru)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMA1","description":"ICD-IEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALA1","description":"ICD-CALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICA1","description":"ICD-MICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABC1","description":"ICD-EABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACD0","description":"ICD-NACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bone lower jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21025","description":"Excision of bone lower jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Giardia ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87269","description":"Giardia ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECC0","description":"ICD-IECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGC1","description":"ICD-CFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repr per/vag pouch sngl proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46710","description":"Repr per/vag pouch sngl proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm ped plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4011","description":"Cast sup sht arm ped plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant_ including fluoroscopy_ transseptal puncture_ catheter placement(s)_ left atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33340","description":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant_ including fluoroscopy_ transseptal puncture_ catheter placement(s)_ left atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair testis injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54670","description":"Repair testis injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occluder lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2770","description":"Occluder lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXD1","description":"ICD-CHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Varicella-zoster ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90396","description":"Varicella-zoster ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75827","description":"Vein x-ray chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medroxyprogesterone acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1050","description":"Medroxyprogesterone acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHC1","description":"ICD-ICHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJD0","description":"ICD-KDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTC0","description":"ICD-EFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSA0","description":"ICD-OKSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ed svc ckd ind per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0420","description":"Ed svc ckd ind per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCF0","description":"ICD-GDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQF1","description":"ICD-ODQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antepartum care only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59426","description":"Antepartum care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXD0","description":"ICD-CDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJD0","description":"ICD-KHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUE1","description":"ICD-CHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCC0","description":"ICD-GFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Introduction of needle or intracatheter_ upper or lower extremity artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36140","description":"Introduction of needle or intracatheter_ upper or lower extremity artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPC0","description":"ICD-GDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87592","description":"N.gonorrhoeae dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Helicobacter pylori antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86677","description":"Helicobacter pylori antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Choline c-11_ diagnostic_ per study dose up to 20 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9515","description":"Choline c-11_ diagnostic_ per study dose up to 20 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0336U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA150","description":"Reduced Physical Function _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spontaneous nystagmus study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92531","description":"Spontaneous nystagmus study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHC1","description":"ICD-JCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFE1","description":"ICD-CDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBID1","description":"ICD-BBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31200","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27700","description":"Revision of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXC0","description":"ICD-OLXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29887","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJF0","description":"ICD-CAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lung lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32150","description":"Removal of lung lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAA1","description":"ICD-ABAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0660U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0660U","description":"CPT-0660U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKC1","description":"ICD-KIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKB1","description":"ICD-BBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Var vaccine live subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90716","description":"Var vaccine live subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mapcp demo physician","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9153","description":"Mapcp demo physician","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic injection/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51715","description":"Endoscopic injection/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLA1","description":"ICD-CDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLC0","description":"ICD-BDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAME0","description":"ICD-BAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGD0","description":"ICD-BHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph scope w/submucous inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43201","description":"Esoph scope w/submucous inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryoprecipitate each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9012","description":"Cryoprecipitate each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAB1","description":"ICD-JDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFC0","description":"ICD-GBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUF1","description":"ICD-AIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen)_ serum_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0058U","description":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen)_ serum_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTE1","description":"ICD-IHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00580","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","description":"CPT-00580","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGF1","description":"ICD-OGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJF1","description":"ICD-NJJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime_ mouthpiece each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4594","description":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime_ mouthpiece each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy c/th facet jnt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64634","description":"Destroy c/th facet jnt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDA1","description":"ICD-EIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABB0","description":"ICD-AABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHE0","description":"ICD-NDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANF0","description":"ICD-OANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25574","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVE0","description":"ICD-ODVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech/hearing therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92507","description":"Speech/hearing therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture ulnar styloid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25652","description":"Treat fracture ulnar styloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the pat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1174","description":"Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary venous angiography of each distinct pulmo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93574","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary venous angiography of each distinct pulmo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel)_ radiological supervisio and interpretation; initial vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75945","description":"Intravascular ultrasound (non-coronary vessel)_ radiological supervisio and interpretation; initial vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAC1","description":"ICD-ACAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove sling repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57287","description":"Revise/remove sling repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX30","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mycobacteria dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87551","description":"Mycobacteria dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRA0","description":"ICD-OBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCC1","description":"ICD-MLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDE1","description":"ICD-MLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA46","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCC1","description":"ICD-KGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC52","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGF1","description":"ICD-JBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0405","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0405","description":"CDT-D0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVC0","description":"ICD-CCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOA0","description":"ICD-GBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33511","description":"Cabg vein two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cont pas motion exercise dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0935","description":"Cont pas motion exercise dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEF0","description":"ICD-JAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRD1","description":"ICD-ODRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Derma-Gide_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4203","description":"Derma-Gide_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPF1","description":"ICD-FDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc no pt rsk death w/in 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1151F","description":"Doc no pt rsk death w/in 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUB0","description":"ICD-CFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHE1","description":"ICD-AIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTE0","description":"ICD-FDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPF0","description":"ICD-CDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3B","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSF1","description":"ICD-KDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acute vitreous hemorrhage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1333","description":"Acute vitreous hemorrhage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIA1","description":"ICD-NFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBE0","description":"ICD-EDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Misc integral lens serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0590","description":"Misc integral lens serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Txmnts 2 phys/qhp by 1 mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5020F","description":"Txmnts 2 phys/qhp by 1 mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKC1","description":"ICD-NFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXC1","description":"ICD-BCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPC1","description":"ICD-FFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAA0","description":"ICD-MIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUA1","description":"ICD-CIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFA1","description":"ICD-GEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0678","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0678","description":"HCPCS-G0678","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMF0","description":"ICD-MIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter_ including recording_ with interpretation and written report_ up to 30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95836","description":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter_ including recording_ with interpretation and written report_ up to 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1417","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","description":"HCPCS-M1417","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKB1","description":"ICD-BGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assist oocyte fertilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89280","description":"Assist oocyte fertilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQA0","description":"ICD-PIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"T cell absolute count/ratio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86360","description":"T cell absolute count/ratio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Christian sci pract visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9900","description":"Christian sci pract visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99379","description":"Nursing fac care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBC0","description":"ICD-ICBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26725","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD255","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc rsn do qual life assm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9635","description":"No doc rsn do qual life assm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; first vein treated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36473","description":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; first vein treated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGB0","description":"ICD-FBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQE1","description":"ICD-LIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB31","description":"ICD-4EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of hip bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27147","description":"Revision of hip bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBB1","description":"ICD-NLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEND1","description":"ICD-BEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFA0","description":"ICD-BGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of natriuretic peptide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83880","description":"Assay of natriuretic peptide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0735T","description":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMC1","description":"ICD-EDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDD0","description":"ICD-IHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAE0","description":"ICD-BCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGD0","description":"ICD-KBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28A","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBD0","description":"ICD-FIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMA1","description":"ICD-IIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"GYPB GNOTYP NTRNS 1 5 SEUX 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0190U","description":"GYPB GNOTYP NTRNS 1 5 SEUX 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGF1","description":"ICD-FFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXD0","description":"ICD-BDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATF0","description":"ICD-KATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6009","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQE1","description":"ICD-GBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cabg w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56751","description":"Anesth cabg w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress fingers/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26035","description":"Decompress fingers/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICE1","description":"ICD-KICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0A","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKA0","description":"ICD-FIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6007","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCF0","description":"ICD-NKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGC0","description":"ICD-NLGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 2-12 Channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77786","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 2-12 Channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/ch access anti-rollback","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0974","description":"W/ch access anti-rollback","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of arm bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24140","description":"Partial removal of arm bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYA1","description":"ICD-CDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLC1","description":"ICD-CFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADF0","description":"ICD-EADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Brixadi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9154","description":"Injection_ buprenorphine extended-release (Brixadi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect forearm/wrist tum<3cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25077","description":"Resect forearm/wrist tum<3cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFD0","description":"ICD-ODFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMF0","description":"ICD-AIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth biopsy of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32251","description":"Anesth biopsy of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25575","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair & revise nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64874","description":"Repair & revise nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCC1","description":"ICD-OGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEE0","description":"ICD-OIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMB1","description":"ICD-KBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23B","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXA1","description":"ICD-BBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 30 MCG/0.3 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91312","description":"SARSCOV2 VACCINE BIVALENT 30 MCG/0.3 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAME1","description":"ICD-GAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXA1","description":"ICD-NEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Posaconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80187","description":"Posaconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWD1","description":"ICD-GGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Habil sup empl waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2018","description":"Habil sup empl waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0144A","description":"IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96932","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYB1","description":"ICD-ODYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMB0","description":"ICD-NCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWC0","description":"ICD-HFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWB0","description":"ICD-CCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBF1","description":"ICD-NGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOC1","description":"ICD-LBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOB1","description":"ICD-KFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEC0","description":"ICD-OLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnicore pro+_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4299","description":"Amnicore pro+_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mtms by pharm est 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99606","description":"Mtms by pharm est 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ moxifloxacin 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2280","description":"Inj_ moxifloxacin 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthodont high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6210","description":"Prosthodont high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/wedge resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32666","description":"Thoracoscopy w/wedge resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDB1","description":"ICD-IDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0270T","description":"Rev/remvl crtd sns dev lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":">85y no hx colo ca/rsn scope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9659","description":">85y no hx colo ca/rsn scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDB0","description":"ICD-MBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUB0","description":"ICD-JBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB204","description":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVA0","description":"ICD-BHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23680","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Path rpt malig cancer docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3317F","description":"Path rpt malig cancer docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEA1","description":"ICD-EIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGED0","description":"ICD-CGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAF1","description":"ICD-KEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISA1","description":"ICD-HISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fimbrioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58760","description":"Fimbrioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBF1","description":"ICD-OKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHA1","description":"ICD-CHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVD0","description":"ICD-FGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIC0","description":"ICD-GEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDE1","description":"ICD-FDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRB1","description":"ICD-HFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCE1","description":"ICD-MLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGA1","description":"ICD-FCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBA1","description":"ICD-BDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shigella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86771","description":"Shigella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leflunomide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80193","description":"Leflunomide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEC1","description":"ICD-MGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg > 48 sq in w/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6247","description":"Hydrogel drg > 48 sq in w/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOE1","description":"ICD-GBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSB1","description":"ICD-PDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUB0","description":"ICD-OCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIE0","description":"ICD-JBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28G","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec knee-shin swing only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5857","description":"Elec knee-shin swing only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect recurrent gyn mal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58957","description":"Resect recurrent gyn mal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subcut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0818T","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subcut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUE0","description":"ICD-GBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0079","description":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBD0","description":"ICD-NEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRC0","description":"ICD-HBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNA1","description":"ICD-JFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWD0","description":"ICD-KFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBC1","description":"ICD-ICBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNA0","description":"ICD-CBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPD0","description":"ICD-GCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apicoect/perirad surg anter","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3410","description":"Apicoect/perirad surg anter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVA0","description":"ICD-CGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJF0","description":"ICD-CEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid monaural in ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5050","description":"Hearing aid monaural in ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMB0","description":"ICD-NGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXB0","description":"ICD-FHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGC0","description":"ICD-OLGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis b dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87515","description":"Hepatitis b dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALB0","description":"ICD-CALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHC1","description":"ICD-AAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sperm procure subs visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4031","description":"Sperm procure subs visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDD0","description":"ICD-GIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0493","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSB1","description":"ICD-OHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral solution hepatic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5100","description":"Parenteral solution hepatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETD1","description":"ICD-FETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0562","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","description":"HCPCS-G0562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYD0","description":"ICD-HFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31579","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEE1","description":"ICD-OCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Palatal lift prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5955","description":"Palatal lift prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQB1","description":"ICD-HHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB02","description":"High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Path consult intraop addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88332","description":"Path consult intraop addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12B","description":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXA0","description":"ICD-OHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBA1","description":"ICD-KBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMC1","description":"ICD-CBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOD1","description":"ICD-LHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lactation class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9443","description":"Lactation class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBF1","description":"ICD-MFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69633","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of insulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83527","description":"Assay of insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seat width 24-27 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2202","description":"Seat width 24-27 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCA1","description":"ICD-EGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHF1","description":"ICD-AGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vestronidase alfa-vjbk_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3397","description":"Injection_ vestronidase alfa-vjbk_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert intracorporeal device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33979","description":"Insert intracorporeal device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOE0","description":"ICD-GBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16377","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16377","description":"CPT-16377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAA0","description":"ICD-FDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACE1","description":"ICD-JACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMB1","description":"ICD-GEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJA1","description":"ICD-BBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX02","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-75577","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","description":"CPT-75577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINE1","description":"ICD-GINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59140","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMC1","description":"ICD-CGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin pro/pos wc cus wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2607","description":"Skin pro/pos wc cus wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPD0","description":"ICD-KGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCF1","description":"ICD-EGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA206","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKA0","description":"ICD-BHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSD1","description":"ICD-DDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjunctive procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9999","description":"Adjunctive procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXF1","description":"ICD-NHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer tub rail attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0246","description":"Transfer tub rail attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB02","description":"Medium Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11100","description":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCF1","description":"ICD-OKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFE1","description":"ICD-GFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8I","description":"Medium Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLE1","description":"ICD-OLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOA1","description":"ICD-DHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJE0","description":"ICD-BHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB224","description":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDF0","description":"ICD-AHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27650","description":"Repair achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0105","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0105","description":"CDT-D0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIF1","description":"ICD-KFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D8671","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D8671","description":"CDT-D8671","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc Uveal MLNMA MRNA gen xprs prfl 15 gene alg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0081U","description":"Onc Uveal MLNMA MRNA gen xprs prfl 15 gene alg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6609","description":"Gradient compression bandaging supply_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Filleted finger/toe flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14350","description":"Filleted finger/toe flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mtms by pharm addl 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99607","description":"Mtms by pharm addl 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDA0","description":"ICD-FEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUC0","description":"ICD-NLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALA1","description":"ICD-OALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVD1","description":"ICD-CIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMC1","description":"ICD-KIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brompheniramine maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0945","description":"Brompheniramine maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL16","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIA1","description":"ICD-ODIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLA0","description":"ICD-IFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical repair of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43502","description":"Surgical repair of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVC1","description":"ICD-BIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0544U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0544U","description":"CPT-0544U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDE1","description":"ICD-EHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periodic oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0120","description":"Periodic oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75716","description":"Artery x-rays arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATB0","description":"ICD-BATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELA0","description":"ICD-FELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8X","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Residential Habilitation 1-3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0100","description":"Residential Habilitation 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNE0","description":"ICD-CDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHB0","description":"ICD-JGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOB1","description":"ICD-GAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB204","description":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Community-acquired bacterial pneumonia assessment (includes all of the foll","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0118U","description":"Community-acquired bacterial pneumonia assessment (includes all of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRD0","description":"ICD-DIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Camp day waiver/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2037","description":"Camp day waiver/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUE0","description":"ICD-JGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTC0","description":"ICD-AFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDD0","description":"ICD-JDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQF0","description":"ICD-HGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAE1","description":"ICD-KBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0651","description":"Injection_ levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attendant care service /15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5125","description":"Attendant care service /15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove thyroid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60200","description":"Remove thyroid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUA0","description":"ICD-OCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1046T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1046T","description":"CPT-1046T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVC0","description":"ICD-JCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PelloGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4320","description":"PelloGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"KLF1 TARGETED SEQUENCING","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0195U","description":"KLF1 TARGETED SEQUENCING","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin tissue procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17999","description":"Skin tissue procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Renal scope w/tumor resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50562","description":"Renal scope w/tumor resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFF1","description":"ICD-NAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA11","description":"ICD-3LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extraoral first film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0250","description":"Extraoral first film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLA1","description":"ICD-MLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLE1","description":"ICD-NDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMB1","description":"ICD-NKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANF1","description":"ICD-CANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0001","description":"Alcohol and/or drug assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01967","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","description":"CPT-01967","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRB0","description":"ICD-CGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMF0","description":"ICD-FAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWA0","description":"ICD-HDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00567","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","description":"CPT-00567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther fostercare child /month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5146","description":"Ther fostercare child /month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWB0","description":"ICD-PBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m depreotide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9536","description":"Tc99m depreotide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-elastic extremity binder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4465","description":"Non-elastic extremity binder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRE0","description":"ICD-HBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect back tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21935","description":"Resect back tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA21","description":"ICD-1JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEC0","description":"ICD-EEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Igh gene rearrange amp meth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81261","description":"Igh gene rearrange amp meth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 4 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP04","description":"Auto.test pane pricing code_ 4 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSB1","description":"ICD-KFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion/graft of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24802","description":"Fusion/graft of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor IX_ albumin fusion protein (recombinant)_ Idelvion_ 1 i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9139","description":"Injection_ Factor IX_ albumin fusion protein (recombinant)_ Idelvion_ 1 i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVF0","description":"ICD-KIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFF1","description":"ICD-KCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGA0","description":"ICD-GBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCA1","description":"ICD-FGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1501","description":"HCPCS-B1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEE0","description":"ICD-IDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"JAK2 (Janus kinase 2) (eg_ myeloproliferative disorder) gene analysis_ targeted sequence analysis exons 12-15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0027U","description":"JAK2 (Janus kinase 2) (eg_ myeloproliferative disorder) gene analysis_ targeted sequence analysis exons 12-15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open reduct compd mandble fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7730","description":"Open reduct compd mandble fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Robot lin-radsurg com_ first","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0339","description":"Robot lin-radsurg com_ first","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGA1","description":"ICD-NAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQA0","description":"ICD-GAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg artery-vein five","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33522","description":"Cabg artery-vein five","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emr pwr source combo vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0491","description":"Emr pwr source combo vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOD1","description":"ICD-DHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC31","description":"ICD-2FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ monaural_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5242","description":"Hearing aid_ monaural_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPE0","description":"ICD-JEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIB0","description":"ICD-MLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla class ii phenotype qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86831","description":"Hla class ii phenotype qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI abdomen w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74183","description":"MRI abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUB1","description":"ICD-JIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNC1","description":"ICD-OFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct hrt w/3d image congen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75573","description":"Ct hrt w/3d image congen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJD0","description":"ICD-BDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOB0","description":"ICD-GDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not prescribing warfarin or another FDA-approved anticoagulation due to patient being currently enrolled in a clinical trial related to A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9927","description":"Documentation of system reason(s) for not prescribing warfarin or another FDA-approved anticoagulation due to patient being currently enrolled in a clinical trial related to A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTF0","description":"ICD-EHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFC1","description":"ICD-KDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCF1","description":"ICD-KGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFF1","description":"ICD-OKFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1079T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1079T","description":"CPT-1079T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA23","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61538","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v interpret","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88141","description":"Cytopath c/v interpret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUA1","description":"ICD-KDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special stains group 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88313","description":"Special stains group 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8711","description":"Pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJC0","description":"ICD-GIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0B","description":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADE1","description":"ICD-AADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had history of immunocompromising conditions prior to or during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1158","description":"Patient had history of immunocompromising conditions prior to or during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx isodose plan simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77316","description":"Brachytx isodose plan simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trnscrv uterin fibroid abltj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0404T","description":"Trnscrv uterin fibroid abltj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEA1","description":"ICD-AAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUB0","description":"ICD-AIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIA1","description":"ICD-FCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive chemotherapy in the last 14 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9848","description":"Patient did not receive chemotherapy in the last 14 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Beclomethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7622","description":"Beclomethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEB0","description":"ICD-IAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD105","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOD0","description":"ICD-DIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICF1","description":"ICD-IICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRD0","description":"ICD-DFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLB0","description":"ICD-MCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEE0","description":"ICD-MEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFF0","description":"ICD-GIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOA1","description":"ICD-LDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYE0","description":"ICD-CEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33250","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOC0","description":"ICD-ODOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPE0","description":"ICD-ODPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGID0","description":"ICD-AGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13C","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge resin base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6251","description":"Bridge resin base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAD0","description":"ICD-IEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine HCl (Immphentiv)_ 20 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2373","description":"Injection_ phenylephrine HCl (Immphentiv)_ 20 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt dischg <=2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9255","description":"Doc pt dischg <=2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDD0","description":"ICD-NGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIB1","description":"ICD-EDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISC1","description":"ICD-GISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBE1","description":"ICD-AEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Axolotl ambient or axolotl cryo_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4215","description":"Axolotl ambient or axolotl cryo_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00103","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","description":"CPT-00103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUD1","description":"ICD-FIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temporary replacement eqpmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0462","description":"Temporary replacement eqpmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Accessories for patient inserted indwelling intraurethral drainage device with valve_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4342","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMC0","description":"ICD-EEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDE1","description":"ICD-FIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANB0","description":"ICD-OANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC11","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXE1","description":"ICD-GDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEF0","description":"ICD-OIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00794","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","description":"CPT-00794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJB0","description":"ICD-JIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (genetic hyperfibrinolysis_ delayed bleeding)_ genomic sequence analysis of 8 genes (F13A1_ F13B_ FGA_ FGB_ FGG_ SERPINA1_ SERPINE1_ SERPINF2_ PLAU)_ blood_ buccal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0273U","description":"Hematology (genetic hyperfibrinolysis_ delayed bleeding)_ genomic sequence analysis of 8 genes (F13A1_ F13B_ FGA_ FGB_ FGG_ SERPINA1_ SERPINE1_ SERPINF2_ PLAU)_ blood_ buccal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lamellas xt_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4291","description":"Lamellas xt_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWB1","description":"ICD-KAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAC0","description":"ICD-EEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD150","description":"Special Care High _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDE1","description":"ICD-FGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec stim other than wound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0283","description":"Elec stim other than wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam drg >16<=48 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6213","description":"Foam drg >16<=48 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDB0","description":"ICD-GFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploratory heart surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33310","description":"Exploratory heart surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Needle Insertion(S) Without Injection(S); 1 Or 2 Muscle(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20560","description":"Needle Insertion(S) Without Injection(S); 1 Or 2 Muscle(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High dose rate_electronic bracytherapy_ per fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0182T","description":"High dose rate_electronic bracytherapy_ per fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDID0","description":"ICD-BDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No recd cortico>=10mg/d >60d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9468","description":"No recd cortico>=10mg/d >60d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRA1","description":"ICD-ODRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLD0","description":"ICD-MHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L0720","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","description":"HCPCS-L0720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pet img wholbod melano nonco","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0219","description":"Pet img wholbod melano nonco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJF0","description":"ICD-NEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGC1","description":"ICD-KGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERE1","description":"ICD-LERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse hand bones with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25825","description":"Fuse hand bones with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC206","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTC1","description":"ICD-FBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHB0","description":"ICD-MKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOE1","description":"ICD-KDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIB1","description":"ICD-EAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Benesch boot pair infant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3212","description":"Benesch boot pair infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDF1","description":"ICD-OKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cocaine hydrochloride nasal solution (numbrino)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9143","description":"Cocaine hydrochloride nasal solution (numbrino)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTE0","description":"ICD-KBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGE1","description":"ICD-JEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBD1","description":"ICD-ODBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RARE DS XOM DNA ALYS PROBAND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0214U","description":"RARE DS XOM DNA ALYS PROBAND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1702","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1702","description":"CDT-D1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUB0","description":"ICD-JFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc of neg or man pos tb scn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9359","description":"Doc of neg or man pos tb scn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTA1","description":"ICD-BBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHED0","description":"ICD-BHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJF1","description":"ICD-KGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENB1","description":"ICD-BENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLD1","description":"ICD-ODLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bevacizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9257","description":"Bevacizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18X","description":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQA1","description":"ICD-DIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVA0","description":"ICD-KFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJB1","description":"ICD-NDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74410","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYA1","description":"ICD-PKYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Audiometry air only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0208T","description":"Audiometry air only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE254","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61020","description":"Remove brain cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPF1","description":"ICD-JCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of nasal adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30560","description":"Release of nasal adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKA0","description":"ICD-BFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGE0","description":"ICD-CAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATC1","description":"ICD-IATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFD1","description":"ICD-KBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ bra_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6528","description":"Gradient compression garment_ bra_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Head control nonproportional","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2329","description":"Head control nonproportional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC213","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27724","description":"Repair/graft of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXB0","description":"ICD-GHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBB0","description":"ICD-EGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc chro add","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9608","description":"Perc d-e cor revasc chro add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWE1","description":"ICD-GDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chem/antisept solution_ 8oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4674","description":"Chem/antisept solution_ 8oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLD0","description":"ICD-KFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAED0","description":"ICD-MAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol 10 gm lipids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4185","description":"Parenteral sol 10 gm lipids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFND1","description":"ICD-CFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJA1","description":"ICD-JDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qual life tool 2x same/impr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9634","description":"Qual life tool 2x same/impr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable collection and storage bag for breast milk_ any size_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4287","description":"Disposable collection and storage bag for breast milk_ any size_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVC0","description":"ICD-NIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1077T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1077T","description":"CPT-1077T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFC1","description":"ICD-NAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL24","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQF0","description":"ICD-LBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Management of a new patient with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0522","description":"Management of a new patient with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSD0","description":"ICD-LCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXC0","description":"ICD-KFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKB1","description":"ICD-NHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQF0","description":"ICD-KCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDD1","description":"ICD-ADDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRB1","description":"ICD-CGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJC1","description":"ICD-FAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40808","description":"Biopsy of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEA1","description":"ICD-CBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28E","description":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14D","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDD0","description":"ICD-MLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLF1","description":"ICD-NLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise windpipe scar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31830","description":"Revise windpipe scar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMA1","description":"ICD-NDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMA0","description":"ICD-OEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQC1","description":"ICD-LBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cnslng provided symp mngmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4350F","description":"Cnslng provided symp mngmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01920","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","description":"CPT-01920","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJF0","description":"ICD-NKJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No cont ppi or h2ra rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4186F","description":"No cont ppi or h2ra rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCE1","description":"ICD-CFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC114","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUF1","description":"ICD-EGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bilirubin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82247","description":"Bilirubin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYE1","description":"ICD-LIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFF0","description":"ICD-BHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ trilaciclib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9078","description":"Injection_ trilaciclib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seat lift incorp lift-chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0627","description":"Seat lift incorp lift-chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9629","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mirikizumab-mrkz_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2267","description":"Injection_ mirikizumab-mrkz_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetic study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88299","description":"Cytogenetic study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMC1","description":"ICD-GFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCA1","description":"ICD-ODCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWF1","description":"ICD-PJWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress spine cord add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63066","description":"Decompress spine cord add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45315","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multi-axial rotation unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5986","description":"Multi-axial rotation unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27502","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer tendon to pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27098","description":"Transfer tendon to pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIF0","description":"ICD-GAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELC1","description":"ICD-KELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRD1","description":"ICD-GIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAD1","description":"ICD-BFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVD1","description":"ICD-BBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX33","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dihydromorphinone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6046","description":"Dihydromorphinone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Truss add to std pad scrotal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8330","description":"Truss add to std pad scrotal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOF0","description":"ICD-CDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33287","description":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGE1","description":"ICD-BCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEB0","description":"ICD-NLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine & cord cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63194","description":"Incise spine & cord cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2]_ oxyhemoglobin [ctHbO2]_ deoxyhemoglobin [ctHbR]_ papillary and reticular dermal hemoglobin concentrat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0061U","description":"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2]_ oxyhemoglobin [ctHbO2]_ deoxyhemoglobin [ctHbR]_ papillary and reticular dermal hemoglobin concentrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sheath upper limb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8415","description":"Sheath upper limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr angio spine w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72159","description":"Mr angio spine w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Candida antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86628","description":"Candida antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTF1","description":"ICD-OBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 30 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91320","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 30 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","description":"HCPCS-Q4389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPB1","description":"ICD-JGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUE1","description":"ICD-GDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUC1","description":"ICD-BEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95149","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA06","description":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair stomach-bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43880","description":"Repair stomach-bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMC1","description":"ICD-GEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDF0","description":"ICD-MBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGF0","description":"ICD-GDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep c scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3514F","description":"Hep c scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; clinical staff under the direction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0822T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; clinical staff under the direction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUA1","description":"ICD-ODUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDED1","description":"ICD-BDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHF1","description":"ICD-GBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test for porphobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84106","description":"Test for porphobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOA0","description":"ICD-KGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64473","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","description":"CPT-64473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrics (preeclampsia)_ kinase insert domain receptor (KDR)_ Endoglin (ENG)_ and retinol-binding protein 4 (RBP4)_ by immunoassay_ serum_ algorithm reported as a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0390U","description":"Obstetrics (preeclampsia)_ kinase insert domain receptor (KDR)_ Endoglin (ENG)_ and retinol-binding protein 4 (RBP4)_ by immunoassay_ serum_ algorithm reported as a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHF1","description":"ICD-FBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNF0","description":"ICD-FCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDD1","description":"ICD-NJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA11","description":"ICD-1EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDC1","description":"ICD-KEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blink reflex test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95933","description":"Blink reflex test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFC1","description":"ICD-OJFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKA1","description":"ICD-GCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enzyme histochemistry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88319","description":"Enzyme histochemistry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21123","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFB1","description":"ICD-OEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8B","description":"Very High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sensorineural acuity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92575","description":"Sensorineural acuity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYD1","description":"ICD-HGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJE0","description":"ICD-CEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGF0","description":"ICD-OHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNC0","description":"ICD-KCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC124","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate biliary duct/ampulla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47542","description":"Dilate biliary duct/ampulla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0102U","description":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOD1","description":"ICD-PGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33820","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPA0","description":"ICD-ODPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHC1","description":"ICD-KGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWE1","description":"ICD-LAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHE0","description":"ICD-AFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef special metabolic inherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4157","description":"Ef special metabolic inherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHF1","description":"ICD-OFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEC1","description":"ICD-BGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSF1","description":"ICD-OBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJND1","description":"ICD-NJND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEC0","description":"ICD-AIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTA1","description":"ICD-EGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLA0","description":"ICD-KCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEC1","description":"ICD-ACEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0514","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQE1","description":"ICD-DHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVA1","description":"ICD-JAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAF0","description":"ICD-JIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFF0","description":"ICD-GFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aortofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35539","description":"Art byp grft aortofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of custom sleep apnea appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9949","description":"Repair of custom sleep apnea appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUB0","description":"ICD-CBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Most recent BP is greater than 140/90 mm Hg_ or blood pressure not documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9790","description":"Most recent BP is greater than 140/90 mm Hg_ or blood pressure not documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11442","description":"Exc face-mm b9+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA23","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac MRI for morph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75557","description":"Cardiac MRI for morph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dtap vaccine < 7 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90700","description":"Dtap vaccine < 7 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26499","description":"Revision of finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection Tocilizumab for COVID-19 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0249","description":"Injection Tocilizumab for COVID-19 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEC0","description":"ICD-IHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10mg (Darzalex)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9476","description":"Injection_ daratumumab_ 10mg (Darzalex)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18X","description":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQE0","description":"ICD-GBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3B","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydroxyzine pamoate 25mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0177","description":"Hydroxyzine pamoate 25mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXB1","description":"ICD-NLXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHB1","description":"ICD-FHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ruptured tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24342","description":"Repair of ruptured tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITE0","description":"ICD-GITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABF0","description":"ICD-MABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27842","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELB1","description":"ICD-OELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSF1","description":"ICD-KFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSA0","description":"ICD-DFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIC1","description":"ICD-EGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27250","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15C","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart revascularize (tmr)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33140","description":"Heart revascularize (tmr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal sinus therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30210","description":"Nasal sinus therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE246","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc stage docd b/4 thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3300F","description":"Ajcc stage docd b/4 thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sodium thiosulfate_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0208","description":"Injection_ sodium thiosulfate_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1409","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","description":"HCPCS-M1409","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVA1","description":"ICD-NIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOA1","description":"ICD-PDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRB1","description":"ICD-LGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22514","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKF1","description":"ICD-FHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRF1","description":"ICD-KFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBB1","description":"ICD-JBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETA0","description":"ICD-EETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"T-cell depletion of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38210","description":"T-cell depletion of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACC1","description":"ICD-NACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYF0","description":"ICD-DCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMF0","description":"ICD-OFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGF1","description":"ICD-NFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecg record/review","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93268","description":"Ecg record/review","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kyphosis pad floating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1025","description":"Kyphosis pad floating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0903","description":"HCPCS-B0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28308","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEB0","description":"ICD-IBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGE1","description":"ICD-OGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUA1","description":"ICD-KCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHE1","description":"ICD-FHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1741","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1741","description":"HCPCS-C1741","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQF0","description":"ICD-GFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69905","description":"Remove inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endothelial function assessment_ using peripheral vascular response to reactive hyperemia_ non-invasive (eg_ brachial artery ultrasound_ peripheral artery tonometry)_ unilater","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0337T","description":"Endothelial function assessment_ using peripheral vascular response to reactive hyperemia_ non-invasive (eg_ brachial artery ultrasound_ peripheral artery tonometry)_ unilater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARC1","description":"ICD-CARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic induction of intra-brain hypothermia_ including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head_ including monit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0776T","description":"Therapeutic induction of intra-brain hypothermia_ including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head_ including monit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96567","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVB1","description":"ICD-BAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENB1","description":"ICD-NENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35361","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOC0","description":"ICD-KDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVD0","description":"ICD-BBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRC1","description":"ICD-GHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stoma cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5055","description":"Stoma cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRC1","description":"ICD-DGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHF1","description":"ICD-NAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTF1","description":"ICD-IGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBB0","description":"ICD-ODBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide for biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76942","description":"Echo guide for biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1 probe&reverse trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87535","description":"Hiv-1 probe&reverse trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 160 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0144U","description":"Drug assay_ definitive_ 160 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test presump not opt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0479","description":"Drug test presump not opt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microcapillary tube sealant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4652","description":"Microcapillary tube sealant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cultr oocyte/embryo <4 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89250","description":"Cultr oocyte/embryo <4 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Addition to lower extremity prosthesis_ endoskeletal_ kneedisarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1022","description":"Addition to lower extremity prosthesis_ endoskeletal_ kneedisarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJB0","description":"ICD-OCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder over 12.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2114","description":"Spherocylinder over 12.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9129","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9129","description":"CDT-D9129","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC150","description":"Special Care High _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol or peroxide per pint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4244","description":"Alcohol or peroxide per pint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt education noc individ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9445","description":"Pt education noc individ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUA0","description":"ICD-BCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrodes_ pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4556","description":"Electrodes_ pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBB1","description":"ICD-OJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSF1","description":"ICD-CGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supplies For Maintenance Of Insulin Infusion Pump With Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing_ Per Week","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4226","description":"Supplies For Maintenance Of Insulin Infusion Pump With Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing_ Per Week","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat pleurodesis w/agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32560","description":"Treat pleurodesis w/agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFB0","description":"ICD-KDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair urethrovaginal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57311","description":"Repair urethrovaginal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEC1","description":"ICD-JCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFC1","description":"ICD-JEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release knuckle contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26520","description":"Release knuckle contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX16","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJE1","description":"ICD-OIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQD1","description":"ICD-OEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEF0","description":"ICD-AAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed ditromethamine_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9323","description":"Injection_ pemetrexed ditromethamine_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPE1","description":"ICD-KHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert nasal septal button","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30220","description":"Insert nasal septal button","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOF0","description":"ICD-KDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21462","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGA0","description":"ICD-GGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bupivicaine hydro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0020","description":"Injection_ bupivicaine hydro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITD1","description":"ICD-OITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOE1","description":"ICD-GDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurectomy foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28055","description":"Neurectomy foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNB1","description":"ICD-NFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC31","description":"ICD-4JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sewho cap design w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3971","description":"Sewho cap design w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLB0","description":"ICD-GFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOA0","description":"ICD-HGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWA0","description":"ICD-HFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLA0","description":"ICD-GHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUB0","description":"ICD-JIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","description":"HCPCS-Q4414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54344","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of choroid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67220","description":"Treatment of choroid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6526","description":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Combination sit to stand sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0637","description":"Combination sit to stand sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJE0","description":"ICD-OAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAC1","description":"ICD-BEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANB1","description":"ICD-OANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBA1","description":"ICD-GHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng arm splint fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4018","description":"Cast sup lng arm splint fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No scr utr malig/us/samp rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9620","description":"No scr utr malig/us/samp rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBC0","description":"ICD-MDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31375","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB256","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMA0","description":"ICD-EBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCF0","description":"ICD-KFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fit spectacles multifocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92342","description":"Fit spectacles multifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18B","description":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair middle ear structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69667","description":"Repair middle ear structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIC0","description":"ICD-OJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0505","description":"HCPCS-B0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCME0","description":"ICD-KCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHD0","description":"ICD-JIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB11","description":"ICD-2HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention_ under skin or into muscle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0012","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention_ under skin or into muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWC1","description":"ICD-KAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whirlpool Tub_ Walk-In_ Portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1003","description":"Whirlpool Tub_ Walk-In_ Portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDME0","description":"ICD-BDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBE1","description":"ICD-ADBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Services performed by birth a doula birth workers_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1032","description":"Services performed by birth a doula birth workers_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6611","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","description":"HCPCS-A6611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIF1","description":"ICD-EHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQE1","description":"ICD-LGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrocardiogram complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93000","description":"Electrocardiogram complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGND0","description":"ICD-CGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQE1","description":"ICD-DCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other specified case mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9012","description":"Other specified case mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXB0","description":"ICD-GIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACA1","description":"ICD-GACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect distal finger tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26262","description":"Resect distal finger tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUE1","description":"ICD-IIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCE0","description":"ICD-ADCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nondisposable pump canister","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7001","description":"Nondisposable pump canister","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0686U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686U","description":"CPT-0686U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27369","description":"Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLF0","description":"ICD-MCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18D","description":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX51","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNA1","description":"ICD-OFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The MDPP b eneficiary achieved at least 9% weight loss (WL) from his/he r baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9881","description":"The MDPP b eneficiary achieved at least 9% weight loss (WL) from his/he r baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGF0","description":"ICD-KEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHD1","description":"ICD-KEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKB1","description":"ICD-KBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA54","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUD1","description":"ICD-GCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA21","description":"ICD-1DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ONC MTC MRNA XPRSN ALYS 108","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0208U","description":"ONC MTC MRNA XPRSN ALYS 108","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4396","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","description":"HCPCS-Q4396","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBC0","description":"ICD-IDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIB1","description":"ICD-EFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ aicd_ endo single coil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1777","description":"Lead_ aicd_ endo single coil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGF0","description":"ICD-JFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWC0","description":"ICD-LCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA16","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFND1","description":"ICD-OFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHD0","description":"ICD-CBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAA0","description":"ICD-GDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHD0","description":"ICD-KBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRD0","description":"ICD-PIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Galactose transferase test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82776","description":"Galactose transferase test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44140","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture_ Typing; Identification Of Blood Pathogen And Resistance Typing_ When Performed_ By Nucleic Acid (Dna Or Rna) Probe_ Multiplexed Amplified Probe Technique Including Mu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87154","description":"Culture_ Typing; Identification Of Blood Pathogen And Resistance Typing_ When Performed_ By Nucleic Acid (Dna Or Rna) Probe_ Multiplexed Amplified Probe Technique Including Mu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Casting/strapping procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29799","description":"Casting/strapping procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMA1","description":"ICD-MFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amphotericin b liposome inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0289","description":"Amphotericin b liposome inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy arm/elbow soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24066","description":"Biopsy arm/elbow soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chloroquine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0390","description":"Chloroquine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove in/ex hem grp w/fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46258","description":"Remove in/ex hem grp w/fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83251","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; initial 4 hours of monitoring time_ including hourly physiological and laboratory a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0895T","description":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; initial 4 hours of monitoring time_ including hourly physiological and laboratory a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEF0","description":"ICD-OJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98009","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","description":"CPT-98009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88167","description":"Cytopath tbs c/v select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone intra implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7312","description":"Dexamethasone intra implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUA0","description":"ICD-BHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAB1","description":"ICD-EGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36905","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8900","description":"Mra w/cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlh uterus 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58570","description":"Tlh uterus 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytomegalovirus imm iv /vial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0850","description":"Cytomegalovirus imm iv /vial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recement supp part denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6093","description":"Recement supp part denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLA1","description":"ICD-OKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doripenem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1267","description":"Doripenem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFB0","description":"ICD-BEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHD1","description":"ICD-BFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Durolane_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9465","description":"Hyaluronan or derivative_ Durolane_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehen metabolic panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80053","description":"Comprehen metabolic panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth hernia repair < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83451","description":"Anesth hernia repair < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/replace penis prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54410","description":"Remove/replace penis prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reset dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21485","description":"Reset dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0772T","description":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGA1","description":"ICD-FFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILD0","description":"ICD-OILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHE0","description":"ICD-JDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_hdr ir-192","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1717","description":"Brachytx_ non-str_hdr ir-192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93312","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEF1","description":"ICD-OAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUB1","description":"ICD-KCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVD0","description":"ICD-CFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCF1","description":"ICD-AGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMD1","description":"ICD-JAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein five","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33514","description":"Cabg vein five","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDD0","description":"ICD-IGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9024","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","description":"HCPCS-J9024","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smear gram stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87205","description":"Smear gram stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9038","description":"Rbc irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neox Cord 1K_ Neox Cord RT_ or Clarix Cord 1K_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4148","description":"Neox Cord 1K_ Neox Cord RT_ or Clarix Cord 1K_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mycobacteria culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87116","description":"Mycobacteria culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYC1","description":"ICD-CDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHA1","description":"ICD-AAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51595","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow fair lead cable molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6584","description":"Elbow fair lead cable molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tumor immunohistochem/manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88360","description":"Tumor immunohistochem/manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC11","description":"ICD-4IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRC0","description":"ICD-OLRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAC1","description":"ICD-AFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special radiation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77470","description":"Special radiation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJB1","description":"ICD-BIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vascular endoscopy procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37501","description":"Vascular endoscopy procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of circumcision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54163","description":"Repair of circumcision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00222","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","description":"CPT-00222","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2005","description":"Extensive (75 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPD1","description":"ICD-KGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAC0","description":"ICD-BFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB110","description":"Special Care High _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPD0","description":"ICD-GAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2071","description":"Medication Assisted Treatment_ Buprenorphine (Implant Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANE0","description":"ICD-NANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHF0","description":"ICD-KEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual pump enema_ reusable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4459","description":"Manual pump enema_ reusable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt neurostim radiofq rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8682","description":"Implt neurostim radiofq rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACC1","description":"ICD-OACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sub pt/ot current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8993","description":"Sub pt/ot current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3d render w/intrp postproces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76376","description":"3d render w/intrp postproces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat trigeminal tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61791","description":"Treat trigeminal tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLE1","description":"ICD-MDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQC0","description":"ICD-DDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meningococcal recombinant lipoprotein vaccine_ serogroup B (MenB-FHbp)_ 2 or 3 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90621","description":"Meningococcal recombinant lipoprotein vaccine_ serogroup B (MenB-FHbp)_ 2 or 3 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCE1","description":"ICD-GFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRF1","description":"ICD-CIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27245","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVB1","description":"ICD-FHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCE1","description":"ICD-IBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKB0","description":"ICD-CIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3B","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPC0","description":"ICD-NCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ATXN2 (ataxin 2) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81179","description":"ATXN2 (ataxin 2) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft wrist bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25440","description":"Repair/graft wrist bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject hrt congntl art/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93564","description":"Inject hrt congntl art/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIB0","description":"ICD-JBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Msh6 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81298","description":"Msh6 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTE1","description":"ICD-ODTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFD0","description":"ICD-NBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99325","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5256","description":"Hearing aid_ digit_ mon_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cell enumeration phys interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86153","description":"Cell enumeration phys interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKE0","description":"ICD-JEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFE0","description":"ICD-JDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDD0","description":"ICD-ACDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD101","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUD1","description":"ICD-FBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXC0","description":"ICD-CGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18G","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; including placement and manipulation of transducer_ image acquisi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76987","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; including placement and manipulation of transducer_ image acquisi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELF1","description":"ICD-GELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECE1","description":"ICD-FECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped hospital bed semi/elect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0329","description":"Ped hospital bed semi/elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMC1","description":"ICD-NDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; reducibl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49621","description":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; reducibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIA0","description":"ICD-NJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9958","description":"Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUC1","description":"ICD-NGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTE0","description":"ICD-MGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC225","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQF1","description":"ICD-KEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ischm stroke symp ge3 hrsb/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1066F","description":"Ischm stroke symp ge3 hrsb/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOC0","description":"ICD-PGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dornase alfa non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7639","description":"Dornase alfa non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBF0","description":"ICD-MIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBF1","description":"ICD-OEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33822","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD224","description":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj tbo filgrastim 1 microg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1447","description":"Inj tbo filgrastim 1 microg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27441","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52315","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMF0","description":"ICD-JGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUB1","description":"ICD-KFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWF1","description":"ICD-GIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit enteral per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9340","description":"Hit enteral per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABA0","description":"ICD-KABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOB0","description":"ICD-PLOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKA0","description":"ICD-OKKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLA1","description":"ICD-EGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00142","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","description":"CPT-00142","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18D","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegcetacoplan_ intravitreal_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2781","description":"Injection_ pegcetacoplan_ intravitreal_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patients with diabetes who have a most recent fasting or direct LDL- C laboratory test result < 70 mg/dl and are not taking statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9783","description":"Documentation of patients with diabetes who have a most recent fasting or direct LDL- C laboratory test result < 70 mg/dl and are not taking statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0604","description":"HCPCS-A0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPA1","description":"ICD-GIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFF0","description":"ICD-FGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYC1","description":"ICD-LIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCD1","description":"ICD-MDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5156","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","description":"HCPCS-Q5156","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGE0","description":"ICD-BAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limit oral eval problm focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0140","description":"Limit oral eval problm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMF1","description":"ICD-IBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSF0","description":"ICD-PBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARD0","description":"ICD-HARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo w/o joint multi-axis an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2038","description":"Kafo w/o joint multi-axis an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWE0","description":"ICD-LBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIA0","description":"ICD-MEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suspend bowel w/prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44700","description":"Suspend bowel w/prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELB1","description":"ICD-MELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHC0","description":"ICD-JIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMC0","description":"ICD-BDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast ductal carcinoma in situ)_ mRNA_ gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0045U","description":"Oncology (breast ductal carcinoma in situ)_ mRNA_ gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMF0","description":"ICD-ABMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYA0","description":"ICD-GIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQD0","description":"ICD-DFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDND0","description":"ICD-BDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKF0","description":"ICD-CCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSE1","description":"ICD-OKSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2168","description":"Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11A","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46606","description":"Anoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61315","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWD0","description":"ICD-HHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTA1","description":"ICD-EDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18B","description":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVF1","description":"ICD-KDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk waist belt webbing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5688","description":"Bk waist belt webbing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMF1","description":"ICD-GEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACA1","description":"ICD-MACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQF1","description":"ICD-DFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOC0","description":"ICD-OHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary artery angio s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93454","description":"Coronary artery angio s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCC1","description":"ICD-CDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXD1","description":"ICD-JCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD220","description":"Special Care Low _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBE0","description":"ICD-CHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0603","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0603","description":"CDT-D0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMA1","description":"ICD-EEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA21","description":"ICD-3GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23B","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ fremanezumab-vfrm_ 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician_ not for use when drug is self-administere","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3031","description":"Injection_ fremanezumab-vfrm_ 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician_ not for use when drug is self-administere","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXC0","description":"ICD-NEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX56","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBE0","description":"ICD-NEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01782","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","description":"CPT-01782","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANB0","description":"ICD-FANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5257","description":"Hearing aid_ digit_ mon_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy forearm soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25065","description":"Biopsy forearm soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAA0","description":"ICD-CDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBA1","description":"ICD-KIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28B","description":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crutch substitute","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0118","description":"Crutch substitute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Term dev_ sport/rec/work att","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6704","description":"Term dev_ sport/rec/work att","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEA0","description":"ICD-OFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No xray/ct/ et al ordd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3320F","description":"No xray/ct/ et al ordd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay_ plasma_ algorithm reports risk of cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0359U","description":"Oncology (prostate cancer)_ analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay_ plasma_ algorithm reports risk of cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBE0","description":"ICD-NFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELB0","description":"ICD-AELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sterile_ gloves per pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4930","description":"Sterile_ gloves per pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home health aide or certifie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9122","description":"Home health aide or certifie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXA1","description":"ICD-JFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLB0","description":"ICD-BFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxy suppl heater for nebuliz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1372","description":"Oxy suppl heater for nebuliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCC1","description":"ICD-ACCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQF1","description":"ICD-GGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFA1","description":"ICD-NGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBA1","description":"ICD-MEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace pretibial shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4130","description":"Replace pretibial shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRD1","description":"ICD-GBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX42","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCB1","description":"ICD-JBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEE0","description":"ICD-KAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSF1","description":"ICD-KHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA155","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKB1","description":"ICD-BCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQC0","description":"ICD-OFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSB0","description":"ICD-OCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDD0","description":"ICD-AFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVE0","description":"ICD-NKVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHE0","description":"ICD-MIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open nasoethmoid fx w/ fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21339","description":"Open nasoethmoid fx w/ fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCA0","description":"ICD-EDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYE1","description":"ICD-GEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD255","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCED1","description":"ICD-OCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1338","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99327","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLF0","description":"ICD-CCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMB1","description":"ICD-AIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cltx thigh fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27268","description":"Cltx thigh fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBED0","description":"ICD-MBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWA1","description":"ICD-LHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNA0","description":"ICD-KDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINB1","description":"ICD-NINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85421","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFF1","description":"ICD-OJFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIID1","description":"ICD-JIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEB0","description":"ICD-CGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1390","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","description":"HCPCS-M1390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit corticosteroid/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9490","description":"Hit corticosteroid/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tetanus immune globulin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1670","description":"Tetanus immune globulin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELE0","description":"ICD-CELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIA0","description":"ICD-EAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEA0","description":"ICD-EIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/hemodynam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75885","description":"Vein x-ray liver w/hemodynam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA31","description":"ICD-1JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2980","description":"Crown repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA14","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYD0","description":"ICD-KHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWB1","description":"ICD-GDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEC1","description":"ICD-NDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breath test heart reject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0085T","description":"Breath test heart reject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA140","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Duodenal exclusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48547","description":"Duodenal exclusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGB0","description":"ICD-CAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVD1","description":"ICD-NAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUF0","description":"ICD-AHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQB0","description":"ICD-LFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ra disease activity high","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3472F","description":"Ra disease activity high","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carbon graphite lamination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2755","description":"Carbon graphite lamination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNF1","description":"ICD-NGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOA0","description":"ICD-HAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64585","description":"Revise/remove neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Igh gene rearrang dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81262","description":"Igh gene rearrang dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41823","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj test 13/> studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95913","description":"Nrv cndj test 13/> studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay rbc cholinesterase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82482","description":"Assay rbc cholinesterase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18F","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDA0","description":"ICD-ICDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB124","description":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCB0","description":"ICD-AFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26080","description":"Explore/treat finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFC0","description":"ICD-OJFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0406","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0406","description":"CDT-D0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE156","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy soft tissue of back","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21925","description":"Biopsy soft tissue of back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRD0","description":"ICD-HDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBA0","description":"ICD-OKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0664U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0664U","description":"CPT-0664U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBE0","description":"ICD-GFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1805","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1805","description":"CDT-D1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITD0","description":"ICD-FITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKE1","description":"ICD-BDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0693U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693U","description":"CPT-0693U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUD0","description":"ICD-EHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multiple sleep latency test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95805","description":"Multiple sleep latency test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5173","description":"HCPCS-Q5173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOF1","description":"ICD-LGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMD0","description":"ICD-NFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15A","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGD0","description":"ICD-BCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDC1","description":"ICD-CDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMB1","description":"ICD-EDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFE0","description":"ICD-OEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-60660","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","description":"CPT-60660","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGF1","description":"ICD-OAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAE0","description":"ICD-IHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABA1","description":"ICD-MABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDA0","description":"ICD-KFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB07","description":"High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHB1","description":"ICD-BAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDE0","description":"ICD-KCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear canal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69145","description":"Remove ear canal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWF1","description":"ICD-PDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXF1","description":"ICD-KFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1127","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEE0","description":"ICD-MBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13D","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert brain-fluid device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61215","description":"Insert brain-fluid device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC112","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext wear ost skn barr >4sqin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4408","description":"Ext wear ost skn barr >4sqin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom mold shoe remov prost","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3250","description":"Custom mold shoe remov prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPF1","description":"ICD-CHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXA1","description":"ICD-BHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWF1","description":"ICD-CCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVF0","description":"ICD-KAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWE0","description":"ICD-GEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIC0","description":"ICD-OEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMF1","description":"ICD-GCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep corneal endo allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65757","description":"Prep corneal endo allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correct malrotation of bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44055","description":"Correct malrotation of bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie_ ex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81211","description":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie_ ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOA0","description":"ICD-GDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove exostosis mandible","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21031","description":"Remove exostosis mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA125","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDC1","description":"ICD-NEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVC1","description":"ICD-GFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0555U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","description":"CPT-0555U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAC1","description":"ICD-GFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart failure assessed (includes assessment of all the following components) (CAD): Blood pressure measured (2000F) Level of activity assessed (1003F) Clinical symptoms of vol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0105U","description":"Heart failure assessed (includes assessment of all the following components) (CAD): Blood pressure measured (2000F) Level of activity assessed (1003F) Clinical symptoms of vol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAF0","description":"ICD-NGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2A","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38380","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFE1","description":"ICD-FCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pertuzumab_ trastuzumab_ and hyaluronidase-zzxf_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9316","description":"Injection_ pertuzumab_ trastuzumab_ and hyaluronidase-zzxf_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYE0","description":"ICD-KHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ileostomy/jejunostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44310","description":"Ileostomy/jejunostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISF0","description":"ICD-KISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGD1","description":"ICD-BHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIB0","description":"ICD-NCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKA1","description":"ICD-JHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood type antigen donor ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86902","description":"Blood type antigen donor ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (oropharyngeal)_ evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR)_ cell-free DNA_ algorithm reported as a prognostic risk score for cancer recurrence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0356U","description":"Oncology (oropharyngeal)_ evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR)_ cell-free DNA_ algorithm reported as a prognostic risk score for cancer recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft brachial-brchl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35525","description":"Art byp grft brachial-brchl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDB0","description":"ICD-FEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHD0","description":"ICD-FEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap part colectomy w/stoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44206","description":"Lap part colectomy w/stoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLE1","description":"ICD-CBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEB0","description":"ICD-NGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert bladder cath complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51703","description":"Insert bladder cath complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVC0","description":"ICD-FFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Tissue Harvesting And Cellular Implant Creation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0565T","description":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Tissue Harvesting And Cellular Implant Creation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; diagnostic_ including collection of specimen(s) by brushing or washing_ when performed (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0652T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; diagnostic_ including collection of specimen(s) by brushing or washing_ when performed (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVF1","description":"ICD-OFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hmes filter holder or cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7503","description":"Hmes filter holder or cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPE0","description":"ICD-KAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUE1","description":"ICD-JDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec lock on manual pw elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6638","description":"Elec lock on manual pw elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUD1","description":"ICD-AEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 2 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64491","description":"Inj paravert f jnt c/t 2 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOB0","description":"ICD-KAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFA0","description":"ICD-GBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Q fever antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86638","description":"Q fever antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unite biomatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4129","description":"Unite biomatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ hips_ bilateral_ minimum of two views of each hip_ including anteroposterior view of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73520","description":"Radiologic examination_ hips_ bilateral_ minimum of two views of each hip_ including anteroposterior view of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAB0","description":"ICD-NEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFF1","description":"ICD-GEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHF1","description":"ICD-IGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc of pain comfort 48hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9250","description":"Doc of pain comfort 48hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML33","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Power module combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0479","description":"Power module combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dissect brain w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62161","description":"Dissect brain w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATF0","description":"ICD-EATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prefab post/core + crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2954","description":"Prefab post/core + crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","description":"HCPCS-E1034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKB0","description":"ICD-GEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYB0","description":"ICD-LDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIF0","description":"ICD-FBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stimulation of spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63610","description":"Stimulation of spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8910","description":"Mra w/o cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCA1","description":"ICD-OBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMA0","description":"ICD-OKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYC1","description":"ICD-PHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo sling operation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51992","description":"Laparo sling operation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIE0","description":"ICD-CBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5161","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","description":"HCPCS-Q5161","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRF0","description":"ICD-DHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADA0","description":"ICD-OADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of c-peptide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84681","description":"Assay of c-peptide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENF0","description":"ICD-BENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinician Documented That Patient Was Not An Eligible Candidate For Autogenous AV Fistula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8531","description":"Clinician Documented That Patient Was Not An Eligible Candidate For Autogenous AV Fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYE1","description":"ICD-OAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Paliperidone palmitate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2426","description":"Paliperidone palmitate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical pathology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88399","description":"Surgical pathology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20251","description":"Open bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAED0","description":"ICD-JAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLB0","description":"ICD-MKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYA1","description":"ICD-DAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB150","description":"Special Care Low _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALE0","description":"ICD-MALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVC1","description":"ICD-FAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL45","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj sulf hexa lipid microsph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9950","description":"Inj sulf hexa lipid microsph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS DELTA ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87380","description":"IAAD IA HEPATITIS DELTA ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1dose menig vac btwn 11 & 13","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9414","description":"1dose menig vac btwn 11 & 13","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLD1","description":"ICD-BGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93615","description":"Esophageal recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGD0","description":"ICD-NEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPF1","description":"ICD-BEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNA1","description":"ICD-NFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBA0","description":"ICD-NEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; singl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36465","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; singl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemodialysis via av graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4053F","description":"Hemodialysis via av graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGB1","description":"ICD-JBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17280","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESB1","description":"ICD-CESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOB0","description":"ICD-DFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATA0","description":"ICD-GATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETF1","description":"ICD-AETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient died including all deaths occurring during the hospitalization in which the operation was performed_ even if after 30 days_ and those deaths occurring after discharge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9812","description":"Patient died including all deaths occurring during the hospitalization in which the operation was performed_ even if after 30 days_ and those deaths occurring after discharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55845","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hh respiratory thrpy nos/day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5181","description":"Hh respiratory thrpy nos/day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLB0","description":"ICD-IHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of surface (transcutaneous) neurostimulator (eg_ TENS unit)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64550","description":"Application of surface (transcutaneous) neurostimulator (eg_ TENS unit)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracran angioplsty w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61635","description":"Intracran angioplsty w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34451","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEC1","description":"ICD-KHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ace inhibitor or arb therapy not prescribed during the measurement period_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1203","description":"Ace inhibitor or arb therapy not prescribed during the measurement period_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDD0","description":"ICD-EEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKF0","description":"ICD-JCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21248","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmi is documented below normal parameters and a follow-up plan is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1287","description":"Bmi is documented below normal parameters and a follow-up plan is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99215","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUE0","description":"ICD-AFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Protein western blot test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84182","description":"Protein western blot test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXE1","description":"ICD-JDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVC0","description":"ICD-BIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure of eyelid by suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67875","description":"Closure of eyelid by suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGE0","description":"ICD-FDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAE0","description":"ICD-OHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKE1","description":"ICD-CAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPC1","description":"ICD-CDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELB1","description":"ICD-AELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploratory elbow surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24000","description":"Exploratory elbow surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJD1","description":"ICD-KHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Forearm/arm cuffs ext/flex a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3730","description":"Forearm/arm cuffs ext/flex a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCD1","description":"ICD-ACCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA_ gene expression profiling of 18 genes_ first-catch post-digital rectal examination urine (or processed first-catch urine)_ algorithm reported as per","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0403U","description":"Oncology (prostate)_ mRNA_ gene expression profiling of 18 genes_ first-catch post-digital rectal examination urine (or processed first-catch urine)_ algorithm reported as per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2013","description":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOF1","description":"ICD-PJOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCA0","description":"ICD-KHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC221","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJB0","description":"ICD-NAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins)_ endovascular_ including all imaging and radiological supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36909","description":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins)_ endovascular_ including all imaging and radiological supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFA0","description":"ICD-NEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Direct refer hospital observ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0379","description":"Direct refer hospital observ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVB0","description":"ICD-CBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group III_ for enzyme constituents (List separately in addition to code for pri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0759T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group III_ for enzyme constituents (List separately in addition to code for pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of finger splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29131","description":"Application of finger splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJD1","description":"ICD-CFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBB0","description":"ICD-MEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone/skin graft great toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20973","description":"Bone/skin graft great toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGE1","description":"ICD-GBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLD0","description":"ICD-GDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18X","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5945","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5945","description":"CDT-D5945","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst stg3-noprogress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9074","description":"Onc dx brst stg3-noprogress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Restraints any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0710","description":"Restraints any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLC1","description":"ICD-BDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHC0","description":"ICD-IIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLB0","description":"ICD-JBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCA0","description":"ICD-BGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26426","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCF0","description":"ICD-EHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLE0","description":"ICD-NCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB217","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDD0","description":"ICD-FGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLC1","description":"ICD-KFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC117","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTA0","description":"ICD-NBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEA1","description":"ICD-KEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lamellas_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4292","description":"Lamellas_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"implant/abutment supported interim fixed denture for edentulous arch - mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6118","description":"implant/abutment supported interim fixed denture for edentulous arch - mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25650","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYB0","description":"ICD-DCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5160","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","description":"HCPCS-Q5160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIC1","description":"ICD-EDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDA1","description":"ICD-KGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0024","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOF1","description":"ICD-GFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Term dev mech hand vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6708","description":"Term dev mech hand vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL56","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC11","description":"ICD-3JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92288","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","description":"CPT-92288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glycosylated hb home device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83037","description":"Glycosylated hb home device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSD0","description":"ICD-DDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDC1","description":"ICD-AIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of erythropoietin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82668","description":"Assay of erythropoietin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUC0","description":"ICD-EHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1431","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","description":"HCPCS-M1431","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKB0","description":"ICD-OLKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERC1","description":"ICD-KERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped wc modify width adjustm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1011","description":"Ped wc modify width adjustm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gallium ga-68_ dotatoc_ diagnostic_ 0.01 mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9067","description":"Gallium ga-68_ dotatoc_ diagnostic_ 0.01 mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETE1","description":"ICD-OETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALA0","description":"ICD-FALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25290","description":"Incise wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part remove hip bone super","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27070","description":"Part remove hip bone super","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFB0","description":"ICD-NLFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96113","description":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sterile water/saline_ 500 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4217","description":"Sterile water/saline_ 500 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFF0","description":"ICD-BFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCA1","description":"ICD-KBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abobotulinumtoxina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0586","description":"Abobotulinumtoxina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0766T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artacent cord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4216","description":"Artacent cord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25915","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESC0","description":"ICD-GESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove pulmonary shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33924","description":"Remove pulmonary shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTB0","description":"ICD-NFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPC0","description":"ICD-FIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive management and care coordination for advanced illness_ per calendar month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0311","description":"Comprehensive management and care coordination for advanced illness_ per calendar month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1067T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1067T","description":"CPT-1067T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99404","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-surg eye measures docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3073F","description":"Pre-surg eye measures docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPB1","description":"ICD-KIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMD1","description":"ICD-IIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUB0","description":"ICD-CIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGF0","description":"ICD-NDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRD0","description":"ICD-PJRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPE0","description":"ICD-JDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDB1","description":"ICD-IFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Major Abdominal Blood Vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77059","description":"Major Abdominal Blood Vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50575","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHC1","description":"ICD-IGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKA1","description":"ICD-GGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLB1","description":"ICD-JFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop follow-up visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99024","description":"Postop follow-up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral; with removal of intragastric bariatric balloon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43291","description":"Esophagogastroduodenoscopy_ flexible_ transoral; with removal of intragastric bariatric balloon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lipoprotein(a)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83695","description":"Assay of lipoprotein(a)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos air press adhere no perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8855","description":"Pos air press adhere no perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAD0","description":"ICD-ODAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSF0","description":"ICD-OCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIA1","description":"ICD-AAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imterprete diagnostic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0391","description":"Imterprete diagnostic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUB1","description":"ICD-KEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETB0","description":"ICD-BETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDB1","description":"ICD-GFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYA1","description":"ICD-CHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTD0","description":"ICD-JHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMC1","description":"ICD-IGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATA0","description":"ICD-IATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Outpatient_ ed_ or observation visits that result in an inpatient admission","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2176","description":"Outpatient_ ed_ or observation visits that result in an inpatient admission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKF1","description":"ICD-CDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81406","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resp virus 3-5 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87631","description":"Resp virus 3-5 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67318","description":"Revise eye muscle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWB1","description":"ICD-HEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC21","description":"ICD-3CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPE1","description":"ICD-FGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place endorectal app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9725","description":"Place endorectal app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer with compression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0570","description":"Nebulizer with compression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe techniq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87635","description":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe techniq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCB0","description":"ICD-MCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRB1","description":"ICD-CCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKC1","description":"ICD-CDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGD0","description":"ICD-KHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGB1","description":"ICD-FBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPA1","description":"ICD-KHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWD1","description":"ICD-OJWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6084","description":"Implant Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maint drug infus cath per wk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4221","description":"Maint drug infus cath per wk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genitourinary nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78799","description":"Genitourinary nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation_ upper extremity_ single access of both the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_ tra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36836","description":"Percutaneous arteriovenous fistula creation_ upper extremity_ single access of both the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_ tra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEA1","description":"ICD-KHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICE0","description":"ICD-CICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A8006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","description":"HCPCS-A8006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGA1","description":"ICD-CIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIB0","description":"ICD-IBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAE0","description":"ICD-BHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDC0","description":"ICD-GFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10C","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIE1","description":"ICD-EDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOD1","description":"ICD-PJOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJB0","description":"ICD-NGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENB0","description":"ICD-CENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21B","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0405","description":"HCPCS-C0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEF1","description":"ICD-GEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPB1","description":"ICD-GGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVE0","description":"ICD-BIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove external ear partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69110","description":"Remove external ear partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMC1","description":"ICD-EGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHF0","description":"ICD-MKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using pretransplant peripheral blood_ algorithm reported as a risk score for early acute reje","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0319U","description":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using pretransplant peripheral blood_ algorithm reported as a risk score for early acute reje","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMA0","description":"ICD-AGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22A","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9798","description":"Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOA1","description":"ICD-KHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBA1","description":"ICD-FIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGD0","description":"ICD-GDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lab labial veneer porcelain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2962","description":"Lab labial veneer porcelain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAE0","description":"ICD-GIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIE1","description":"ICD-AHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDC1","description":"ICD-IFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENE1","description":"ICD-NENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1335","description":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSB1","description":"ICD-OGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ BTE/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5221","description":"Hearing aid_ contralateral routing system_ binaural_ BTE/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADD1","description":"ICD-NADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDD1","description":"ICD-EBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEF0","description":"ICD-OBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct soft tissue neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70490","description":"Ct soft tissue neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAB1","description":"ICD-MIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICB1","description":"ICD-OICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release muscles of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26593","description":"Release muscles of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJA1","description":"ICD-NDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test socket above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5624","description":"Test socket above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBB0","description":"ICD-OBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAA0","description":"ICD-IEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIF0","description":"ICD-GGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDD1","description":"ICD-FCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1high risk no ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9366","description":"1high risk no ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insrt/redo pn/gastr stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64590","description":"Insrt/redo pn/gastr stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGD0","description":"ICD-KAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change of ureter tube/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50688","description":"Change of ureter tube/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCD0","description":"ICD-GFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Reliant medical group_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1015","description":"Clinical decision support mechanism Reliant medical group_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cervical pneum trac equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0849","description":"Cervical pneum trac equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBA0","description":"ICD-OLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCB0","description":"ICD-NJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETB0","description":"ICD-AETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYA0","description":"ICD-OCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAE0","description":"ICD-NCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recd f/u w/in 30d disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9402","description":"Recd f/u w/in 30d disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIC1","description":"ICD-NAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD146","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVE1","description":"ICD-BEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKB0","description":"ICD-OJKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect metatarsal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28173","description":"Resect metatarsal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMB1","description":"ICD-KCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0738","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","description":"HCPCS-J0738","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQC0","description":"ICD-KBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj ferric carboxymaltos 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1439","description":"Inj ferric carboxymaltos 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCB1","description":"ICD-GBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSC0","description":"ICD-PLSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB54","description":"Medium Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBF0","description":"ICD-JFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0517T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBF1","description":"ICD-BFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWF0","description":"ICD-KCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVE1","description":"ICD-CBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","description":"HCPCS-J9382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELE0","description":"ICD-IELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQF0","description":"ICD-OLQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 4 genotyping (HPA-4)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81108","description":"Human Platelet Antigen 4 genotyping (HPA-4)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCD0","description":"ICD-GCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMA0","description":"ICD-AHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCC0","description":"ICD-GGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALE0","description":"ICD-NALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB220","description":"Special Care High _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMC1","description":"ICD-OGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLB1","description":"ICD-ICLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0698T","description":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auditory function + 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92621","description":"Auditory function + 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29877","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUC0","description":"ICD-GBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDF0","description":"ICD-OGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hand bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26034","description":"Treat hand bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC45","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental sealant per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1351","description":"Dental sealant per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIC1","description":"ICD-BGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE206","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACC0","description":"ICD-FACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAB1","description":"ICD-GCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA31","description":"ICD-4IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ plasminogen_ human-tvmh_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9090","description":"Injection_ plasminogen_ human-tvmh_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD105","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKA1","description":"ICD-NHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPE0","description":"ICD-OCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No 1dose meni vac btwn 11&13","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9415","description":"No 1dose meni vac btwn 11&13","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEB0","description":"ICD-ACEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWD1","description":"ICD-PIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMC1","description":"ICD-OBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70557","description":"MRI brain w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLD1","description":"ICD-ICLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMB1","description":"ICD-NEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWC1","description":"ICD-GAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHE1","description":"ICD-FAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHA0","description":"ICD-OHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27686","description":"Revise lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDND1","description":"ICD-NDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko rigid w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1836","description":"Ko rigid w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8D","description":"Very High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44143","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLME0","description":"ICD-MLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0601","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0601","description":"CDT-D0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Erythro lactobionate /500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1364","description":"Erythro lactobionate /500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICA0","description":"ICD-KICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPB0","description":"ICD-CBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scan proc spinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61783","description":"Scan proc spinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSB1","description":"ICD-DBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No early ind/delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9355","description":"No early ind/delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sheath below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8400","description":"Sheath below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKA1","description":"ICD-NKKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSE1","description":"ICD-HGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98977","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMC1","description":"ICD-BEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9879","description":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise knuckle with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26531","description":"Revise knuckle with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXF0","description":"ICD-NGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRC1","description":"ICD-GBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABC0","description":"ICD-FABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0565U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","description":"CPT-0565U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIC0","description":"ICD-NJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBD0","description":"ICD-NFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIF0","description":"ICD-IBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; first 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96136","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA expression profiling of HOXC6 and DLX1_ reverse transcription polymerase chain reaction (RT-PCR)_ first-void urine following digital rectal examinati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0339U","description":"Oncology (prostate)_ mRNA expression profiling of HOXC6 and DLX1_ reverse transcription polymerase chain reaction (RT-PCR)_ first-void urine following digital rectal examinati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLB0","description":"ICD-KGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYF0","description":"ICD-LCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88165","description":"Cytopath tbs c/v redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC10","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair rect/bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45800","description":"Repair rect/bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKA1","description":"ICD-CHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDF0","description":"ICD-FIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levalbuterol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7607","description":"Levalbuterol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ganciclovir long act implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7310","description":"Ganciclovir long act implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYB0","description":"ICD-OKYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPA0","description":"ICD-JFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Humidif extens supple w ippb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0550","description":"Humidif extens supple w ippb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87534","description":"Hiv-1 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRF1","description":"ICD-HCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVC0","description":"ICD-GFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYF1","description":"ICD-DFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBF0","description":"ICD-OIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj w/fluor eval cv device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36598","description":"Inj w/fluor eval cv device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEC1","description":"ICD-CEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSE0","description":"ICD-KHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65260","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6071","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHE1","description":"ICD-MAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE235","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB31","description":"ICD-2AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAD0","description":"ICD-GGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC21","description":"ICD-2HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXA0","description":"ICD-JFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMA1","description":"ICD-OBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBC1","description":"ICD-JGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAB1","description":"ICD-JFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ secukinumab_ intravenous_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9166","description":"Injection_ secukinumab_ intravenous_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCED1","description":"ICD-JCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUC0","description":"ICD-JBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway press prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8845","description":"Pos airway press prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA251","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27630","description":"Removal of tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFF1","description":"ICD-OBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUA0","description":"ICD-AAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWE1","description":"ICD-OAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGF0","description":"ICD-CBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc prac mgmt disagree w/gui","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9058","description":"Onc prac mgmt disagree w/gui","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penicillin g procaine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2510","description":"Penicillin g procaine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJD0","description":"ICD-OCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOF1","description":"ICD-CCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Benzodiazepines1-12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80346","description":"Benzodiazepines1-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWA0","description":"ICD-CFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIC0","description":"ICD-AHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVA1","description":"ICD-FEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQF0","description":"ICD-PGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVD0","description":"ICD-OBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEF0","description":"ICD-ODEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFB1","description":"ICD-NFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUD1","description":"ICD-NEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWD0","description":"ICD-HIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPA1","description":"ICD-NLPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTF1","description":"ICD-IFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27097","description":"Revision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEE1","description":"ICD-EHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWC1","description":"ICD-DIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty per toot","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4211","description":"Gingivectomy/plasty per toot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18B","description":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAE1","description":"ICD-BFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7299","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","description":"HCPCS-J7299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSB0","description":"ICD-DGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of skin abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10061","description":"Drainage of skin abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJC1","description":"ICD-NIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBF1","description":"ICD-NIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Island pedicle flap graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15740","description":"Island pedicle flap graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"KEL GNOTYP KEL EXON 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0194U","description":"KEL GNOTYP KEL EXON 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Porcine implant_ permacol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9364","description":"Porcine implant_ permacol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSC1","description":"ICD-PCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE110","description":"Special Care High _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNA1","description":"ICD-NDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft subclav-vertbrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35515","description":"Art byp grft subclav-vertbrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 mins) home care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2015","description":"Comprehensive (60 mins) home care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC220","description":"Special Care Low _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWA0","description":"ICD-PCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artificial larynx_ accessory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8505","description":"Artificial larynx_ accessory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETA0","description":"ICD-AETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1826","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","description":"HCPCS-E1826","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins lt atrl mont pres lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0294T","description":"Ins lt atrl mont pres lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of a subcutaneously implanted peritoneal ascites pump system_ any component (ascites pump_ associated peritoneal catheter_ associated bladder catheter)_ including ima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0873T","description":"Revision of a subcutaneously implanted peritoneal ascites pump system_ any component (ascites pump_ associated peritoneal catheter_ associated bladder catheter)_ including ima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mesh (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1781","description":"Mesh (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES346","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of insulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83525","description":"Assay of insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHD0","description":"ICD-OEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBC0","description":"ICD-CGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD236","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX07","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRD0","description":"ICD-HBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Canal prep/fitting of dowel","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3950","description":"Canal prep/fitting of dowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUB1","description":"ICD-EEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transport chair pt wt<=300lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1038","description":"Transport chair pt wt<=300lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25A","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Path rpt malig cancer docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3318F","description":"Path rpt malig cancer docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAE0","description":"ICD-JGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTE1","description":"ICD-NFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBF0","description":"ICD-GIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETF1","description":"ICD-OETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBC0","description":"ICD-EBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eps Gast Cardia Plic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9724","description":"Eps Gast Cardia Plic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of heel spur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28119","description":"Removal of heel spur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther behav svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2020","description":"Ther behav svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAA1","description":"ICD-FEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48146","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIB0","description":"ICD-FAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trans shoe calip plate exist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3600","description":"Trans shoe calip plate exist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25B","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAE1","description":"ICD-NLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWB0","description":"ICD-HAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHF0","description":"ICD-FEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESD1","description":"ICD-CESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJF0","description":"ICD-GFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBE0","description":"ICD-GCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11604","description":"Exc tr-ext mal+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63600","description":"Remove spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFA0","description":"ICD-CDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRF1","description":"ICD-GGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft hepatorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35535","description":"Art byp grft hepatorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCC0","description":"ICD-OFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cancer treatmentplan initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0353","description":"Cancer treatmentplan initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attach bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51841","description":"Attach bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGD1","description":"ICD-NIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFD0","description":"ICD-GHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSA0","description":"ICD-HFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC106","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINC1","description":"ICD-JINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEED1","description":"ICD-NEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPE0","description":"ICD-JAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Position wc cush wdth>=22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2606","description":"Position wc cush wdth>=22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77610","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHE0","description":"ICD-FHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0838","description":"Pwc gp 2 hd sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8G","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull for treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61770","description":"Incise skull for treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXF1","description":"ICD-FEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0528","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0528","description":"HCPCS-J0528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXC1","description":"ICD-NKXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYC0","description":"ICD-GIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBE1","description":"ICD-NLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assess vol mgmt not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8958","description":"Assess vol mgmt not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37244","description":"Vasc embolize/occlude bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDF1","description":"ICD-AFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGC1","description":"ICD-JGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYA0","description":"ICD-PLYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; includes set-up_ patient training_ configuration o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0533T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; includes set-up_ patient training_ configuration o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC11","description":"ICD-1EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41140","description":"Removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin fluid swg & stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5728","description":"Knee-shin fluid swg & stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIF1","description":"ICD-GAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTA1","description":"ICD-ACTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6037","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","description":"HCPCS-L6037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAF0","description":"ICD-EDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHE1","description":"ICD-BFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4A","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADB1","description":"ICD-IADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemi-facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8044","description":"Hemi-facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grafix plus_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4304","description":"Grafix plus_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJA0","description":"ICD-NCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGA0","description":"ICD-FFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQF0","description":"ICD-ODQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUA1","description":"ICD-KHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5A","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC240","description":"Special Care Low _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJC1","description":"ICD-NLJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0603","description":"HCPCS-B0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including CT guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10010","description":"Fine needle aspiration biopsy_ including CT guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLF1","description":"ICD-CHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caster wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2225","description":"Caster wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tofersen_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9157","description":"Injection_ tofersen_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFA0","description":"ICD-OHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: headache radiating to the neck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2190","description":"Patients with clinical indications for imaging of the head: headache radiating to the neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag rigid frame cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0632","description":"Lso sag rigid frame cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debride nail 1-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11720","description":"Debride nail 1-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFF1","description":"ICD-JCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAB0","description":"ICD-KGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARD0","description":"ICD-OARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDD0","description":"ICD-NBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGB0","description":"ICD-CHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64865","description":"Repair of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIB1","description":"ICD-CAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBED0","description":"ICD-KBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8H","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA135","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00192","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","description":"CPT-00192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBB1","description":"ICD-FCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMB0","description":"ICD-EEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOF0","description":"ICD-CAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOA0","description":"ICD-DCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHC0","description":"ICD-EAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYD1","description":"ICD-DHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETC1","description":"ICD-OETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26700","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mntr io press 24hrs/> uni/bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0329T","description":"Mntr io press 24hrs/> uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88007","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6536","description":"Gc stocking full lngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23156","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIC0","description":"ICD-OKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCE0","description":"ICD-FHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDA0","description":"ICD-MLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIED0","description":"ICD-MIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33414","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACE0","description":"ICD-NACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28A","description":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQB0","description":"ICD-CBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67923","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXD1","description":"ICD-FHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermagraft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4106","description":"Dermagraft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEF0","description":"ICD-JBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient received at least one well-child visit with a PCP during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9964","description":"Patient received at least one well-child visit with a PCP during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC130","description":"Special Care High _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGE0","description":"ICD-CHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANB0","description":"ICD-NANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prefabricated porcelain/ceramic crown - permanent tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2928","description":"Prefabricated porcelain/ceramic crown - permanent tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJB0","description":"ICD-NEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMA0","description":"ICD-GBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv rna vrl ldnot<lmts quntf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3503F","description":"Hiv rna vrl ldnot<lmts quntf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47120","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51520","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCD0","description":"ICD-ACCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lang comp goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9160","description":"Lang comp goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93979","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHB0","description":"ICD-NLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPB1","description":"ICD-OEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQC0","description":"ICD-CEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRF1","description":"ICD-OCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove elctrd transvenously","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33244","description":"Remove elctrd transvenously","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61533","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE131","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX03","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADA1","description":"ICD-MADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Global eswl kidney","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0400","description":"Global eswl kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ necitumumab_ 1mg (Portrazza)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9475","description":"Injection_ necitumumab_ 1mg (Portrazza)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 30-60 minutes_ provided remotely by hospital staff who are licensed to pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7901","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 30-60 minutes_ provided remotely by hospital staff who are licensed to pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00100","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","description":"CPT-00100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEB1","description":"ICD-JAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJF1","description":"ICD-GCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTD0","description":"ICD-ODTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIC1","description":"ICD-JAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33025","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9844","description":"Patient did not receive anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhc lis nurse train ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0164","description":"Hhc lis nurse train ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCC0","description":"ICD-GBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKE1","description":"ICD-GEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNA0","description":"ICD-FCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens pmma bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2502","description":"Contact lens pmma bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHA0","description":"ICD-AFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISB1","description":"ICD-CISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTE0","description":"ICD-ABTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEA1","description":"ICD-NCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERA0","description":"ICD-OERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA32","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELD0","description":"ICD-NELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"History of or active diagnosis of familial or pure hypercholesterolemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9782","description":"History of or active diagnosis of familial or pure hypercholesterolemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3D","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); duplication/deletion variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81363","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); duplication/deletion variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tx/proph/dg addl seq iv inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96367","description":"Tx/proph/dg addl seq iv inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair uro sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53449","description":"Repair uro sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incontinence treatment systm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0740","description":"Incontinence treatment systm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization admin by intramuscular injection of s (SARS-CoV-2) ([COVID-19]) vacc_ mRNA-LNP_ spike protein_ presev free_ 30mcg/0.3 mL dosage_ tris-sucrose formula; third dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053A","description":"Immunization admin by intramuscular injection of s (SARS-CoV-2) ([COVID-19]) vacc_ mRNA-LNP_ spike protein_ presev free_ 30mcg/0.3 mL dosage_ tris-sucrose formula; third dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJF1","description":"ICD-OGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRC1","description":"ICD-PHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIC1","description":"ICD-IEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKID1","description":"ICD-NKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGA0","description":"ICD-KCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of upper eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15822","description":"Revision of upper eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit tpn over 3l diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9368","description":"Hit tpn over 3l diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ear mold/insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5264","description":"Ear mold/insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50546","description":"Laparoscopic nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBE0","description":"ICD-MJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHF0","description":"ICD-JEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXB0","description":"ICD-NFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48145","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bls defibrillation supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0384","description":"Bls defibrillation supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1352","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25B","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No tob assess or cess inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9460","description":"No tob assess or cess inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit anti-spasmotic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9363","description":"Hit anti-spasmotic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of primidone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80188","description":"Assay of primidone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXE0","description":"ICD-FAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIB0","description":"ICD-KHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46730","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGA0","description":"ICD-BFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc abdl tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22901","description":"Exc abdl tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of rectal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45160","description":"Excision of rectal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSE1","description":"ICD-HBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAF1","description":"ICD-OFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tkr composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9233","description":"Tkr composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQB0","description":"ICD-OBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNE0","description":"ICD-OKNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUC0","description":"ICD-GHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOB0","description":"ICD-CAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg sacrococ teratoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2405","description":"Fetal surg sacrococ teratoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKC1","description":"ICD-OIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIF1","description":"ICD-NIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; capable of being read by direct optical observation only (eg_ utilizing immunoassay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80305","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; capable of being read by direct optical observation only (eg_ utilizing immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJF0","description":"ICD-JCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00864","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","description":"CPT-00864","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPA1","description":"ICD-OKPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59135","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4B","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral dexamethasone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8540","description":"Oral dexamethasone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRE1","description":"ICD-HDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPB1","description":"ICD-FGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore limb vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35860","description":"Explore limb vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVC1","description":"ICD-KBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ster wd ifx 30 d postop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8571","description":"Ster wd ifx 30 d postop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAC0","description":"ICD-MCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUF0","description":"ICD-IEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTD1","description":"ICD-KHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00164","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","description":"CPT-00164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alemtuzumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9010","description":"Alemtuzumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVC1","description":"ICD-FDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIB1","description":"ICD-BDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWC1","description":"ICD-PEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBID0","description":"ICD-CBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAF1","description":"ICD-OHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBD1","description":"ICD-CGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albumin; urine (eg_ microalbumin)_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82043","description":"Albumin; urine (eg_ microalbumin)_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHA1","description":"ICD-CGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAA0","description":"ICD-BIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB216","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"2high risk no ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9368","description":"2high risk no ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj naloxone hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2310","description":"Inj naloxone hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Serum immunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86320","description":"Serum immunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILE0","description":"ICD-KILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVE0","description":"ICD-FHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES211","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYB1","description":"ICD-PJYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wilate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7183","description":"Wilate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of chest wall respiratory sensor electrode or electrode array_ including connection to pulse generator (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0466T","description":"Insertion of chest wall respiratory sensor electrode or electrode array_ including connection to pulse generator (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIC1","description":"ICD-EFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score shdl not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8666","description":"Fun stat score shdl not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIF0","description":"ICD-ECIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUB1","description":"ICD-GBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MECP2 (methyl CpG binding protein 2) (eg_ Rett syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ mobile","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0234U","description":"MECP2 (methyl CpG binding protein 2) (eg_ Rett syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ mobile","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMD0","description":"ICD-OGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEA1","description":"ICD-NDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKF0","description":"ICD-OBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQF1","description":"ICD-HDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ intraspinal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1755","description":"Catheter_ intraspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHD0","description":"ICD-BFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUE1","description":"ICD-EDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ureter stent percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50384","description":"Remove ureter stent percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYE0","description":"ICD-DCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFA1","description":"ICD-OGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHA0","description":"ICD-KBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEE0","description":"ICD-BAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9768","description":"Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22D","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQC0","description":"ICD-KEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOB1","description":"ICD-CFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHC0","description":"ICD-CFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXB0","description":"ICD-CAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0903","description":"HCPCS-C0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test feces for trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84488","description":"Test feces for trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC21","description":"ICD-2GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDA1","description":"ICD-JGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD115","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWA1","description":"ICD-KDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epcoritamab-bysp_ 0.16 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9155","description":"Injection_ epcoritamab-bysp_ 0.16 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20665","description":"Removal of fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIB0","description":"ICD-FBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open chest heart massage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32160","description":"Open chest heart massage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35286","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis g dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87526","description":"Hepatitis g dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIB0","description":"ICD-EGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWD0","description":"ICD-KDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ferumoxytol_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0138","description":"Ferumoxytol_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUC1","description":"ICD-BFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6516","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","description":"HCPCS-A6516","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXD0","description":"ICD-OGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Space maintainer fxd unilat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1510","description":"Space maintainer fxd unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYA1","description":"ICD-PFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplt autol hct/donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38241","description":"Transplt autol hct/donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65410","description":"Biopsy of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lower extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93926","description":"Lower extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv tstng asked/docd/revwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3292F","description":"Hiv tstng asked/docd/revwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLC1","description":"ICD-KCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evoked auditory test qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92558","description":"Evoked auditory test qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLB0","description":"ICD-BCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNC1","description":"ICD-CFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice refer visit nonmd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0255","description":"Hospice refer visit nonmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir and rilpivirine_ 2 mg/3 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0741","description":"Injection_ cabotegravir and rilpivirine_ 2 mg/3 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of shoulder cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29058","description":"Application of shoulder cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2114","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mental/Behavioral Health Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4013","description":"Mental/Behavioral Health Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIA0","description":"ICD-ODIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIF1","description":"ICD-ODIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1757","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1757","description":"HCPCS-J1757","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6097","description":"Abutment Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatobil syst image w/drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78227","description":"Hepatobil syst image w/drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYE0","description":"ICD-HCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Principal illness navigation - peer support_ additional 30 minutes per calendar month (list separately in addition to g0140)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0146","description":"Principal illness navigation - peer support_ additional 30 minutes per calendar month (list separately in addition to g0140)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spirom fev/fvc>/=70%/w/ocopd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3027F","description":"Spirom fev/fvc>/=70%/w/ocopd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94761","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sheath above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8410","description":"Sheath above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assess hlth/behave subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96151","description":"Assess hlth/behave subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36572","description":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained Without Diagnostic Ultrasound Examination Of The Same Anatom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0689T","description":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained Without Diagnostic Ultrasound Examination Of The Same Anatom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of figure eight","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29049","description":"Application of figure eight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABC1","description":"ICD-JABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDB0","description":"ICD-OHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNC0","description":"ICD-FHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0426","description":"Inpt/ed teleconsult50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iliac aneurysm endovas rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75954","description":"Iliac aneurysm endovas rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diathermy eg microwave","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97024","description":"Diathermy eg microwave","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open wedge/bx lung nodule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32097","description":"Open wedge/bx lung nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOA1","description":"ICD-ODOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External radiation dosimetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77399","description":"External radiation dosimetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDB1","description":"ICD-KCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27894","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37615","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIB0","description":"ICD-EEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOF1","description":"ICD-GCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX53","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99211","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKD0","description":"ICD-FCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHE0","description":"ICD-AIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRE0","description":"ICD-OFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply forearm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29126","description":"Apply forearm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQD1","description":"ICD-GHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interv hlth/behav fam no pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96155","description":"Interv hlth/behav fam no pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pasrr level i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2010","description":"Pasrr level i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01756","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","description":"CPT-01756","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBD0","description":"ICD-OHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56634","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXE0","description":"ICD-BCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIC1","description":"ICD-GGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1B","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCF0","description":"ICD-EFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQE0","description":"ICD-CDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARF0","description":"ICD-KARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTE1","description":"ICD-JHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTB1","description":"ICD-NBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Omegaven_ 10 Grams Lipids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4187","description":"Omegaven_ 10 Grams Lipids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXC1","description":"ICD-JDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA31","description":"ICD-2HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQC1","description":"ICD-OJQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIE1","description":"ICD-NIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBC1","description":"ICD-FFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61312","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEB1","description":"ICD-CGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBE1","description":"ICD-AFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB154","description":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCB1","description":"ICD-KFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68100","description":"Biopsy of eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0903T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","description":"CPT-0903T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIB1","description":"ICD-MBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDE0","description":"ICD-MDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFF1","description":"ICD-KDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor ix non-recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7193","description":"Factor ix non-recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5C","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHC0","description":"ICD-CAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBA1","description":"ICD-NHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPE0","description":"ICD-JHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMA1","description":"ICD-BBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQE0","description":"ICD-GHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst w/uro repair compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58293","description":"Vag hyst w/uro repair compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cannula nasal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4615","description":"Cannula nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLE0","description":"ICD-FFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEB1","description":"ICD-MGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVD0","description":"ICD-KDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJC1","description":"ICD-BDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc supervision palliative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9054","description":"Onc supervision palliative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWD0","description":"ICD-KHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB31","description":"ICD-1BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80329","description":"Analgesics non-opioid 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADB0","description":"ICD-GADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUE1","description":"ICD-GHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pituitary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61546","description":"Removal of pituitary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANB0","description":"ICD-CANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVC0","description":"ICD-KDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWE1","description":"ICD-GIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (coronary artery disease [CAD])_ analysis of 3 proteins (high sensitivity [hs] troponin_ adiponectin_ and kidney injury molecule-1 [KIM-1])_ plasma_ algorithm repor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0308U","description":"Cardiology (coronary artery disease [CAD])_ analysis of 3 proteins (high sensitivity [hs] troponin_ adiponectin_ and kidney injury molecule-1 [KIM-1])_ plasma_ algorithm repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLC1","description":"ICD-NCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA43","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUE1","description":"ICD-CIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQA1","description":"ICD-PJQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFB1","description":"ICD-CIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEA1","description":"ICD-MJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21615","description":"Removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pediatrics (vasculitis_ Kawasaki disease [KD])_ analysis of 3 biomarkers (NT-proBNP_ C-reactive protein_ and T-uptake)_ plasma_ algorithm reported as a risk score for KD","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0310U","description":"Pediatrics (vasculitis_ Kawasaki disease [KD])_ analysis of 3 biomarkers (NT-proBNP_ C-reactive protein_ and T-uptake)_ plasma_ algorithm reported as a risk score for KD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHA1","description":"ICD-OBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cont intraop neuro monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0453","description":"Cont intraop neuro monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDF1","description":"ICD-GCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multi den insert custom mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5513","description":"Multi den insert custom mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; Each Additional 50 Cc Injectate_ Or Part Thereof (List Separately In","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15772","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; Each Additional 50 Cc Injectate_ Or Part Thereof (List Separately In","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOB0","description":"ICD-GCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUF1","description":"ICD-GCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGD1","description":"ICD-KDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Waterproof tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4452","description":"Waterproof tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstr lwr jaw w/advance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21199","description":"Reconstr lwr jaw w/advance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1003","description":"HCPCS-A1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd demo bundle-level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9014","description":"Esrd demo bundle-level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clamp neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61703","description":"Clamp neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDC0","description":"ICD-IEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBA0","description":"ICD-OJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXC0","description":"ICD-BEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPE0","description":"ICD-CCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytarabine hcl 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9100","description":"Cytarabine hcl 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQA1","description":"ICD-KFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEA1","description":"ICD-NEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Function stat assessed rvwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1175F","description":"Function stat assessed rvwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUD1","description":"ICD-JEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXF0","description":"ICD-KAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc viral load >=200","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9242","description":"Doc viral load >=200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15C","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAC1","description":"ICD-EDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9959","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9959","description":"CDT-D9959","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD221","description":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKE1","description":"ICD-NDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery-vein nonautograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36830","description":"Artery-vein nonautograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27810","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETE0","description":"ICD-EETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of urethra abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53040","description":"Drainage of urethra abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXE1","description":"ICD-KFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Loudness balance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92562","description":"Loudness balance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens bifocal speciality","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2299","description":"Lens bifocal speciality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of oxalate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83945","description":"Assay of oxalate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removable unilateral partial denture - one piece cast metal_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5283","description":"Removable unilateral partial denture - one piece cast metal_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPA0","description":"ICD-OLPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB235","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96170","description":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKD1","description":"ICD-OLKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMF0","description":"ICD-GIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPE1","description":"ICD-NAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral infusion pump sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0791","description":"Parenteral infusion pump sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVA0","description":"ICD-OIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDE0","description":"ICD-ECDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC42","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dent therapeutic drug inject","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9610","description":"Dent therapeutic drug inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6555","description":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59855","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALE0","description":"ICD-JALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Single transfer toe-hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26553","description":"Single transfer toe-hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVB1","description":"ICD-KIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57400","description":"Dilation of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraop oct breast cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0353T","description":"Intraop oct breast cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVA0","description":"ICD-KGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ femur_ two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73550","description":"Radiologic examination_ femur_ two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBE1","description":"ICD-CCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pediatric speech aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5952","description":"Pediatric speech aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHD0","description":"ICD-CDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 50 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91322","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 50 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA155","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Positional change of finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26555","description":"Positional change of finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUE0","description":"ICD-JAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-97007","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","description":"CPT-97007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9259","description":"Injection_ paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41250","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein access cutdown > 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36425","description":"Vein access cutdown > 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJF1","description":"ICD-JEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22C","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPF0","description":"ICD-CAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antithrombin iii antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85301","description":"Antithrombin iii antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJID0","description":"ICD-MJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEB0","description":"ICD-GIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWE1","description":"ICD-KIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAA0","description":"ICD-MGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg >48 in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6244","description":"Hydrogel drg >48 in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGF0","description":"ICD-CIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11626","description":"Exc s/n/h/f/g mal+mrg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indium in-111 auto platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9571","description":"Indium in-111 auto platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBME0","description":"ICD-IBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01942","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","description":"CPT-01942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay for calprotectin fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83993","description":"Assay for calprotectin fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHA0","description":"ICD-KEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e._ remote patient monitoring)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0322","description":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e._ remote patient monitoring)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj intercost sng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64420","description":"N block inj intercost sng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL15","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol carb > 50%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4180","description":"Parenteral sol carb > 50%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home uterine monitor with or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9001","description":"Home uterine monitor with or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCC0","description":"ICD-EDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ft arch suprt premold longit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3040","description":"Ft arch suprt premold longit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial valve init insert","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31647","description":"Bronchial valve init insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBE1","description":"ICD-FHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKA0","description":"ICD-KHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (brixadi)_ less than or equal to 7 days of therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0577","description":"Injection_ buprenorphine extended-release (brixadi)_ less than or equal to 7 days of therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMD1","description":"ICD-OIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTD0","description":"ICD-OCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXE1","description":"ICD-BEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27680","description":"Release of lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTB1","description":"ICD-OGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53215","description":"Removal of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJD0","description":"ICD-JHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXE1","description":"ICD-BIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERC1","description":"ICD-PERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIED1","description":"ICD-BIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBD1","description":"ICD-OKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBB1","description":"ICD-BBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain w/ h noble m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2750","description":"Crown porcelain w/ h noble m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOA1","description":"ICD-KFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEE0","description":"ICD-MCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22B","description":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 1 std port cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0814","description":"Pwc gp 1 std port cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYA1","description":"ICD-LAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYA0","description":"ICD-OEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAC0","description":"ICD-BBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWA0","description":"ICD-OJWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA55","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSC0","description":"ICD-DFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3268","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3268","description":"HCPCS-J3268","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whole mitochondrial genome","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81465","description":"Whole mitochondrial genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray nose to rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76010","description":"X-ray nose to rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMC1","description":"ICD-BDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens trifocal speciality","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2399","description":"Lens trifocal speciality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHC1","description":"ICD-CEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSD0","description":"ICD-GGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunotherapy administration with electroporation_ intramuscular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0732T","description":"Immunotherapy administration with electroporation_ intramuscular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIE0","description":"ICD-FHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOC1","description":"ICD-GBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA260","description":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8E","description":"Medium Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cyp2c9 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81227","description":"Cyp2c9 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPB0","description":"ICD-OGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESD0","description":"ICD-CESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd endo mucosal resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43254","description":"Egd endo mucosal resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28I","description":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50957","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKA1","description":"ICD-JAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13121","description":"Cmplx rpr s/a/l 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAF1","description":"ICD-OIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis one evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90945","description":"Dialysis one evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWA0","description":"ICD-PIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis_ review_ and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0529T","description":"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis_ review_ and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0774T","description":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht inj hormone diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9560","description":"Ht inj hormone diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryotherapy of skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17340","description":"Cryotherapy of skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEF1","description":"ICD-IIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYA1","description":"ICD-CAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYD0","description":"ICD-CBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUB1","description":"ICD-GHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NFCT DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0225U","description":"NFCT DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC215","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMA0","description":"ICD-JFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVA0","description":"ICD-GGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQF1","description":"ICD-CHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFF0","description":"ICD-OFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00926","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","description":"CPT-00926","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA11","description":"ICD-4EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLD1","description":"ICD-CHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of jaw 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70110","description":"X-ray exam of jaw 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVA0","description":"ICD-CHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert tray w/o bag/cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4310","description":"Insert tray w/o bag/cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cont airway pressure device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0601","description":"Cont airway pressure device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFC1","description":"ICD-OIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOB1","description":"ICD-OCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abd paracentesis w/imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49083","description":"Abd paracentesis w/imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILA0","description":"ICD-KILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHF1","description":"ICD-BHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20D","description":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Carry current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8984","description":"Carry current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYD0","description":"ICD-HAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTC1","description":"ICD-KDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHE1","description":"ICD-EBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNA0","description":"ICD-GFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOD0","description":"ICD-PHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC140","description":"Reduced Physical Function _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESF0","description":"ICD-PESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ophth us b w/non-quant a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76512","description":"Ophth us b w/non-quant a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWA1","description":"ICD-GBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33956","description":"Ecmo/ecls insj ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJF0","description":"ICD-KGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ag detect nos ia single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87450","description":"Ag detect nos ia single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMA1","description":"ICD-EBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4208","description":"3 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKF1","description":"ICD-OCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5247","description":"Hearing aid_ prog_ mon_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB225","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBD0","description":"ICD-FFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEF1","description":"ICD-BAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAD0","description":"ICD-KGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGC0","description":"ICD-KCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCF0","description":"ICD-BFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJA0","description":"ICD-NJJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISD1","description":"ICD-LISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLC0","description":"ICD-MDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ initial site (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0843T","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ initial site (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27284","description":"Fusion of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNA0","description":"ICD-CDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0502","description":"HCPCS-B0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21138","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAA1","description":"ICD-MHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adrenalin epinephrine inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0171","description":"Adrenalin epinephrine inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTF0","description":"ICD-OCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0607U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","description":"CPT-0607U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFF1","description":"ICD-NJFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVB0","description":"ICD-OAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mopath procedure level 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81402","description":"Mopath procedure level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD215","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ivf canc p aspir case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4021","description":"Ivf canc p aspir case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX50","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fabrication athletic guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9941","description":"Fabrication athletic guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWA1","description":"ICD-HDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQC1","description":"ICD-KIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHE0","description":"ICD-MFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reopen fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58350","description":"Reopen fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNB0","description":"ICD-CBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISA0","description":"ICD-OISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMA0","description":"ICD-OIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped critical care initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99471","description":"Ped critical care initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln cmplt max lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5750","description":"Denture reln cmplt max lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDB0","description":"ICD-FCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYD1","description":"ICD-CFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQF0","description":"ICD-CCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metaproterenol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7668","description":"Metaproterenol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1418","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","description":"HCPCS-M1418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Cyclophosphamide_ (Auromedics)_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9087","description":"Injection_ Cyclophosphamide_ (Auromedics)_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of intrastromal corneal ring segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0099T","description":"Implantation of intrastromal corneal ring segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHA1","description":"ICD-NHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIB1","description":"ICD-MCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWD1","description":"ICD-KHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYF0","description":"ICD-HAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJB1","description":"ICD-OLJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFC1","description":"ICD-KEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Neisseria gonorrhoeae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87850","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Neisseria gonorrhoeae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTD0","description":"ICD-AGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEF0","description":"ICD-CGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRD1","description":"ICD-HCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPF0","description":"ICD-JEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPF0","description":"ICD-KCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61520","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYA0","description":"ICD-KDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML55","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVD0","description":"ICD-BHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46045","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEA0","description":"ICD-AAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hbv assess&results intrp 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3517F","description":"Hbv assess&results intrp 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKC0","description":"ICD-OIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPD0","description":"ICD-OCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28111","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47612","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHD1","description":"ICD-BGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUD1","description":"ICD-KBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser surgery of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52647","description":"Laser surgery of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert electrodes for eeg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95830","description":"Insert electrodes for eeg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Humidifier nonheated w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0561","description":"Humidifier nonheated w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB251","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAA1","description":"ICD-EDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNB1","description":"ICD-GBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA151","description":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLD0","description":"ICD-NDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47361","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJE1","description":"ICD-FCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFD1","description":"ICD-KCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14C","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVA1","description":"ICD-OFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAC0","description":"ICD-MHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWD1","description":"ICD-PKWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQE1","description":"ICD-KFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXE1","description":"ICD-KHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44366","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRA1","description":"ICD-LDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No photodoc cecal ldmk exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9614","description":"No photodoc cecal ldmk exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBB0","description":"ICD-NLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Histotripsy (i.e._ nonthermal ablation via acoustic energy delivery) of malignant renal tissue_ including image gu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9790","description":"Histotripsy (i.e._ nonthermal ablation via acoustic energy delivery) of malignant renal tissue_ including image gu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPB1","description":"ICD-JCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telecare equipment installation and removal with training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W2025","description":"Telecare equipment installation and removal with training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61600","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVE0","description":"ICD-OBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANB1","description":"ICD-CANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUA0","description":"ICD-KBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Augmentation of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21208","description":"Augmentation of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACA1","description":"ICD-AACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISD1","description":"ICD-HISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUD1","description":"ICD-JBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retinal prosthesis_ includes all internal and external components; add-on to C1841","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1842","description":"Retinal prosthesis_ includes all internal and external components; add-on to C1841","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24110","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYA1","description":"ICD-PJYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQB1","description":"ICD-KCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/2.25-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2112","description":"Spherocylindr 7.25d/2.25-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPB0","description":"ICD-JFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCB0","description":"ICD-GBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dipropylacetic acid free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80165","description":"Dipropylacetic acid free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAB0","description":"ICD-AEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incontinence supply","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4335","description":"Incontinence supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPD0","description":"ICD-BIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rabies ig im/sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90375","description":"Rabies ig im/sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSA0","description":"ICD-CDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4400","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","description":"HCPCS-Q4400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLD0","description":"ICD-IDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable ext urethral dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4360","description":"Disposable ext urethral dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWE0","description":"ICD-HCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXB0","description":"ICD-KIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCD1","description":"ICD-BHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIB1","description":"ICD-JBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"User adjustable heel height","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5990","description":"User adjustable heel height","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTB0","description":"ICD-CCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ls < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8660","description":"Fun stat score ls < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In111 pentetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9548","description":"In111 pentetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLF1","description":"ICD-JDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist/forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25115","description":"Remove wrist/forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANE0","description":"ICD-CANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAA1","description":"ICD-FDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syst bp lt 130 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3074F","description":"Syst bp lt 130 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSB0","description":"ICD-CDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMA1","description":"ICD-ABMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ex for speech device rx 1hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92607","description":"Ex for speech device rx 1hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEC1","description":"ICD-IIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLID1","description":"ICD-MLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision addl breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19126","description":"Excision addl breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovas non-cardiac abl cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1888","description":"Endovas non-cardiac abl cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB11","description":"ICD-1CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDC0","description":"ICD-BCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sc r ant/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0637","description":"Lso sc r ant/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUB1","description":"ICD-JHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKE0","description":"ICD-KDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspirin recvd w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4084F","description":"Aspirin recvd w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATC0","description":"ICD-EATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAA0","description":"ICD-BDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft aor/carot/innom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35526","description":"Art byp grft aor/carot/innom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1259","description":"Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHB0","description":"ICD-MAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHC0","description":"ICD-MEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFF1","description":"ICD-NCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11623","description":"Exc s/n/h/f/g mal+mrg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD215","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Services provided in urgent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9088","description":"Services provided in urgent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of kidney wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50500","description":"Repair of kidney wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRA1","description":"ICD-GGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX34","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCND1","description":"ICD-KCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDA1","description":"ICD-CHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSF1","description":"ICD-OCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIE1","description":"ICD-KDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA24","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITE0","description":"ICD-MITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD116","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1455","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","description":"HCPCS-M1455","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWF0","description":"ICD-DDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJE0","description":"ICD-GAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implnt_bon void filler-putty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9359","description":"Implnt_bon void filler-putty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGC1","description":"ICD-KIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEB1","description":"ICD-BDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHC0","description":"ICD-NDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0519","description":"Management of new patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJF0","description":"ICD-CBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCF0","description":"ICD-JBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPA0","description":"ICD-GHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXE1","description":"ICD-NHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCE0","description":"ICD-ECCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADB0","description":"ICD-NADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFD0","description":"ICD-GCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA214","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28I","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIE1","description":"ICD-KEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/revise wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25320","description":"Repair/revise wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngeal function studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92520","description":"Laryngeal function studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20B","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood typing serologic abo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86900","description":"Blood typing serologic abo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replcmnt breastpump lok ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4286","description":"Replcmnt breastpump lok ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTF0","description":"ICD-IFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52214","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37247","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLA1","description":"ICD-NBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/family 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90837","description":"Psytx pt&/family 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20A","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25126","description":"Remove/graft forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBE1","description":"ICD-MGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Set-Up Fees)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7335","description":"Community Transition Svcs (Set-Up Fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQF1","description":"ICD-PKQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75580","description":"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLC0","description":"ICD-JCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOA0","description":"ICD-PDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51580","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIME1","description":"ICD-MIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB130","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMB1","description":"ICD-GCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPA1","description":"ICD-NKPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-auto graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4285","description":"Non-auto graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42961","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXD1","description":"ICD-NKXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33660","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8F","description":"Medium Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHA0","description":"ICD-BBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrical bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20975","description":"Electrical bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67210","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFF1","description":"ICD-FDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGB0","description":"ICD-JAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUF1","description":"ICD-AAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0134U","description":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive assessment of blood oxygenation_ gas exchange efficiency_ and cardiorespiratory status_ with physician or other qualified health care professional interpretation a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0893T","description":"Noninvasive assessment of blood oxygenation_ gas exchange efficiency_ and cardiorespiratory status_ with physician or other qualified health care professional interpretation a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1280","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEC1","description":"ICD-EEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNE0","description":"ICD-JBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8013","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8013","description":"HCPCS-C8013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCB0","description":"ICD-OCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEA1","description":"ICD-GFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00216","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","description":"CPT-00216","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEF0","description":"ICD-CCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glucose tolerance test (gtt)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82951","description":"Glucose tolerance test (gtt)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leuprolide Injectable_ Camcevi_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1952","description":"Leuprolide Injectable_ Camcevi_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-93897","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","description":"CPT-93897","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGB1","description":"ICD-CCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFC1","description":"ICD-OCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIE1","description":"ICD-KHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBA1","description":"ICD-EEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88150","description":"Cytopath c/v manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXD1","description":"ICD-FIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g._ prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1172","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g._ prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICC0","description":"ICD-CICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s)_ with endoscopic cannulation of papilla with direct visual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7544","description":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s)_ with endoscopic cannulation of papilla with direct visual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of pancreas lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48120","description":"Removal of pancreas lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0590U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","description":"CPT-0590U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal contract stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59020","description":"Fetal contract stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Measure venous pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93770","description":"Measure venous pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMC1","description":"ICD-MBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOD0","description":"ICD-GAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph fundoplasty thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43328","description":"Esoph fundoplasty thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice evaluation preelecti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0337","description":"Hospice evaluation preelecti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRB1","description":"ICD-OBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJF1","description":"ICD-OHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYB1","description":"ICD-LCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGME1","description":"ICD-MGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Jaw arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29804","description":"Jaw arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC31","description":"ICD-2AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBC0","description":"ICD-ODBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMB0","description":"ICD-KFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-2 antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86702","description":"Hiv-2 antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","description":"HCPCS-M1373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc Lung 5 Clinical Risk Factors Alg Prblty Mal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0080U","description":"Onc Lung 5 Clinical Risk Factors Alg Prblty Mal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Soft interface below knee se","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2820","description":"Soft interface below knee se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAF1","description":"ICD-FBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSC0","description":"ICD-OLSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00848","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","description":"CPT-00848","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1089","description":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test hemidiaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95866","description":"Muscle test hemidiaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUF0","description":"ICD-OJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy lower leg soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27614","description":"Biopsy lower leg soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1A","description":"Default_ /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pentostatin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9268","description":"Pentostatin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22B","description":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unclassified drug or biological used for ESRD on dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3591","description":"Unclassified drug or biological used for ESRD on dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDE0","description":"ICD-GGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9073","description":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m pentetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9539","description":"Tc99m pentetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAD1","description":"ICD-JFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJF1","description":"ICD-FAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVB1","description":"ICD-OLVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0201","description":"HCPCS-A0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Segmental pneumatic chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0657","description":"Segmental pneumatic chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1022","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJB1","description":"ICD-KEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMB0","description":"ICD-JAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37275","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","description":"CPT-37275","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monocyte distribution width_ whole blood (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0427U","description":"Monocyte distribution width_ whole blood (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYB1","description":"ICD-DGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVF1","description":"ICD-CDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL42","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXA1","description":"ICD-JEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIA0","description":"ICD-NHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vertebral axial decompressio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9090","description":"Vertebral axial decompressio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ three protein biomarkers_ immunoassay using magnetic nanosensor technology_ plasma_ algorithm reported as risk score for likelihood of malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0092U","description":"Oncology (lung)_ three protein biomarkers_ immunoassay using magnetic nanosensor technology_ plasma_ algorithm reported as risk score for likelihood of malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspirin or another antiplatelet therapy used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1055","description":"Aspirin or another antiplatelet therapy used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXF0","description":"ICD-FHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1063T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1063T","description":"CPT-1063T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEA1","description":"ICD-AEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIB0","description":"ICD-GAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVF0","description":"ICD-JDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEA0","description":"ICD-AGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMF1","description":"ICD-CIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFD0","description":"ICD-BDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracranial bilat study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93880","description":"Extracranial bilat study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHF0","description":"ICD-JAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQB0","description":"ICD-CAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1302","description":"HCPCS-A1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYA1","description":"ICD-OAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA)_ Chlamydia trachomatis and Neisseria gonorrhoeae_ multiplex amplified probe technique_ urine_ vaginal_ pharyngeal_ or rectal_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0353U","description":"Infectious agent detection by nucleic acid (DNA)_ Chlamydia trachomatis and Neisseria gonorrhoeae_ multiplex amplified probe technique_ urine_ vaginal_ pharyngeal_ or rectal_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBD1","description":"ICD-GBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCD1","description":"ICD-FCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLA1","description":"ICD-CFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCA0","description":"ICD-FDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MLH1 (mutL homolog 1) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0158U","description":"MLH1 (mutL homolog 1) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBE1","description":"ICD-OIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAD0","description":"ICD-CIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDD1","description":"ICD-IHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPE0","description":"ICD-JFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJF1","description":"ICD-GAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXB1","description":"ICD-CHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HER2-targeted therapies administered during the initial course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9828","description":"HER2-targeted therapies administered during the initial course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colorec ca scr_ sto bas dna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0464","description":"Colorec ca scr_ sto bas dna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC15","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA130","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8X","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADE1","description":"ICD-CADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJB1","description":"ICD-OGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-maly_ biosimilar_ (alymsys)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5126","description":"Injection_ bevacizumab-maly_ biosimilar_ (alymsys)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLC1","description":"ICD-MKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCC0","description":"ICD-ODCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUD1","description":"ICD-BCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corrugated tubing_ non-disposable_ used with large volume nebulizer_ 10 feet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7011","description":"Corrugated tubing_ non-disposable_ used with large volume nebulizer_ 10 feet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise foot tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28086","description":"Excise foot tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Daily cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0512","description":"Daily cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJD0","description":"ICD-OIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWA0","description":"ICD-CCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28D","description":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ evaluation for mutations of APC_ BRAF_ CTNNB1_ KRAS_ NRAS_ PIK3CA_ SMAD4_ and TP53_ and methylation markers (MYO1G_ KCNQ5_ C9ORF50_ FLI1_ CLIP4_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0368U","description":"Oncology (colorectal cancer)_ evaluation for mutations of APC_ BRAF_ CTNNB1_ KRAS_ NRAS_ PIK3CA_ SMAD4_ and TP53_ and methylation markers (MYO1G_ KCNQ5_ C9ORF50_ FLI1_ CLIP4_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC212","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJD1","description":"ICD-BCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit hydra 3 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9376","description":"Hit hydra 3 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wearable artificial kidney","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1632","description":"Wearable artificial kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPF1","description":"ICD-OFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mgmt gene methylation anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81287","description":"Mgmt gene methylation anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAC0","description":"ICD-FFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSC0","description":"ICD-PHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bartonella dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87470","description":"Bartonella dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJE1","description":"ICD-JAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01622","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","description":"CPT-01622","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSB1","description":"ICD-ODSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90955","description":"Esrd srv 2-3 vsts p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Hypotensive Patients Who Are At Immediate Risk Of Cardiogenic Shock_ Hospita","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2093","description":"Documentation Of Medical Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Hypotensive Patients Who Are At Immediate Risk Of Cardiogenic Shock_ Hospita","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUE0","description":"ICD-CBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHD0","description":"ICD-GGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat each add spine fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22328","description":"Treat each add spine fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHB1","description":"ICD-FIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTD0","description":"ICD-AHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTD0","description":"ICD-FHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75756","description":"Artery x-rays chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPA1","description":"ICD-JEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKC0","description":"ICD-CEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec osteogen stim not spine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0747","description":"Elec osteogen stim not spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFE1","description":"ICD-CAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resin two surfaces-anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2331","description":"Resin two surfaces-anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0560U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","description":"CPT-0560U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB45","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYE1","description":"ICD-PEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRE1","description":"ICD-PCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83051","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Str markers specimen anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81265","description":"Str markers specimen anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVD0","description":"ICD-JBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGB1","description":"ICD-BDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWD0","description":"ICD-LCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5272","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPA0","description":"ICD-BHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXE0","description":"ICD-JCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFC0","description":"ICD-NHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8H","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOC1","description":"ICD-PEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53620","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXF0","description":"ICD-FEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCA0","description":"ICD-IBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFED1","description":"ICD-NFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6782","description":"Crown 3/4 cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBF0","description":"ICD-OEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29435","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rad dos limts b/4 3d rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0520F","description":"Rad dos limts b/4 3d rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYE0","description":"ICD-GAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKE1","description":"ICD-FEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA22","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUC0","description":"ICD-JHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1348","description":"Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFA1","description":"ICD-BDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKC0","description":"ICD-BFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrial Shunt Or Placebo Control_ Including Right Heart Catheterization_ Trans-Esophag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9758","description":"Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrial Shunt Or Placebo Control_ Including Right Heart Catheterization_ Trans-Esophag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNF0","description":"ICD-JHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXF1","description":"ICD-GBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grp b strep screening docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3294F","description":"Grp b strep screening docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB11","description":"ICD-4LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWE1","description":"ICD-KAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHE0","description":"ICD-EBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIF1","description":"ICD-FFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gr24 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2363","description":"Gr24 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUE1","description":"ICD-NEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35246","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCD1","description":"ICD-ADCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGC1","description":"ICD-KBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMD0","description":"ICD-EEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXB0","description":"ICD-CCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0235","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","description":"HCPCS-M0235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMD0","description":"ICD-KDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBE1","description":"ICD-JCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEB0","description":"ICD-BCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSC0","description":"ICD-DDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0541U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","description":"CPT-0541U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ureteral embolization/occl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50705","description":"Ureteral embolization/occl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36575","description":"Repair tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo hormon antineopl sq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96402","description":"Chemo hormon antineopl sq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Activate matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4301","description":"Activate matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34706","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVA0","description":"ICD-KIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATD0","description":"ICD-OATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1001","description":"HCPCS-C1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transab esoph hiat hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43333","description":"Transab esoph hiat hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSB0","description":"ICD-DFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscp harv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2112","description":"Knee arthroscp harv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLC0","description":"ICD-ADLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXB0","description":"ICD-NJXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUF0","description":"ICD-JFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDF0","description":"ICD-MFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogen m array copy no&snp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81229","description":"Cytogen m array copy no&snp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Com wrap-around sv_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2022","description":"Com wrap-around sv_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bl donor search management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38204","description":"Bl donor search management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL01","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEE0","description":"ICD-JCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBB0","description":"ICD-FEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telethx isodose plan cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77307","description":"Telethx isodose plan cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUF1","description":"ICD-MEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-rays bone survey infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77076","description":"X-rays bone survey infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJC0","description":"ICD-GEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33413","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMD1","description":"ICD-EDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDE0","description":"ICD-JIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATE0","description":"ICD-JATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medication admin visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1502","description":"Medication admin visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUC1","description":"ICD-FCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUE1","description":"ICD-JHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mifepristone_ oral_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0190","description":"Mifepristone_ oral_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTD0","description":"ICD-MLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXE0","description":"ICD-KEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2025F","description":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23550","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace high roll cuff","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4060","description":"Replace high roll cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATD0","description":"ICD-FATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat sternum fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21825","description":"Treat sternum fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESE0","description":"ICD-HESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I & d of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56405","description":"I & d of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIC0","description":"ICD-KDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0671","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0671","description":"HCPCS-G0671","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0B","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIE1","description":"ICD-MIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frontier extended stay demo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9140","description":"Frontier extended stay demo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKA0","description":"ICD-BEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHE1","description":"ICD-NLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1161","description":"Patient had anaphylaxis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQD0","description":"ICD-DEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFF0","description":"ICD-GGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILA1","description":"ICD-GILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Testosterone undecanoate 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3145","description":"Testosterone undecanoate 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHE1","description":"ICD-CFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCA1","description":"ICD-CHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSF1","description":"ICD-PBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKC0","description":"ICD-NCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cover eye w/membrane","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65778","description":"Cover eye w/membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast_ Followed By Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0635T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast_ Followed By Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCC0","description":"ICD-JDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEF0","description":"ICD-JIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tendon & muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23405","description":"Incision of tendon & muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBC1","description":"ICD-NEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUD1","description":"ICD-KFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22869","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAE0","description":"ICD-ODAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rad exp time w/o fluor doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9501","description":"Rad exp time w/o fluor doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0281","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","description":"HCPCS-J0281","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLD1","description":"ICD-EBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX55","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33365","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder ASD) RNA next-generation sequencing saliva algorithmic analysis and results reported as predictive probability of ASD diagnosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0170U","description":"Neurology (autism spectrum disorder ASD) RNA next-generation sequencing saliva algorithmic analysis and results reported as predictive probability of ASD diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQB1","description":"ICD-LEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIF1","description":"ICD-NLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKE0","description":"ICD-BAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryosurg ablate fa each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19105","description":"Cryosurg ablate fa each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQB0","description":"ICD-PCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQC0","description":"ICD-CAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Polycarb lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0580","description":"Polycarb lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMB1","description":"ICD-OAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of neonatal thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84437","description":"Assay of neonatal thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRC0","description":"ICD-OBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEB1","description":"ICD-KHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Online service by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98969","description":"Online service by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJC0","description":"ICD-NDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCD1","description":"ICD-NGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIB1","description":"ICD-FIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMA0","description":"ICD-GDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB11","description":"ICD-4EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELF1","description":"ICD-FELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVA0","description":"ICD-OCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct pelvis w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72192","description":"Ct pelvis w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg monitoring/giving drugs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95954","description":"Eeg monitoring/giving drugs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMB0","description":"ICD-BIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHD0","description":"ICD-NAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDE0","description":"ICD-ABDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0145","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44120","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJD0","description":"ICD-FDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRF1","description":"ICD-OHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLB0","description":"ICD-EHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dtap-hep b-ipv vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90723","description":"Dtap-hep b-ipv vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27513","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKF1","description":"ICD-NEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPE1","description":"ICD-KGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHC1","description":"ICD-NCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology (diabetic chronic kidney disease [CKD])_ multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1)_ soluble tumor n","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0407U","description":"Nephrology (diabetic chronic kidney disease [CKD])_ multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1)_ soluble tumor n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interphalangeal joint repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8659","description":"Interphalangeal joint repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth heart surg w/o pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56051","description":"Anesth heart surg w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation stating the patient has an active diagnosis of depression or has diagnosed bipolar disorder_ therefore screening or follow-up not required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9717","description":"Documentation stating the patient has an active diagnosis of depression or has diagnosed bipolar disorder_ therefore screening or follow-up not required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99437","description":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg cylinder fb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4034","description":"Cast sup lng leg cylinder fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFF0","description":"ICD-BBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8710","description":"Pt pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITB1","description":"ICD-KITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAA0","description":"ICD-GHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMC1","description":"ICD-JBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAC1","description":"ICD-CCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMF0","description":"ICD-JHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar bolster pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1030","description":"Lumbar bolster pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSC0","description":"ICD-GGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact layer <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6206","description":"Contact layer <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost skn barrier sld ext wear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4385","description":"Ost skn barrier sld ext wear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63005","description":"Remove spine lamina 1/2 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj repair of joint disc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7852","description":"Tmj repair of joint disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEE0","description":"ICD-IAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLF1","description":"ICD-JFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBA1","description":"ICD-KGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUE1","description":"ICD-MBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDD0","description":"ICD-KGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA20","description":"High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLB0","description":"ICD-NCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILC0","description":"ICD-BILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coombs test indirect titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86886","description":"Coombs test indirect titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNC1","description":"ICD-NDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1701","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1701","description":"CDT-D1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria_ fungi_ parasites_ and DNA viruses)_ DNA_ PCR and next-generation sequencing_ plasma_ detection of >1_000 potential microbial organisms for signif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0152U","description":"Infectious disease (bacteria_ fungi_ parasites_ and DNA viruses)_ DNA_ PCR and next-generation sequencing_ plasma_ detection of >1_000 potential microbial organisms for signif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87662","description":"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemi-wheelchair detachable a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1084","description":"Hemi-wheelchair detachable a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26352","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41017","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSC1","description":"ICD-CHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYD0","description":"ICD-CCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEA1","description":"ICD-IFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg over 1 hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95813","description":"Eeg over 1 hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD245","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETF0","description":"ICD-FETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0527T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUE0","description":"ICD-NJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXE1","description":"ICD-JEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 std port cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0821","description":"Pwc gp 2 std port cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0143U","description":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADD0","description":"ICD-FADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGD0","description":"ICD-NGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTC0","description":"ICD-IFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 cast base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2781","description":"Crown 3/4 cast base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dent anesthesia w/o surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9210","description":"Dent anesthesia w/o surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHC1","description":"ICD-EAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft carotid-vertbrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35508","description":"Art byp grft carotid-vertbrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54100","description":"Biopsy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDD1","description":"ICD-CBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAE0","description":"ICD-KCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aac non-electronic board","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1902","description":"Aac non-electronic board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy unspecified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96549","description":"Chemotherapy unspecified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon t1-3_n1-2_no pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9084","description":"Onc dx colon t1-3_n1-2_no pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ruptured spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38115","description":"Repair of ruptured spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNC0","description":"ICD-GBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXF1","description":"ICD-GFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWA1","description":"ICD-KHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOB1","description":"ICD-PHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFC0","description":"ICD-FFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOE1","description":"ICD-HAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNA1","description":"ICD-BFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28H","description":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSA1","description":"ICD-DDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQE0","description":"ICD-HHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBC0","description":"ICD-MEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer for use w/ regulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0580","description":"Nebulizer for use w/ regulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGF0","description":"ICD-NJGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFE0","description":"ICD-BDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis test procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81099","description":"Urinalysis test procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper ext fx orthosis rad/ul","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3982","description":"Upper ext fx orthosis rad/ul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE221","description":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAD1","description":"ICD-EAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPE1","description":"ICD-JGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHF1","description":"ICD-MJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRA1","description":"ICD-PCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped hydrolyzed/amino acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4161","description":"Ef ped hydrolyzed/amino acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ imm glob bivigam_ 500mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1556","description":"Inj_ imm glob bivigam_ 500mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0641U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0641U","description":"CPT-0641U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQB1","description":"ICD-LAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEE1","description":"ICD-CFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC30","description":"Very High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEC1","description":"ICD-FDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFF1","description":"ICD-NEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0550U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0550U","description":"CPT-0550U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCC0","description":"ICD-KBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9121","description":"Injection_ argatroban","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPF1","description":"ICD-KIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm aud input receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5285","description":"Ald fm/dm aud input receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLD1","description":"ICD-KHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve pedicle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64905","description":"Nerve pedicle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr f/c/c/m/n/a/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14040","description":"Tis trnfr f/c/c/m/n/a/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo molded ankle gauntlet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1904","description":"Afo molded ankle gauntlet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAD0","description":"ICD-EDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXE1","description":"ICD-CEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDE1","description":"ICD-ADDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ benralizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0517","description":"Injection_ benralizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dt vaccine under 7 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90702","description":"Dt vaccine under 7 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incis addl spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22216","description":"Incis addl spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abut support crown titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6094","description":"Abut support crown titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHC0","description":"ICD-NIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVC0","description":"ICD-JDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDB0","description":"ICD-EHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Participant-Directed Community Supports","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1900","description":"Participant-Directed Community Supports","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEF0","description":"ICD-BGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTB1","description":"ICD-FGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Medication Not Otherwise Specified; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group The","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2075","description":"Medication Assisted Treatment_ Medication Not Otherwise Specified; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAC1","description":"ICD-MIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYB1","description":"ICD-GEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9936","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9936","description":"CDT-D9936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q9997","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","description":"HCPCS-Q9997","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ evinacumab-dgnb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1305","description":"Injection_ evinacumab-dgnb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGE1","description":"ICD-OIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25927","description":"Amputation of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWC1","description":"ICD-LAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJB1","description":"ICD-OHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20A","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62323","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Buttock fasciotomy w/dbrdmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27057","description":"Buttock fasciotomy w/dbrdmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETB1","description":"ICD-GETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQD0","description":"ICD-PAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2D","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ durvalumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9173","description":"Injection_ durvalumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92235","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auditory function 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92620","description":"Auditory function 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt falls assess-docd le1/yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1101F","description":"Pt falls assess-docd le1/yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLA1","description":"ICD-OBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWF0","description":"ICD-LHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUF1","description":"ICD-AEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amines vaginal fluid qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82120","description":"Amines vaginal fluid qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Strain Imaging Using Speckle Tracking-Derived Assessment Of Myocardial Mechanics (List Separately In Addition To Codes For Echocardiography Imaging)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93356","description":"Myocardial Strain Imaging Using Speckle Tracking-Derived Assessment Of Myocardial Mechanics (List Separately In Addition To Codes For Echocardiography Imaging)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAF1","description":"ICD-JGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEB0","description":"ICD-CHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOD1","description":"ICD-KAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMC0","description":"ICD-EDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDA1","description":"ICD-CCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair dura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61619","description":"Repair dura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression glove_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6581","description":"Gradient compression glove_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arbutamine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0395","description":"Arbutamine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMF1","description":"ICD-BGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDD1","description":"ICD-MBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHED1","description":"ICD-EHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPD0","description":"ICD-CBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echosclerotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2202","description":"Echosclerotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJC1","description":"ICD-JFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWB1","description":"ICD-LFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWC1","description":"ICD-DDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDF0","description":"ICD-IBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp femoral-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35661","description":"Art byp femoral-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preop asses 4 cataract surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3325F","description":"Preop asses 4 cataract surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRA1","description":"ICD-GCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/maint cont hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4890","description":"Repair/maint cont hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB240","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thrombin time plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85670","description":"Thrombin time plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80400","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQC1","description":"ICD-OGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22325","description":"Treat spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Belimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0490","description":"Belimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain breast lesion add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19001","description":"Drain breast lesion add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCC1","description":"ICD-OBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0204","description":"HCPCS-C0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEC0","description":"ICD-BIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50570","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADA0","description":"ICD-BADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1372","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","description":"HCPCS-M1372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFME0","description":"ICD-EFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCB1","description":"ICD-JDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGB1","description":"ICD-GEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 2.6-5.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12052","description":"Intmd rpr face/mm 2.6-5.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rep perf anoper fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46715","description":"Rep perf anoper fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOB0","description":"ICD-OEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARF0","description":"ICD-DARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDF0","description":"ICD-EGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC55","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUD1","description":"ICD-BFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sinus augmentation vertical","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7952","description":"Sinus augmentation vertical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLA1","description":"ICD-NLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair vessel defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33803","description":"Repair vessel defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWD0","description":"ICD-CDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove femur lesion/fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27358","description":"Remove femur lesion/fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Topical ox deliver sys_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0446","description":"Topical ox deliver sys_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDE0","description":"ICD-KHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB56","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total disc arthroplasty (artificial disc)_ anterior approach_ including discectomy to prepare interspace (other than for decompression); second interspace_ lumbar (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22860","description":"Total disc arthroplasty (artificial disc)_ anterior approach_ including discectomy to prepare interspace (other than for decompression); second interspace_ lumbar (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFC0","description":"ICD-JDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sterile eye pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6410","description":"Sterile eye pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQA0","description":"ICD-OHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDE1","description":"ICD-OCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWD0","description":"ICD-GDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB21","description":"ICD-4FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4345","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","description":"HCPCS-Q4345","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm splint plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4021","description":"Cast sup sht arm splint plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB115","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cranial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64716","description":"Revision of cranial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Male vacuum erection system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7900","description":"Male vacuum erection system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ccp antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86200","description":"Ccp antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWD1","description":"ICD-DEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydration iv infusion init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96360","description":"Hydration iv infusion init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; with insertion of intraluminal tube or catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0654T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; with insertion of intraluminal tube or catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTE0","description":"ICD-GDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKA1","description":"ICD-OIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAA0","description":"ICD-AAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC11","description":"ICD-4JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam k transpl w/doppler","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76776","description":"Us exam k transpl w/doppler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy for treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31527","description":"Laryngoscopy for treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMF0","description":"ICD-BCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tinnitus assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92625","description":"Tinnitus assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain image < 4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78600","description":"Brain image < 4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMC0","description":"ICD-FCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of abdominal wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49900","description":"Repair of abdominal wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ unilateral; complete_ minimum of two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73510","description":"Radiologic examination_ hip_ unilateral; complete_ minimum of two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAE0","description":"ICD-FAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBD0","description":"ICD-CHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult size pull-on sm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4525","description":"Adult size pull-on sm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRB0","description":"ICD-OKRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl zinc air battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8621","description":"Repl zinc air battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTC1","description":"ICD-OLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEA1","description":"ICD-ACEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1478","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","description":"HCPCS-M1478","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ahi or rdi initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8842","description":"Ahi or rdi initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB21","description":"ICD-3EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA43","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNE0","description":"ICD-ODNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Robotic surgical system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2900","description":"Robotic surgical system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYE0","description":"ICD-CGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVB0","description":"ICD-JCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTD1","description":"ICD-GHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHD1","description":"ICD-ABHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXA0","description":"ICD-JGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHD1","description":"ICD-CAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAA1","description":"ICD-JCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOD1","description":"ICD-HAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHE1","description":"ICD-CEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSF0","description":"ICD-DFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUF1","description":"ICD-MIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9726","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDE0","description":"ICD-ICDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18F","description":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTF1","description":"ICD-GDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRD1","description":"ICD-LHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Hyalgan_ Supartz or Visco-3_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7321","description":"Hyaluronan or derivative_ Hyalgan_ Supartz or Visco-3_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXE1","description":"ICD-BHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0202","description":"HCPCS-C0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Storage/year reprod tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89344","description":"Storage/year reprod tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEE0","description":"ICD-ODEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caster fork","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2396","description":"Caster fork","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung)_ augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK_ BRAF_ EGFR_ ERBB2_ MET_ NTRK1-3_ RET_ ROS1)_ and KRAS G12C and PD-L1_ if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0414U","description":"Oncology (lung)_ augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK_ BRAF_ EGFR_ ERBB2_ MET_ NTRK1-3_ RET_ ROS1)_ and KRAS G12C and PD-L1_ if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTB0","description":"ICD-KCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWE1","description":"ICD-LFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYF1","description":"ICD-OFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL45","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOF1","description":"ICD-GBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOE1","description":"ICD-KEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth neck organ 1yr/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32051","description":"Anesth neck organ 1yr/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Positional nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92532","description":"Positional nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unipuncture control system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1580","description":"Unipuncture control system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Morphine sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2270","description":"Morphine sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ inebilizumab-cdon_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1823","description":"Injection_ inebilizumab-cdon_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRF0","description":"ICD-OKRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWF1","description":"ICD-HAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28126","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEA1","description":"ICD-FIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arm trough each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2209","description":"Arm trough each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA13","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQD1","description":"ICD-PEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace vad pump ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33981","description":"Replace vad pump ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASA0","description":"ICD-GASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBA1","description":"ICD-ODBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLD1","description":"ICD-KGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAE1","description":"ICD-EIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of endocrine hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84235","description":"Assay of endocrine hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 1999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4722","description":"Dialys sol fld vol > 1999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQC0","description":"ICD-DEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft subclav-carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35506","description":"Art byp grft subclav-carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBE1","description":"ICD-CIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNB1","description":"ICD-KFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE111","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPF0","description":"ICD-NAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient lift electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0635","description":"Patient lift electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx dprsd malar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21360","description":"Opn tx dprsd malar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cerv artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22864","description":"Remove cerv artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diuretic thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4221F","description":"Diuretic thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7571","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7571","description":"HCPCS-C7571","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCND0","description":"ICD-BCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDF1","description":"ICD-OHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19364","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator_ dual lead system_ with insertion of pacing electrode_ cardiac venous system_ for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7540","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator_ dual lead system_ with insertion of pacing electrode_ cardiac venous system_ for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHC1","description":"ICD-OFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMC0","description":"ICD-FIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXC0","description":"ICD-GGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Offset knee joint heavy duty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2395","description":"Offset knee joint heavy duty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice_ inpatient hospital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5005","description":"Hospice_ inpatient hospital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLD1","description":"ICD-OFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Molded socket shin sach foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5100","description":"Molded socket shin sach foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPF0","description":"ICD-CIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBA1","description":"ICD-GGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l addl 5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13153","description":"Cmplx rpr e/n/e/l addl 5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0824T","description":"Transcatheter removal of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc rf ablate renal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50592","description":"Perc rf ablate renal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES221","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWA1","description":"ICD-LEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Planar seat for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2292","description":"Planar seat for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDA1","description":"ICD-OKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/hemodynam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75889","description":"Vein x-ray liver w/hemodynam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINE1","description":"ICD-BINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Financial Management Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7341","description":"Financial Management Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair with fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0163","description":"Commode chair with fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAA0","description":"ICD-NCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOB1","description":"ICD-CGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLE1","description":"ICD-GDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDF0","description":"ICD-OJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain thigh/knee lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27301","description":"Drain thigh/knee lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPA1","description":"ICD-NJPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQD0","description":"ICD-PLQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manipulat palm cord post inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26341","description":"Manipulat palm cord post inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01382","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","description":"CPT-01382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWB1","description":"ICD-KFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below elbow switch control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6930","description":"Below elbow switch control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKB0","description":"ICD-FAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCF1","description":"ICD-CCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21121","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQB1","description":"ICD-PFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0614U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","description":"CPT-0614U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFD1","description":"ICD-FHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBA0","description":"ICD-NFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alglucerase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0205","description":"Alglucerase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of facial bone(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21026","description":"Excision of facial bone(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Triamcinolone acet inj nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3301","description":"Triamcinolone acet inj nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIF1","description":"ICD-BCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATB1","description":"ICD-CATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imm admin by intramusc inj of (SARS-CoV-2) (coronavirus disease [COVID-19]) vacc_ mRNA-LNP_ spike protein_ preserv free_ 30mcg/0.3 mL dose_ tris-sucrose formula_ booster dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054A","description":"Imm admin by intramusc inj of (SARS-CoV-2) (coronavirus disease [COVID-19]) vacc_ mRNA-LNP_ spike protein_ preserv free_ 30mcg/0.3 mL dose_ tris-sucrose formula_ booster dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ teclistamab-cqyv_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9380","description":"Injection_ teclistamab-cqyv_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELE1","description":"ICD-GELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of pyloric muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43520","description":"Incision of pyloric muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOA1","description":"ICD-DAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc death in hosp aaa repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9262","description":"Doc death in hosp aaa repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDD0","description":"ICD-ICDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMF1","description":"ICD-BFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJB0","description":"ICD-BDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHD0","description":"ICD-FHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Herpes simplex 1 ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87274","description":"Herpes simplex 1 ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11421","description":"Exc h-f-nk-sp b9+marg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12002","description":"Rpr s/n/ax/gen/trnk2.6-7.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIC1","description":"ICD-AGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct maxilla segment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7947","description":"Reconstruct maxilla segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test def 1-7 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0480","description":"Drug test def 1-7 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0598U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","description":"CPT-0598U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDC0","description":"ICD-GEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUF0","description":"ICD-OIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIA0","description":"ICD-FBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27600","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATB1","description":"ICD-IATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA44","description":"Low Rehab_ ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNC0","description":"ICD-NJNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBF1","description":"ICD-EHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUB0","description":"ICD-MLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDA0","description":"ICD-IDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEF0","description":"ICD-OGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4048","description":"Cast sup sht leg splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHF1","description":"ICD-JIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scale","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2140","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scale","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFC1","description":"ICD-OKFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA24","description":"Very High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAND0","description":"ICD-GAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31084","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYA1","description":"ICD-GCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUE0","description":"ICD-OEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCE0","description":"ICD-MKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary angiography of major aortopulmonary colla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93575","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary angiography of major aortopulmonary colla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AmnioCoreTM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4227","description":"AmnioCoreTM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNC0","description":"ICD-OBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTA0","description":"ICD-GFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIF0","description":"ICD-NBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit alpha-1-proteinas diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9346","description":"Hit alpha-1-proteinas diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCF0","description":"ICD-OLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD211","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDA0","description":"ICD-AIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast prosthesis bra & form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8001","description":"Breast prosthesis bra & form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHA1","description":"ICD-EBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93243","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJC1","description":"ICD-KHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient safety and support of positive experiences with anesthesia mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0059","description":"Patient safety and support of positive experiences with anesthesia mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHC1","description":"ICD-GEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITA0","description":"ICD-OITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXA0","description":"ICD-GGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adults currently taking pharmacotherapy for OUD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1032","description":"Adults currently taking pharmacotherapy for OUD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMA0","description":"ICD-JIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAA0","description":"ICD-FEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNE0","description":"ICD-OLNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dc power adapter_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1358","description":"Dc power adapter_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0234","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0234","description":"HCPCS-Q0234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKME0","description":"ICD-MKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95977","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bath tub wall rail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0241","description":"Bath tub wall rail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFA1","description":"ICD-FCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAE1","description":"ICD-JFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imaging of the head (CT or MRI) was obtained","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1027","description":"Imaging of the head (CT or MRI) was obtained","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHD0","description":"ICD-OFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMB1","description":"ICD-OKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impr vis acuit w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9516","description":"Impr vis acuit w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWF0","description":"ICD-DFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTE1","description":"ICD-GBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELA0","description":"ICD-IELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDA1","description":"ICD-FGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEE1","description":"ICD-JDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esano aaa_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4273","description":"Esano aaa_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Polysom <6 yrs 4/> paramtrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95782","description":"Polysom <6 yrs 4/> paramtrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise aqueous shunt eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66185","description":"Revise aqueous shunt eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGD1","description":"ICD-BGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/o dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3761F","description":"Pt w/o dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHE0","description":"ICD-JCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise cornea with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65770","description":"Revise cornea with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29888","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each additional single probe stain procedure (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0849T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each additional single probe stain procedure (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAA1","description":"ICD-ACAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3B","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPC0","description":"ICD-BEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLD0","description":"ICD-BGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB11","description":"ICD-3IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNF1","description":"ICD-GGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4437","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","description":"HCPCS-Q4437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBD1","description":"ICD-IDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ureter calculus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51065","description":"Remove ureter calculus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLB1","description":"ICD-MKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA21","description":"ICD-3KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB120","description":"Clinically Complex _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visualization adjunct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9968","description":"Visualization adjunct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31510","description":"Laryngoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDC0","description":"ICD-FIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLF1","description":"ICD-OCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ftl cgen abnor three anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81510","description":"Ftl cgen abnor three anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65730","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHB1","description":"ICD-OIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX54","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0526T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic prop tire insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2213","description":"Pneumatic prop tire insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEC1","description":"ICD-CFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENC0","description":"ICD-CENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSE1","description":"ICD-OFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vinorelbine tartrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9390","description":"Vinorelbine tartrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICD1","description":"ICD-IICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUE1","description":"ICD-IAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMB0","description":"ICD-KEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUF0","description":"ICD-KHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove tonsils and adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42821","description":"Remove tonsils and adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETB1","description":"ICD-OETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCB1","description":"ICD-BHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary art/grft angio s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93455","description":"Coronary art/grft angio s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFID1","description":"ICD-EFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCID0","description":"ICD-NCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement pressure alarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1540","description":"Replacement pressure alarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIA1","description":"ICD-OIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLB0","description":"ICD-NLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGE0","description":"ICD-GBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cnslng chldbrng women epi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4340F","description":"Cnslng chldbrng women epi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAD1","description":"ICD-NHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intestinal stricturoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44615","description":"Intestinal stricturoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWA0","description":"ICD-CGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLB1","description":"ICD-CFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFA0","description":"ICD-NLFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHC0","description":"ICD-EEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFF1","description":"ICD-OAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDB1","description":"ICD-OCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIF1","description":"ICD-NDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVD0","description":"ICD-GEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ off-the-shelf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3761","description":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ off-the-shelf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; common variant(s) (eg_ A_ A-)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81247","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; common variant(s) (eg_ A_ A-)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10B","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETA0","description":"ICD-CETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQE1","description":"ICD-PGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLF0","description":"ICD-NDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17271","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insrt drug device for iop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0356T","description":"Insrt drug device for iop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cemiplimab-rwlc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9119","description":"Injection_ cemiplimab-rwlc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKB0","description":"ICD-NGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0504","description":"HCPCS-A0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27506","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFF0","description":"ICD-ODFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAE1","description":"ICD-AEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUC0","description":"ICD-NFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB02","description":"Very High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Femoral lgth sock fx or equa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2850","description":"Femoral lgth sock fx or equa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"VitoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4317","description":"VitoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERF0","description":"ICD-LERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC144","description":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conn tiss_ human(inc fascia)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1762","description":"Conn tiss_ human(inc fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHD1","description":"ICD-EAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28I","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX10","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQC1","description":"ICD-OCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp genet test hyp cardiomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3865","description":"Comp genet test hyp cardiomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIF1","description":"ICD-GHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab_ via sustained release intravitreal implant (Susvimo)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9093","description":"Injection_ ranibizumab_ via sustained release intravitreal implant (Susvimo)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD116","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dispens fee immunosupressive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0510","description":"Dispens fee immunosupressive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supplies for home delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8415","description":"Supplies for home delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUB0","description":"ICD-FFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOA1","description":"ICD-DFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18D","description":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE146","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWA1","description":"ICD-GHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99213","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVC0","description":"ICD-JHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJF1","description":"ICD-OIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB250","description":"Reduced Physical Function _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phenotype dna hiv w/clt add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87904","description":"Phenotype dna hiv w/clt add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFF1","description":"ICD-BDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJD0","description":"ICD-OAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of heart damage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33545","description":"Repair of heart damage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGC1","description":"ICD-NFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ glove_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6521","description":"Gradient compression garment_ glove_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASA1","description":"ICD-OASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemotx admn prtl cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96446","description":"Chemotx admn prtl cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAF1","description":"ICD-FGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEC1","description":"ICD-KEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA51","description":"Medium Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRE1","description":"ICD-HBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDME0","description":"ICD-JDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXB1","description":"ICD-KIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILD0","description":"ICD-FILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21A","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIB0","description":"ICD-NDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUD1","description":"ICD-OJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCE1","description":"ICD-NJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDF1","description":"ICD-NFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1401","description":"HCPCS-B1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTA1","description":"ICD-IGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLC1","description":"ICD-AHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prol intubation req","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8569","description":"Prol intubation req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Work related disability exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99455","description":"Work related disability exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYA1","description":"ICD-GGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDF1","description":"ICD-CCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXF1","description":"ICD-BHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHD1","description":"ICD-KCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYB0","description":"ICD-HGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1014T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","description":"CPT-1014T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES151","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFC0","description":"ICD-JBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01852","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","description":"CPT-01852","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUB0","description":"ICD-NKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLC1","description":"ICD-GGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0837","description":"Pwc gp 2 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXD0","description":"ICD-JFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOA0","description":"ICD-GEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vancomycin hcl (mylan) not therapeutically equivalent to j3370_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3371","description":"Injection_ vancomycin hcl (mylan) not therapeutically equivalent to j3370_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl artific disc addl crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0095T","description":"Rmvl artific disc addl crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with di","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7560","description":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXB0","description":"ICD-BDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYD1","description":"ICD-OIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Benzodiazepines 13 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80347","description":"Benzodiazepines 13 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBA1","description":"ICD-OIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEC1","description":"ICD-NAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis_ including fluoroscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0499T","description":"Cystourethroscopy_ with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis_ including fluoroscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 4 visits p mo <2yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90951","description":"Esrd serv 4 visits p mo <2yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYA0","description":"ICD-OLYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAF0","description":"ICD-JHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC131","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCA0","description":"ICD-BBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWA0","description":"ICD-CBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33422","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analyze sp inf pump w/reprog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62368","description":"Analyze sp inf pump w/reprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLD0","description":"ICD-GCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWE1","description":"ICD-LBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Woundfix_ BioWound_ Woundfix Plus_ BioWound Plus_ Woundfix Xplus or BioWound Xplus_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4217","description":"Woundfix_ BioWound_ Woundfix Plus_ BioWound Plus_ Woundfix Xplus or BioWound Xplus_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRA1","description":"ICD-OIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYC1","description":"ICD-PFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hocm 250-299mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9961","description":"Hocm 250-299mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24130","description":"Removal of head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWB0","description":"ICD-LBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on nose and accessory sinuses; biopsy_ soft tissu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0124U","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy_ soft tissu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJF1","description":"ICD-BHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25119","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIA0","description":"ICD-NLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLB0","description":"ICD-ECLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D7-2D6 hybrid gene) (List separately in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0073U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D7-2D6 hybrid gene) (List separately in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUB1","description":"ICD-CEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap mobil splenic fl add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44213","description":"Lap mobil splenic fl add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place breast cath for rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19297","description":"Place breast cath for rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELC1","description":"ICD-OELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; REMOVAL_ EACH BALLOON","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53453","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; REMOVAL_ EACH BALLOON","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAC1","description":"ICD-CFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aurothioglucose injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2910","description":"Aurothioglucose injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infrared ht sys replcmnt pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4639","description":"Infrared ht sys replcmnt pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair fistula w/colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45805","description":"Repair fistula w/colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB44","description":"Low Rehab_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5274","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMA0","description":"ICD-NBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ artesunate_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0391","description":"Injection_ artesunate_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65130","description":"Insert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Pembrolizumab_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9027","description":"Injection_ Pembrolizumab_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2B","description":"Default_ /PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0654","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","description":"HCPCS-J0654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILB0","description":"ICD-KILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTD1","description":"ICD-MKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary cardiomyopathy (eg_ hypertrophic cardiomyopathy_ dilated cardiomyopathy_ arrhythmogenic right ventricular cardiomyopathy)_ genomic sequence analysis panel_ must inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81439","description":"Hereditary cardiomyopathy (eg_ hypertrophic cardiomyopathy_ dilated cardiomyopathy_ arrhythmogenic right ventricular cardiomyopathy)_ genomic sequence analysis panel_ must inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGA1","description":"ICD-FBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove muti-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54406","description":"Remove muti-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXF0","description":"ICD-JAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLA1","description":"ICD-MHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB12","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALA1","description":"ICD-KALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23A","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28G","description":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for elbow x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24220","description":"Injection for elbow x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50961","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39499","description":"Chest procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0602U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","description":"CPT-0602U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAC0","description":"ICD-NAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPE1","description":"ICD-OIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD151","description":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGE1","description":"ICD-CCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine ost pch bar w lock fln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4433","description":"Urine ost pch bar w lock fln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUC1","description":"ICD-ACUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHD0","description":"ICD-EFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHF0","description":"ICD-EDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with one patie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97153","description":"Adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with one patie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap inc hern recur comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49657","description":"Lap inc hern recur comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","description":"HCPCS-Q4373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepc measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8545","description":"Hepc measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJE0","description":"ICD-KBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX42","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE126","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove armpit lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38740","description":"Remove armpit lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2C","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1023T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","description":"CPT-1023T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-51721","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","description":"CPT-51721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJB1","description":"ICD-ODJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASE0","description":"ICD-HASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXD1","description":"ICD-CBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA53","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seo mobile arm sup att to wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2626","description":"Seo mobile arm sup att to wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10A","description":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open femoral artery exposure for delivery of endovascular prosthesis_ by groin incision_ unilateral (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34812","description":"Open femoral artery exposure for delivery of endovascular prosthesis_ by groin incision_ unilateral (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14D","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCF0","description":"ICD-AFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diazoxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1730","description":"Diazoxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDB1","description":"ICD-BGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artificial larynx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8500","description":"Artificial larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not eligible ace/arb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8936","description":"Pt not eligible ace/arb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost skn barr extnd =4sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4411","description":"Ost skn barr extnd =4sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBA1","description":"ICD-BHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIF1","description":"ICD-IAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIB0","description":"ICD-CIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICF1","description":"ICD-AICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup body cast plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4001","description":"Cast sup body cast plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8X","description":"Very High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetics 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88272","description":"Cytogenetics 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mod or severe osa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8846","description":"Mod or severe osa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPC0","description":"ICD-OJPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide (sandoz)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9074","description":"Injection_ cyclophosphamide (sandoz)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNA0","description":"ICD-KFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDA0","description":"ICD-OLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEB0","description":"ICD-MLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYF1","description":"ICD-CFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKF0","description":"ICD-GDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAC0","description":"ICD-AAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBED0","description":"ICD-BBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWF0","description":"ICD-GGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLC0","description":"ICD-EHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEC0","description":"ICD-JIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMB1","description":"ICD-NJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOD1","description":"ICD-OAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTE0","description":"ICD-ADTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9220","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","description":"HCPCS-J9220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIE0","description":"ICD-CGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BellaCell HD or Surederm_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4220","description":"BellaCell HD or Surederm_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALD0","description":"ICD-AALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Organic acid single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83921","description":"Organic acid single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUE0","description":"ICD-MIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1553","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","description":"HCPCS-J1553","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRD1","description":"ICD-OGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electron elbow adolescent sw","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7185","description":"Electron elbow adolescent sw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGF0","description":"ICD-KFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory bp monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93784","description":"Ambulatory bp monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31367","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUF0","description":"ICD-CHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFC0","description":"ICD-BAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTB1","description":"ICD-GDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull for surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61460","description":"Incise skull for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNE0","description":"ICD-GCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICE1","description":"ICD-MICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYE0","description":"ICD-PCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation for wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9156","description":"Evaluation for wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB21","description":"ICD-4DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWE1","description":"ICD-DGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-77438","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","description":"CPT-77438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74400","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28F","description":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adhesiolysis tube ovary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58740","description":"Adhesiolysis tube ovary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEC1","description":"ICD-IEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body fluid cell count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89050","description":"Body fluid cell count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUB1","description":"ICD-OAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth for liver biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70251","description":"Anesth for liver biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWF1","description":"ICD-LCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METB1","description":"ICD-METB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIB0","description":"ICD-IIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Report_ prev care measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8486","description":"Report_ prev care measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64898","description":"Nerve graft arm/leg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWB0","description":"ICD-PAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOA0","description":"ICD-PEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGA0","description":"ICD-KDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percussor elect/pneum home m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0480","description":"Percussor elect/pneum home m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17107","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBC0","description":"ICD-FHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"(Blincyto)Injection_ Blinatumomab_ 1mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9449","description":"(Blincyto)Injection_ Blinatumomab_ 1mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of jaw muscle/bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21295","description":"Revision of jaw muscle/bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMD0","description":"ICD-CCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aortic anrysm5.5-5.9cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9003F","description":"Aortic anrysm5.5-5.9cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip midline cath insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5523","description":"Hip midline cath insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq tcat intratrl septl sht","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0613T","description":"Perq tcat intratrl septl sht","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFB0","description":"ICD-GHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA201","description":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scaling in the presence of generalized moderate or severe gingival inflammation--full mouth_ after oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4346","description":"Scaling in the presence of generalized moderate or severe gingival inflammation--full mouth_ after oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ratchet assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0050","description":"Ratchet assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGB1","description":"ICD-CBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insemination of oocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89268","description":"Insemination of oocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOE1","description":"ICD-CDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable underpads","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4554","description":"Disposable underpads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1150","description":"Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCD0","description":"ICD-BFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIB0","description":"ICD-ACIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33863","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAE0","description":"ICD-AFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phys review of motion tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96004","description":"Phys review of motion tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophys map 3d add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93613","description":"Electrophys map 3d add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRF0","description":"ICD-HFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24C","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Td vacc no presv 7 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90714","description":"Td vacc no presv 7 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteoarthritis assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1006F","description":"Osteoarthritis assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAF1","description":"ICD-FDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (hikma)_ not therapeutically equivalent to j0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0688","description":"Injection_ cefazolin sodium (hikma)_ not therapeutically equivalent to j0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPD1","description":"ICD-JIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery/speech prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31611","description":"Surgery/speech prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBE1","description":"ICD-CHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Position back cush wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2613","description":"Position back cush wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0563","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","description":"HCPCS-G0563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contour cranial bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21181","description":"Contour cranial bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFA0","description":"ICD-CCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23B","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocyte immune globulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7504","description":"Lymphocyte immune globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ceftaroline fosamil inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0712","description":"Ceftaroline fosamil inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVF0","description":"ICD-CDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amphotericin b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0285","description":"Amphotericin b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chd risk imt study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0126T","description":"Chd risk imt study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23C","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMF1","description":"ICD-FHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64657","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","description":"CPT-64657","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWD0","description":"ICD-GAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Typhoid vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90691","description":"Typhoid vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for wrist x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25246","description":"Injection for wrist x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUF1","description":"ICD-CIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLF1","description":"ICD-EHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEF0","description":"ICD-IGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOF0","description":"ICD-DHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc endocrine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60659","description":"Laparo proc endocrine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPD1","description":"ICD-CDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0673U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673U","description":"CPT-0673U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt w cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9240","description":"Doc pt w cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVE0","description":"ICD-KDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammo bx proven malig docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3350F","description":"Mammo bx proven malig docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAB1","description":"ICD-NBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation heart device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93640","description":"Evaluation heart device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJC0","description":"ICD-OKJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQE0","description":"ICD-GIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHC0","description":"ICD-AAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABA0","description":"ICD-FABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPE1","description":"ICD-JFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA236","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung transplant single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32851","description":"Lung transplant single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUA1","description":"ICD-AAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDF0","description":"ICD-MJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy w/markers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31626","description":"Bronchoscopy w/markers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFA1","description":"ICD-GBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLB1","description":"ICD-OKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUD0","description":"ICD-BGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLC0","description":"ICD-GHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76827","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ccnd1/Igh (T(11;14)) (Eg_ Mantle Cell Lymphoma) Translocation Analysis_ Major Breakpoint_ Qualitative And Quantitative_ If Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81168","description":"Ccnd1/Igh (T(11;14)) (Eg_ Mantle Cell Lymphoma) Translocation Analysis_ Major Breakpoint_ Qualitative And Quantitative_ If Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUA0","description":"ICD-MJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0544","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","description":"HCPCS-G0544","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor xiii recomb a-subunit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7181","description":"Factor xiii recomb a-subunit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ central nervous system pathogen_ metagenomic next-generation sequencing_ cerebrospinal fluid (CSF)_ identification of","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0323U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ central nervous system pathogen_ metagenomic next-generation sequencing_ cerebrospinal fluid (CSF)_ identification of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37241","description":"Vasc embolize/occlude venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUE1","description":"ICD-MLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAE1","description":"ICD-OFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMD0","description":"ICD-EIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRF1","description":"ICD-PGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESF1","description":"ICD-GESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0A","description":"Medium Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00754","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","description":"CPT-00754","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytherapy needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1715","description":"Brachytherapy needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWF1","description":"ICD-OIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBB1","description":"ICD-OBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNA0","description":"ICD-NJNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNC1","description":"ICD-JCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACC0","description":"ICD-JACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysate conc sol add 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4766","description":"Dialysate conc sol add 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (accord) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9296","description":"Injection_ pemetrexed (accord) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMA0","description":"ICD-JBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHD1","description":"ICD-JFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWB1","description":"ICD-KIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI joint upr extrem w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73221","description":"MRI joint upr extrem w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise thumb tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26496","description":"Revise thumb tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE112","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLF1","description":"ICD-GBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFE1","description":"ICD-BBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5261","description":"Hearing aid_ digit_ bin_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull for brain wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61458","description":"Incise skull for brain wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj suprascapular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64418","description":"N block inj suprascapular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFF0","description":"ICD-JAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLA0","description":"ICD-FFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 5/> mus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64644","description":"Chemodenerv 1 extrem 5/> mus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lobar lung transplantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2060","description":"Lobar lung transplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA41","description":"Medium Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25405","description":"Repair/graft radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCE0","description":"ICD-JCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWF0","description":"ICD-PKWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular Repair Of Iliac Artery_ Not Associated With Placement Of An Aorto-Iliac Artery Endograft At The Same Session_ By Deployment Of An Iliac Branched Endograft_ Includ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34718","description":"Endovascular Repair Of Iliac Artery_ Not Associated With Placement Of An Aorto-Iliac Artery Endograft At The Same Session_ By Deployment Of An Iliac Branched Endograft_ Includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBF0","description":"ICD-CFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGB0","description":"ICD-KBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crisis intervention mental h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9485","description":"Crisis intervention mental h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA11","description":"ICD-4DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXA0","description":"ICD-FHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sbrt delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77373","description":"Sbrt delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNE1","description":"ICD-ODNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ younger than 12 years of age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31551","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ younger than 12 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDD0","description":"ICD-NFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pin ulnar styloid fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25651","description":"Pin ulnar styloid fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLF1","description":"ICD-AHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUC0","description":"ICD-MGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQD0","description":"ICD-OBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIC1","description":"ICD-KIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Typhoid vaccine oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90690","description":"Typhoid vaccine oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vertical shock reducing pylo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5988","description":"Vertical shock reducing pylo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUC0","description":"ICD-OFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBF0","description":"ICD-BIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med reas rpt no histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9423","description":"Med reas rpt no histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYA0","description":"ICD-CAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQB0","description":"ICD-GDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGD0","description":"ICD-KEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTA0","description":"ICD-GBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISD1","description":"ICD-PISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNE1","description":"ICD-GFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCA1","description":"ICD-BCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOB0","description":"ICD-GEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVA1","description":"ICD-GDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Detach adjust armrst upper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0018","description":"Detach adjust armrst upper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0623U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","description":"CPT-0623U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJB1","description":"ICD-BBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCE0","description":"ICD-JDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBC1","description":"ICD-MLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYC1","description":"ICD-CCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject sinus tract for x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20501","description":"Inject sinus tract for x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKD1","description":"ICD-NKKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of elbow or wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29260","description":"Strapping of elbow or wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE125","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair oviduct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58750","description":"Repair oviduct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDC1","description":"ICD-FDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14A","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFB1","description":"ICD-KBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBD0","description":"ICD-FBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect neck tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21558","description":"Resect neck tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8H","description":"Medium Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo unilat torsion cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2080","description":"Hkafo unilat torsion cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate esophagus 1/mult pass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43450","description":"Dilate esophagus 1/mult pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAA0","description":"ICD-IAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMA0","description":"ICD-OCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTC0","description":"ICD-JCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trichomonas vaginalis amplif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87661","description":"Trichomonas vaginalis amplif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDF0","description":"ICD-NFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0D","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0681","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","description":"HCPCS-G0681","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISA1","description":"ICD-DISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surface emg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3900","description":"Surface emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Performance Not Met: Multimodal Pain Management Was Not Used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2150","description":"Performance Not Met: Multimodal Pain Management Was Not Used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEB1","description":"ICD-GIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYE1","description":"ICD-PHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) Class II_ III_ IVA heart failure; transcatheter implantation of left atrial to coronary sinus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9792","description":"Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) Class II_ III_ IVA heart failure; transcatheter implantation of left atrial to coronary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCC1","description":"ICD-CGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJD1","description":"ICD-JHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAD1","description":"ICD-OCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHB0","description":"ICD-NEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFC0","description":"ICD-BEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBA0","description":"ICD-JEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear rx intracav admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79200","description":"Nuclear rx intracav admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYD1","description":"ICD-LHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYD1","description":"ICD-PAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chiropractic medicine mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0065","description":"Chiropractic medicine mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHE0","description":"ICD-KCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAB1","description":"ICD-KGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAE1","description":"ICD-AIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIC0","description":"ICD-IIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer reservoir bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7009","description":"Nebulizer reservoir bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCF0","description":"ICD-GCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54240","description":"Penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEE0","description":"ICD-GHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cysto laser tx ureteral calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2070","description":"Cysto laser tx ureteral calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xray place prox ext thor ao","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75958","description":"Xray place prox ext thor ao","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose with potassium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5012","description":"5% dextrose with potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial visit for episode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0525F","description":"Initial visit for episode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0950T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","description":"CPT-0950T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPA0","description":"ICD-OKPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIE1","description":"ICD-AGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQE1","description":"ICD-CGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFD1","description":"ICD-OAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDB0","description":"ICD-NIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKB0","description":"ICD-NCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOA0","description":"ICD-CDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBC0","description":"ICD-KCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAA1","description":"ICD-CIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTD1","description":"ICD-KGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin suppression panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80432","description":"Insulin suppression panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUF1","description":"ICD-EHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJE1","description":"ICD-FEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALF1","description":"ICD-OALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAC1","description":"ICD-CBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","description":"HCPCS-J9003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63287","description":"Bx/exc idrl imed lesn thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASC1","description":"ICD-PASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ischm stroke symp lt3 hrsb/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1065F","description":"Ischm stroke symp lt3 hrsb/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEND0","description":"ICD-KEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Demo-smoking cessation coun","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9016","description":"Demo-smoking cessation coun","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1200","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD114","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pelvis bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26991","description":"Drainage of pelvis bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNF0","description":"ICD-JGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHE0","description":"ICD-EEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6199","description":"Implant procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFE1","description":"ICD-FHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIF0","description":"ICD-NEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Water seal drain container","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7041","description":"Water seal drain container","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDF1","description":"ICD-GHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5273","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0629U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","description":"CPT-0629U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDD1","description":"ICD-MCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA210","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHE0","description":"ICD-GGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAF0","description":"ICD-NKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBA1","description":"ICD-GCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBA0","description":"ICD-KEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWE0","description":"ICD-DCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVD1","description":"ICD-CBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA02","description":"Medium Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bcg live intravesical vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9031","description":"Bcg live intravesical vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped size pull-on lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4532","description":"Ped size pull-on lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct both jaws","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0383","description":"Cone beam ct both jaws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01272","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","description":"CPT-01272","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOE0","description":"ICD-CHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech Language Pathology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4034","description":"Speech Language Pathology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0690U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690U","description":"CPT-0690U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shrinker below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8440","description":"Shrinker below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGC1","description":"ICD-OGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIA0","description":"ICD-OEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31360","description":"Removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1098","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","description":"HCPCS-J1098","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spun microhematocrit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85013","description":"Spun microhematocrit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBE1","description":"ICD-GDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKB1","description":"ICD-CIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTA1","description":"ICD-GGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTE1","description":"ICD-GDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX41","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIA1","description":"ICD-KFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGF0","description":"ICD-KDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95725","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPD1","description":"ICD-KAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKC1","description":"ICD-JCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opps/php; train & educ serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0177","description":"Opps/php; train & educ serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace strap_ any orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4002","description":"Replace strap_ any orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELA1","description":"ICD-CELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ necitumumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9295","description":"Injection_ necitumumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording_ and disconnection per patient encounter_ wireless cardiac stimula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0521T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording_ and disconnection per patient encounter_ wireless cardiac stimula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDID1","description":"ICD-BDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIC1","description":"ICD-BBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDC1","description":"ICD-EBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAB1","description":"ICD-EFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIB1","description":"ICD-CGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Io map of sent lymph node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38900","description":"Io map of sent lymph node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMD1","description":"ICD-EEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC141","description":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skull base/brainstem surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61575","description":"Skull base/brainstem surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQC1","description":"ICD-CIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSF0","description":"ICD-GFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hair trnspl 1-15 punch grfts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15775","description":"Hair trnspl 1-15 punch grfts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automated reticulocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85045","description":"Automated reticulocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADE0","description":"ICD-MADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCE0","description":"ICD-GGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJA0","description":"ICD-JFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc hip/pelv tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27045","description":"Exc hip/pelv tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M.pneumon dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87582","description":"M.pneumon dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry_ formalin-fixed paraffin-embedded (FFPE) tissue_ report for risk o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0387U","description":"Oncology (melanoma)_ autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry_ formalin-fixed paraffin-embedded (FFPE) tissue_ report for risk o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVE1","description":"ICD-JEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pp eval/edu perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9357","description":"Pp eval/edu perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDB1","description":"ICD-GBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0602","description":"HCPCS-B0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCME1","description":"ICD-NCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC20","description":"Ultra High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trach pros cleaning device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8513","description":"Trach pros cleaning device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEND0","description":"ICD-BEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBB1","description":"ICD-AGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD120","description":"Reduced Physical Function _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWA0","description":"ICD-KBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injections of stem cell product into perianal perifistular soft tissue_ including fistula preparation (eg_ removal of setons_ fistula curettage_ closure of internal openings)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0748T","description":"Injections of stem cell product into perianal perifistular soft tissue_ including fistula preparation (eg_ removal of setons_ fistula curettage_ closure of internal openings)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/ stablj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21320","description":"Closed tx nose fx w/ stablj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_c-131","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2643","description":"Brachytx_ non-stranded_c-131","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt asked re sleep disturb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4328F","description":"Pt asked re sleep disturb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0203","description":"HCPCS-C0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD230","description":"Special Care Low _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFE0","description":"ICD-JGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPE0","description":"ICD-OFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJB1","description":"ICD-OFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHA1","description":"ICD-AGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPA0","description":"ICD-OFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Socket insert w/o lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5679","description":"Socket insert w/o lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTC0","description":"ICD-OLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6556","description":"Gradient compression stocking_ thigh length_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99254","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTB1","description":"ICD-MCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA42","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTF1","description":"ICD-NBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiography neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70548","description":"Mr angiography neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skn sub grft f/n/hf/g child","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15277","description":"Skn sub grft f/n/hf/g child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAE0","description":"ICD-OBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"WoundEx_ BioSkin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4163","description":"WoundEx_ BioSkin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin substitute_ synthetic_ resorbable_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1849","description":"Skin substitute_ synthetic_ resorbable_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4C","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavior identification-supporting assessment_ administered by one technician under the direction of a physician or other qualified health care professional_ face-to-face with","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97152","description":"Behavior identification-supporting assessment_ administered by one technician under the direction of a physician or other qualified health care professional_ face-to-face with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic positional obstructive sleep apnea treatment_ with sensor_ includes all components and accessories_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0530","description":"Electronic positional obstructive sleep apnea treatment_ with sensor_ includes all components and accessories_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFD0","description":"ICD-KEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUD0","description":"ICD-ECUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLF1","description":"ICD-FBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBC1","description":"ICD-EIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transport port x-ray multipl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0075","description":"Transport port x-ray multipl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLID0","description":"ICD-OLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1003","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1003","description":"CDT-D1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYE1","description":"ICD-DCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hdr rdncl skn surf brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77768","description":"Hdr rdncl skn surf brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFD1","description":"ICD-KDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ moderate complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0520","description":"Management of new patient-caregiver dyad with dementia_ moderate complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKE0","description":"ICD-GHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sympt sten-tia/strk<120days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9006F","description":"Sympt sten-tia/strk<120days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIF1","description":"ICD-JFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHE1","description":"ICD-NDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUC0","description":"ICD-FDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWA0","description":"ICD-LFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB36","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/o pseudobulbaffect/als","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3757F","description":"Pt w/o pseudobulbaffect/als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVB0","description":"ICD-CCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCE1","description":"ICD-MFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOA1","description":"ICD-LHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX60","description":"High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENA1","description":"ICD-CENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKD1","description":"ICD-JBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJF1","description":"ICD-JDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGD0","description":"ICD-BGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJC0","description":"ICD-KAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGE1","description":"ICD-JAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4D","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUB0","description":"ICD-KIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home Adaptations (<$6_000)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0140","description":"Home Adaptations (<$6_000)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ DNA (80 genes) and RNA (36 genes)_ by next-generation sequencing from plasma_ including single nucleotide variants_ insertions/deletions_ copy number a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0409U","description":"Oncology (solid tumor)_ DNA (80 genes) and RNA (36 genes)_ by next-generation sequencing from plasma_ including single nucleotide variants_ insertions/deletions_ copy number a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67505","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES230","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL13","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung bx plug w/del sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2613","description":"Lung bx plug w/del sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj iris prosth w/rmvl&insj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0617T","description":"Insj iris prosth w/rmvl&insj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLB0","description":"ICD-OCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB22","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDC1","description":"ICD-GDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) dir CAR-positive T cells_ inc leukapheresis and dose prep procs_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2056","description":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) dir CAR-positive T cells_ inc leukapheresis and dose prep procs_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIA0","description":"ICD-GDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14B","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIME1","description":"ICD-EIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQB0","description":"ICD-LGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair paravag defect open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57284","description":"Repair paravag defect open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Etanercept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1438","description":"Etanercept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDC0","description":"ICD-NKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFD0","description":"ICD-CEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0697U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697U","description":"CPT-0697U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEB1","description":"ICD-FEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart first pass add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78496","description":"Heart first pass add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29891","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUB0","description":"ICD-GFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMF0","description":"ICD-FCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPD1","description":"ICD-FFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE151","description":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUE0","description":"ICD-FFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBF0","description":"ICD-NLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIE1","description":"ICD-GEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVA1","description":"ICD-FDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOB0","description":"ICD-CBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1442","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","description":"HCPCS-M1442","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYF0","description":"ICD-LAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPE1","description":"ICD-JDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37788","description":"Revascularization penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHF1","description":"ICD-EHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath fl nongyn filter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88106","description":"Cytopath fl nongyn filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVE1","description":"ICD-JBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFA0","description":"ICD-KIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urea nitrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84520","description":"Assay of urea nitrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGC1","description":"ICD-OHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0260U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infliximab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80230","description":"Infliximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJA1","description":"ICD-KAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98010","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","description":"CPT-98010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Isoproterenol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7657","description":"Isoproterenol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMA0","description":"ICD-EFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRA0","description":"ICD-HHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABD1","description":"ICD-KABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINE0","description":"ICD-JINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cryofibrinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82585","description":"Assay of cryofibrinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUD0","description":"ICD-KEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ remimazolam_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2249","description":"Injection_ remimazolam_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUB1","description":"ICD-AGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADF0","description":"ICD-AADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEE1","description":"ICD-NGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLD0","description":"ICD-FCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo-vag hyst w/t/o compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58554","description":"Laparo-vag hyst w/t/o compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGD0","description":"ICD-OKGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair gum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41872","description":"Repair gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32999","description":"Chest surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXC1","description":"ICD-CEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNE1","description":"ICD-FHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13B","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGB1","description":"ICD-OLGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCA0","description":"ICD-MCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86051","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tb test cell immun measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86480","description":"Tb test cell immun measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDB0","description":"ICD-JGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr);","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0301U","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr);","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIB1","description":"ICD-KIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26356","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulmonary service/procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94799","description":"Pulmonary service/procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVF1","description":"ICD-NLVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continent stoma catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5082","description":"Continent stoma catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Integra drt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4105","description":"Integra drt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0557","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","description":"HCPCS-G0557","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1165","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHE0","description":"ICD-FCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLF0","description":"ICD-EBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sach foot_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5971","description":"Sach foot_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSA1","description":"ICD-LBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amniowrap2_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4221","description":"Amniowrap2_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of arm muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24330","description":"Revision of arm muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKE1","description":"ICD-GIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAD1","description":"ICD-OHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional Status Was Not Measured By The Oxford Knee Score (Oks) At One Year (9 To 15 Months) Postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1141","description":"Functional Status Was Not Measured By The Oxford Knee Score (Oks) At One Year (9 To 15 Months) Postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elevat proximal arm support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2631","description":"Elevat proximal arm support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKC0","description":"ICD-NJKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/o leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1171","description":"Wheelchair amputee w/o leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46751","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX45","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47610","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (Teva) not therapeutically equivalent to J9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9314","description":"Injection_ pemetrexed (Teva) not therapeutically equivalent to J9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMD1","description":"ICD-MAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVE1","description":"ICD-JCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSD1","description":"ICD-KCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSB1","description":"ICD-PKSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGB1","description":"ICD-OEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph optical endomicroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43206","description":"Esoph optical endomicroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD231","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINC1","description":"ICD-GINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBD1","description":"ICD-IBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1302","description":"Screening_ diagnostic_ film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ transluminal intravascular lithotripsy_ coronary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1761","description":"Catheter_ transluminal intravascular lithotripsy_ coronary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKA1","description":"ICD-BGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADB0","description":"ICD-AADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOE1","description":"ICD-OGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64835","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVA1","description":"ICD-KDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urea nitrogen semi-quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84525","description":"Urea nitrogen semi-quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHB0","description":"ICD-NFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth genitalia surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92051","description":"Anesth genitalia surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRA1","description":"ICD-HBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit cath maintain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99507","description":"Home visit cath maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXE1","description":"ICD-JIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Palonosetron hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2469","description":"Palonosetron hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVD1","description":"ICD-GEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEID1","description":"ICD-IEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8H","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0824","description":"Pwc gp 2 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFD1","description":"ICD-OJFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMB1","description":"ICD-ODMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Granisetron hcl 1 mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0166","description":"Granisetron hcl 1 mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGA1","description":"ICD-NCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA21","description":"ICD-4HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort iii w/fhd w/ lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21160","description":"Lefort iii w/fhd w/ lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOF0","description":"ICD-PKOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anterior gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8002","description":"Anterior gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC215","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUB0","description":"ICD-OGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ivf canc a aspir case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4020","description":"Ivf canc a aspir case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAD1","description":"ICD-CIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRC0","description":"ICD-DCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRE0","description":"ICD-DGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXB0","description":"ICD-NIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/w resect addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32667","description":"Thoracoscopy w/w resect addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAF0","description":"ICD-CCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect nasopharynx skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61586","description":"Resect nasopharynx skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elec osteogen stim implanted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0749","description":"Elec osteogen stim implanted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBA0","description":"ICD-EIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDF0","description":"ICD-KFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABB0","description":"ICD-EABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA31","description":"ICD-1LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bupivacaine_ Collagen-Matrix Implant_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9089","description":"Bupivacaine_ Collagen-Matrix Implant_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27330","description":"Biopsy knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prefab stnlss steel crwn pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2930","description":"Prefab stnlss steel crwn pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYE0","description":"ICD-OAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALB1","description":"ICD-IALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01931","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","description":"CPT-01931","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIC0","description":"ICD-EGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon metas evid dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9087","description":"Onc dx colon metas evid dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29871","description":"Knee arthroscopy/drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPE0","description":"ICD-GHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Placental alpha-micro globulin-1 (PAMG-1)_ immunoassay with direct optical observation_ cervico-vaginal fluid_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0066U","description":"Placental alpha-micro globulin-1 (PAMG-1)_ immunoassay with direct optical observation_ cervico-vaginal fluid_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 7.6-12.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12054","description":"Intmd rpr face/mm 7.6-12.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAA1","description":"ICD-IIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPA0","description":"ICD-NGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0301","description":"HCPCS-B0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reason for not administering trastuzumab documented (e.g._ patient declined_ patient died_ patient transferred_ contraindication or other clinical exclusion_ neoadjuvant chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9836","description":"Reason for not administering trastuzumab documented (e.g._ patient declined_ patient died_ patient transferred_ contraindication or other clinical exclusion_ neoadjuvant chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFC1","description":"ICD-BIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHME1","description":"ICD-AHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC54","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENC0","description":"ICD-KENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPC1","description":"ICD-OLPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with destruction by cryoablation_ posterior nasal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31243","description":"Nasal/sinus endoscopy_ surgical; with destruction by cryoablation_ posterior nasal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIF0","description":"ICD-KBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGD1","description":"ICD-CFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBED1","description":"ICD-GBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ear impression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5275","description":"Ear impression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYE1","description":"ICD-HIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVF0","description":"ICD-KBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVC0","description":"ICD-NFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB111","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWA0","description":"ICD-DDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGE0","description":"ICD-CIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBC1","description":"ICD-FHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-43889","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","description":"CPT-43889","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; read by instrument assisted direct optical observation (eg_ utilizing immunoassay [","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80306","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; read by instrument assisted direct optical observation (eg_ utilizing immunoassay [","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76604","description":"Us exam chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mohs 1 stage t/a/l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17313","description":"Mohs 1 stage t/a/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aud osseo dev_ abutment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8693","description":"Aud osseo dev_ abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise finger joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26140","description":"Revise finger joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJC1","description":"ICD-NEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Followup eval of foot pt lop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0246","description":"Followup eval of foot pt lop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVA1","description":"ICD-NBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLB0","description":"ICD-NGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone graft peri each addl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3429","description":"Bone graft peri each addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTD0","description":"ICD-BHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add proc construct new crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2971","description":"Add proc construct new crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12B","description":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95148","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTF0","description":"ICD-EBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPE0","description":"ICD-KEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Near-infrared dual imaging (ie_ simultaneous reflective and trans-illuminated light) of meibomian glands_ unilateral or bilateral_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0507T","description":"Near-infrared dual imaging (ie_ simultaneous reflective and trans-illuminated light) of meibomian glands_ unilateral or bilateral_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLA1","description":"ICD-JCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8H","description":"Very High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXF0","description":"ICD-FAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86413","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKF0","description":"ICD-FDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0826","description":"Pwc gp 2 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert vad art&vein access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33991","description":"Insert vad art&vein access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28F","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVE0","description":"ICD-GDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAA1","description":"ICD-JBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXD1","description":"ICD-NIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANC0","description":"ICD-CANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65600","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCB1","description":"ICD-MJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27454","description":"Realignment of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBB1","description":"ICD-ACBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRE1","description":"ICD-DDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUF1","description":"ICD-CCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frenulectomy/frenulotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7960","description":"Frenulectomy/frenulotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKC0","description":"ICD-FAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg cerv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22210","description":"Incis 1 vertebral seg cerv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ctlso a-p-l control w/ inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0710","description":"Ctlso a-p-l control w/ inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ctrl dose inh drug deliv sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0730","description":"Ctrl dose inh drug deliv sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUE1","description":"ICD-MAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIA0","description":"ICD-OAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIA1","description":"ICD-FEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient lift bathroom or toi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0625","description":"Patient lift bathroom or toi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQC0","description":"ICD-PKQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE125","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Second stage implant surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6011","description":"Second stage implant surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermabrasion suprfl any site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15783","description":"Dermabrasion suprfl any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX26","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levoleucovorin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0641","description":"Levoleucovorin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove forearm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25145","description":"Remove forearm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML10","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGC0","description":"ICD-JBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dorsiflexion assist each joi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2210","description":"Dorsiflexion assist each joi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible; proximal to splenic flexure; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6024","description":"Colonoscopy_ flexible; proximal to splenic flexure; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr pul art unifocal w/o cpb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33925","description":"Rpr pul art unifocal w/o cpb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABE1","description":"ICD-BABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALB0","description":"ICD-AALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respite not-in-home per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0045","description":"Respite not-in-home per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUB0","description":"ICD-AHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acute gi blood loss imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78278","description":"Acute gi blood loss imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECB0","description":"ICD-AECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYC0","description":"ICD-DHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVB1","description":"ICD-OHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJC0","description":"ICD-JDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOB0","description":"ICD-GFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Advnc care plan tlk docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1158F","description":"Advnc care plan tlk docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wig any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9282","description":"Wig any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx infiltrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32607","description":"Thoracoscopy w/bx infiltrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg > 48 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6253","description":"Absorpt drg > 48 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL54","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBD1","description":"ICD-AEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change of bladder tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51710","description":"Change of bladder tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA217","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICE1","description":"ICD-JICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant_ inclusive of all radiological supervision and interpretation_ intraprocedural roadmapping_ and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0553T","description":"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant_ inclusive of all radiological supervision and interpretation_ intraprocedural roadmapping_ and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB31","description":"ICD-2FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGD0","description":"ICD-OGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repos nstim apnea sensing ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0433T","description":"Repos nstim apnea sensing ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIE1","description":"ICD-BBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proton trmt simple w/comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77522","description":"Proton trmt simple w/comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2136","description":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA11","description":"ICD-2KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRC0","description":"ICD-KHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy)_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9908","description":"Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy)_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAD1","description":"ICD-FGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBD0","description":"ICD-OFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHF1","description":"ICD-KFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE144","description":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of palm bursas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26030","description":"Drainage of palm bursas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVC0","description":"ICD-KHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHID1","description":"ICD-NHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC154","description":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9161","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","description":"HCPCS-J9161","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVB1","description":"ICD-JHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAD0","description":"ICD-NDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDF0","description":"ICD-MGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB21","description":"ICD-2BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEA0","description":"ICD-AEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone imaging limited area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78300","description":"Bone imaging limited area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADC1","description":"ICD-IADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJF0","description":"ICD-CIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8F","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMA1","description":"ICD-AAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genet virus isolate hsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87255","description":"Genet virus isolate hsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUE0","description":"ICD-EAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare donor lung single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32855","description":"Prepare donor lung single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCC1","description":"ICD-ODCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUB1","description":"ICD-BFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE231","description":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALB1","description":"ICD-GALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUE1","description":"ICD-NFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEC1","description":"ICD-NFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGE1","description":"ICD-NLGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCC0","description":"ICD-KCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Completed epsdt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0302","description":"Completed epsdt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smoking & 2nd hand assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1031F","description":"Smoking & 2nd hand assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ anesthetic agent; spinal accessory nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64412","description":"Injection_ anesthetic agent; spinal accessory nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIB1","description":"ICD-OLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvef <40%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8694","description":"Lvef <40%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB21","description":"ICD-4LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81286","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDE1","description":"ICD-BIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYA0","description":"ICD-KBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWF0","description":"ICD-OKWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITE0","description":"ICD-KITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8002","description":"HCPCS-C8002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Support broker waiver/15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2041","description":"Support broker waiver/15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXE1","description":"ICD-OEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gauze >16<=48 sq in watr/sal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6229","description":"Gauze >16<=48 sq in watr/sal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEE0","description":"ICD-ACEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doxorubicin inj 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2050","description":"Doxorubicin inj 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWD1","description":"ICD-KAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDME1","description":"ICD-GDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0521","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","description":"HCPCS-Q0521","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stereotactic radiation trmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77432","description":"Stereotactic radiation trmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAE0","description":"ICD-OKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLA0","description":"ICD-ADLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOD1","description":"ICD-KEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc shoulder tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23073","description":"Exc shoulder tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2D","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heavy duty wheeled walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0149","description":"Heavy duty wheeled walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB13","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCB1","description":"ICD-NHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESB0","description":"ICD-DESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote retinal imaging mgmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92228","description":"Remote retinal imaging mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of tacrolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80197","description":"Assay of tacrolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIA0","description":"ICD-NGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEF0","description":"ICD-EHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHA1","description":"ICD-FIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA131","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Memoderm/derma/tranz/integup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4126","description":"Memoderm/derma/tranz/integup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct injured chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32820","description":"Reconstruct injured chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adj motion knee jnt lerman t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2186","description":"Adj motion knee jnt lerman t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23620","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC31","description":"ICD-4BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCF1","description":"ICD-ABCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPE1","description":"ICD-OHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of gastrostomy tube_ percutaneous_ with magnetic gastropexy_ under ultrasound guidance_ image documentation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0647T","description":"Insertion of gastrostomy tube_ percutaneous_ with magnetic gastropexy_ under ultrasound guidance_ image documentation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBE0","description":"ICD-OBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ diffuse large B-cell lymphoma) gene analysis_ common variant(s) (eg_ codon 646)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81237","description":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ diffuse large B-cell lymphoma) gene analysis_ common variant(s) (eg_ codon 646)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopathology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88199","description":"Cytopathology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antithromb no presc no reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8698","description":"Antithromb no presc no reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA41","description":"Very High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50572","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum dep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27634","description":"Exc leg/ankle tum dep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMC1","description":"ICD-BGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37600","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy inner cannula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4623","description":"Tracheostomy inner cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDA1","description":"ICD-FBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARF1","description":"ICD-LARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cine/video x-rays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76120","description":"Cine/video x-rays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESC1","description":"ICD-KESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7523","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD115","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIED1","description":"ICD-AIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA17","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ abdominal aorta_ real time with image documentation_ screening study for abdominal aortic aneurysm (AAA)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76706","description":"Ultrasound_ abdominal aorta_ real time with image documentation_ screening study for abdominal aortic aneurysm (AAA)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (urothelial cancer)_ RNA_ analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie_ p.R248C [c.742C>T]_ p.S249C [c.746C>G]_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0154U","description":"Oncology (urothelial cancer)_ RNA_ analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie_ p.R248C [c.742C>T]_ p.S249C [c.746C>G]_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBC0","description":"ICD-JDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPE0","description":"ICD-CGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHA0","description":"ICD-FIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSE1","description":"ICD-CFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHE0","description":"ICD-AEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31239","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBE0","description":"ICD-KEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERF0","description":"ICD-PERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVD1","description":"ICD-FBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive med svc 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2010","description":"Comprehensive med svc 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTC0","description":"ICD-NLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA135","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXD0","description":"ICD-JGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDE1","description":"ICD-JHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0267T","description":"Implt/rpl crtd sns dev lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL52","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bartonella dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87472","description":"Bartonella dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIA0","description":"ICD-KDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56159","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-htn or htn doc_ f/u indc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8950","description":"Pre-htn or htn doc_ f/u indc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQA0","description":"ICD-GEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSD1","description":"ICD-CCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLB1","description":"ICD-EHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69601","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWC0","description":"ICD-PFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ human fibrinogen concentrate (Fibryga)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7177","description":"Injection_ human fibrinogen concentrate (Fibryga)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEA1","description":"ICD-CAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ polycentric_ pneumatic swing_ and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5841","description":"Addition_ endoskeletal knee-shin system_ polycentric_ pneumatic swing_ and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Av fusion direct any site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36821","description":"Av fusion direct any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDB0","description":"ICD-NCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ etranacogene dezaparvovec-drlb_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1411","description":"Injection_ etranacogene dezaparvovec-drlb_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62115","description":"Reduction of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL52","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHC0","description":"ICD-ODHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infus insulin pump non needl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4230","description":"Infus insulin pump non needl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWE1","description":"ICD-PCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGND1","description":"ICD-JGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inactivated je vacc im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90738","description":"Inactivated je vacc im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGB0","description":"ICD-KEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBD1","description":"ICD-EGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIF0","description":"ICD-MAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emergency anesthesia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99140","description":"Emergency anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28715","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMF0","description":"ICD-OLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27780","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKC0","description":"ICD-GEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNA0","description":"ICD-FFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVA0","description":"ICD-FFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBA1","description":"ICD-GDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAB0","description":"ICD-OIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermabrasion segmental face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15781","description":"Dermabrasion segmental face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tagraxofusp-erzs_ 10mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9049","description":"Injection_ tagraxofusp-erzs_ 10mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBD1","description":"ICD-BEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52318","description":"Remove bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB116","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAB0","description":"ICD-OKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rilonacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2793","description":"Rilonacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00912","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","description":"CPT-00912","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXD0","description":"ICD-GHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast tomosynthesis uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77061","description":"Breast tomosynthesis uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXA0","description":"ICD-BDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCE1","description":"ICD-EBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lancets per box","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4259","description":"Lancets per box","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBA1","description":"ICD-JHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"C diff amplified probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87493","description":"C diff amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYE0","description":"ICD-HFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLE0","description":"ICD-MFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESE1","description":"ICD-OESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMB0","description":"ICD-BBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDE1","description":"ICD-NDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFC0","description":"ICD-GHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRE0","description":"ICD-GBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERC1","description":"ICD-CERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1050","description":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29826","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC201","description":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve_ percutaneous approach_ including right heart catheterization_ temporary pacemaker insertio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0646T","description":"Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve_ percutaneous approach_ including right heart catheterization_ temporary pacemaker insertio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv4 vaccine 6-35 months im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90687","description":"Iiv4 vaccine 6-35 months im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB21","description":"ICD-4HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor ix recombinan rixubis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7200","description":"Factor ix recombinan rixubis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3C","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLD1","description":"ICD-CGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0101","description":"CDT-D0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPD1","description":"ICD-JHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens spher single plano 4.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2100","description":"Lens spher single plano 4.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNB1","description":"ICD-KBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart image (pet) single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78491","description":"Heart image (pet) single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNA1","description":"ICD-OBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/density","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86972","description":"Rbc pretx incubatj w/density","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUB0","description":"ICD-ICUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urgent Care Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4036","description":"Urgent Care Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Truss single w/ standard pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8300","description":"Truss single w/ standard pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visc & infraren abd 4+ prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34848","description":"Visc & infraren abd 4+ prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIA1","description":"ICD-AFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Swallow d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8998","description":"Swallow d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 1 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0816","description":"Pwc gp 1 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complex body section x-rays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76102","description":"Complex body section x-rays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear exam of tear flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78660","description":"Nuclear exam of tear flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUC1","description":"ICD-FEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQA0","description":"ICD-GFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATB0","description":"ICD-KATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A5001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5001","description":"HCPCS-A5001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rh ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90386","description":"Rh ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIC1","description":"ICD-EIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain canal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61050","description":"Remove brain canal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Angina present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1011F","description":"Angina present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shrt leg fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4038","description":"Cast sup shrt leg fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB226","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject spine w/cath lmb/scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62319","description":"Inject spine w/cath lmb/scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAE1","description":"ICD-JAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cat scan follow-up study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76380","description":"Cat scan follow-up study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis-periapical radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0389","description":"intraoral tomosynthesis-periapical radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSE0","description":"ICD-GBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1163","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","description":"HCPCS-J1163","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1201","description":"HCPCS-B1201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0922T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","description":"CPT-0922T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLE0","description":"ICD-MDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIA0","description":"ICD-AHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27472","description":"Repair/graft of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCE1","description":"ICD-JDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKE1","description":"ICD-FGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHE0","description":"ICD-NKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOA0","description":"ICD-PJOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPF0","description":"ICD-KFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNB0","description":"ICD-OFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBC1","description":"ICD-AFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21C","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAE0","description":"ICD-EFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNC1","description":"ICD-NFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","description":"HCPCS-J7172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99253","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMD1","description":"ICD-MDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chronic b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2175","description":"Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chronic b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close mult vsd w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33676","description":"Close mult vsd w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRE0","description":"ICD-OCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonemerg transp mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0215","description":"Nonemerg transp mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoperfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90997","description":"Hemoperfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIB1","description":"ICD-NCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAF1","description":"ICD-GHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA11","description":"ICD-4IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper gi endo shows barrtts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3140F","description":"Upper gi endo shows barrtts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDB0","description":"ICD-FDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orth foot non-standard size/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3255","description":"Orth foot non-standard size/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Semiquantitative Analysis Of 32 Phosphoproteins And Protein Analytes_ Includes Laser Capture Microdissection_ With Algorithmic Analysis And Interpretative R","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0249U","description":"Oncology (Breast)_ Semiquantitative Analysis Of 32 Phosphoproteins And Protein Analytes_ Includes Laser Capture Microdissection_ With Algorithmic Analysis And Interpretative R","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12D","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit12.6-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12045","description":"Intmd rpr n-hf/genit12.6-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening of a patient","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0190","description":"Screening of a patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMA0","description":"ICD-KHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Safety counseling dementia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6101F","description":"Safety counseling dementia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVC1","description":"ICD-OJVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urgent care center global","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9083","description":"Urgent care center global","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6011","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj open reduct-dislocation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7810","description":"Tmj open reduct-dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9190","description":"Medical reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vert bitewings-sev to eight","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0277","description":"Vert bitewings-sev to eight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not disch to home day#7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8825","description":"Pt not disch to home day#7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electric heat pad moist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0215","description":"Electric heat pad moist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repos car modulj tranvns elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0415T","description":"Repos car modulj tranvns elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVE0","description":"ICD-JDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNF0","description":"ICD-CCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27403","description":"Repair of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35211","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25280","description":"Revise wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAC0","description":"ICD-OAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0664","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","description":"HCPCS-G0664","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMC1","description":"ICD-MHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1357","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28A","description":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEC1","description":"ICD-GDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/sac drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32659","description":"Thoracoscopy w/sac drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopy of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50951","description":"Endoscopy of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01360","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","description":"CPT-01360","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJD1","description":"ICD-BAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES255","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCA1","description":"ICD-OCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add tooth to partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5650","description":"Add tooth to partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem exostosis any site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7471","description":"Rem exostosis any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation nasal sinus artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30915","description":"Ligation nasal sinus artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system_ including placement of an oral device_ monitoring of patient tolerance to treatment_ and remov","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0881T","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system_ including placement of an oral device_ monitoring of patient tolerance to treatment_ and remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWD1","description":"ICD-OCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTC0","description":"ICD-JDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVF1","description":"ICD-JEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAB0","description":"ICD-ADAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete aa_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4303","description":"Complete aa_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOD1","description":"ICD-OCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCD0","description":"ICD-JCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9009","description":"Mccd_ risk adj_ level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDF1","description":"ICD-MBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11404","description":"Exc tr-ext b9+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCC0","description":"ICD-MGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDD0","description":"ICD-CIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNE0","description":"ICD-FHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychiatric symp absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1183F","description":"Neuropsychiatric symp absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap inc hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49654","description":"Lap inc hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGE1","description":"ICD-CAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVB1","description":"ICD-FAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHC1","description":"ICD-NGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXD1","description":"ICD-FGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFB0","description":"ICD-KHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0501T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood clot retraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85170","description":"Blood clot retraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74425","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWA0","description":"ICD-HGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18A","description":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family/couple counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1006","description":"Family/couple counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27372","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSB1","description":"ICD-CFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Refer to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9524","description":"Refer to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMB1","description":"ICD-AGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(S)_ Bone-Substitute Material (Eg_ Calcium Phosphate) Into Subchondral Bone Defect (Ie_ Bone Marrow Lesion_ Bone Bruise_ Stress Injury_ Microtrabecular Fracture)_ Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0707T","description":"Injection(S)_ Bone-Substitute Material (Eg_ Calcium Phosphate) Into Subchondral Bone Defect (Ie_ Bone Marrow Lesion_ Bone Bruise_ Stress Injury_ Microtrabecular Fracture)_ Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4416","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","description":"HCPCS-Q4416","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exam/biopsy of vag w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57421","description":"Exam/biopsy of vag w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTE1","description":"ICD-CGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNA0","description":"ICD-FDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGD1","description":"ICD-KBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPB0","description":"ICD-FIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE151","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4362","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","description":"HCPCS-Q4362","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote 30 day ecg rev/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93270","description":"Remote 30 day ecg rev/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31645","description":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWA1","description":"ICD-LFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEB0","description":"ICD-CAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDA0","description":"ICD-OJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEA0","description":"ICD-KCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_ initial rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9001","description":"Mccd_ initial rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77066","description":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQD0","description":"ICD-GHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAB1","description":"ICD-IBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis_ each comparator genome (eg_ parents_ siblings)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0425U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis_ each comparator genome (eg_ parents_ siblings)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIA1","description":"ICD-JIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (inherited thrombocytopenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Inherited Thrombocytopenia Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0276U","description":"Hematology (inherited thrombocytopenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Inherited Thrombocytopenia Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKA1","description":"ICD-NLKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYE0","description":"ICD-LFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRD1","description":"ICD-CIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILC0","description":"ICD-NILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVE1","description":"ICD-ODVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Membrane wrap-hydro_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4290","description":"Membrane wrap-hydro_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analysis skeletal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88355","description":"Analysis skeletal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery expos/graft artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33987","description":"Artery expos/graft artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCE0","description":"ICD-MCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Golimumab for iv use 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1602","description":"Golimumab for iv use 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","description":"HCPCS-M1414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sphincteroplasty_ anal_ for incontinence_ adult; implantation artificial sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46762","description":"Sphincteroplasty_ anal_ for incontinence_ adult; implantation artificial sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRC0","description":"ICD-DBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECF0","description":"ICD-CECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stk cabg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8573","description":"Stk cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCD0","description":"ICD-MJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDA1","description":"ICD-EDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPE1","description":"ICD-GBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFC1","description":"ICD-JAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spec childcare waiver 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2027","description":"Spec childcare waiver 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGC1","description":"ICD-FHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant spine infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62362","description":"Implant spine infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cefazolin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0690","description":"Cefazolin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXC1","description":"ICD-NAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHE1","description":"ICD-BAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVF1","description":"ICD-NGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRE0","description":"ICD-LDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of chest artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37616","description":"Ligation of chest artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFB0","description":"ICD-FBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1C","description":"Default_ /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA31","description":"Medium Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOD1","description":"ICD-CGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc post surg anatomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9613","description":"Doc post surg anatomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc iliac repr w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34900","description":"Endovasc iliac repr w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBC1","description":"ICD-JIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI)_ administered by a computer_ wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96103","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI)_ administered by a computer_ wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMD1","description":"ICD-MJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHC1","description":"ICD-KDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytal_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4166","description":"Cytal_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25D","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTF1","description":"ICD-GFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of oral tissue hard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7285","description":"Biopsy of oral tissue hard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optx of rib fx w/fixj scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21811","description":"Optx of rib fx w/fixj scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0D","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVA1","description":"ICD-FBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCE1","description":"ICD-JFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAC0","description":"ICD-JFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFD0","description":"ICD-KBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXE1","description":"ICD-BGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE226","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHC0","description":"ICD-GIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx rectal t4_n_m0 no prg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9093","description":"Onc dx rectal t4_n_m0 no prg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMD1","description":"ICD-FEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 30MCG/0.3 ML BST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004A","description":"ADM SARSCOV2 30MCG/0.3 ML BST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFC0","description":"ICD-OIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pres/absn urine incon assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1090F","description":"Pres/absn urine incon assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIB1","description":"ICD-BBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOB0","description":"ICD-HBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped compr care pkg_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1025","description":"Ped compr care pkg_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate bone tumor(s) perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20983","description":"Ablate bone tumor(s) perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cus elbo skt in not con/atyp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6697","description":"Cus elbo skt in not con/atyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAB0","description":"ICD-CGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUD1","description":"ICD-EHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50785","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21282","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47538","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc rehab svcs considered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4079F","description":"Doc rehab svcs considered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLA1","description":"ICD-BFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow adolescent myoelectron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7190","description":"Elbow adolescent myoelectron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATB1","description":"ICD-KATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nutri counsel-control caries","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1310","description":"Nutri counsel-control caries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVA1","description":"ICD-CFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8G","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGD1","description":"ICD-NHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88005","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBC1","description":"ICD-OHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCC1","description":"ICD-AHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDB0","description":"ICD-CDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBC1","description":"ICD-BDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJC0","description":"ICD-KHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMD1","description":"ICD-IDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWC0","description":"ICD-LDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWF0","description":"ICD-LGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Levalbuterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7614","description":"Levalbuterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTD1","description":"ICD-ACTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"A/d halfway house_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2034","description":"A/d halfway house_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXD0","description":"ICD-GDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBB1","description":"ICD-MEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGE0","description":"ICD-BIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAD1","description":"ICD-BGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDB1","description":"ICD-MDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHB0","description":"ICD-GGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0406","description":"Inpt/tele follow up 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEE0","description":"ICD-FHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67930","description":"Repair eyelid wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKC0","description":"ICD-CGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVC1","description":"ICD-CAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMB1","description":"ICD-NBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOE1","description":"ICD-HCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIA1","description":"ICD-JEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOB0","description":"ICD-OBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26390","description":"Revise hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUA0","description":"ICD-OKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDA0","description":"ICD-NJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10A","description":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEE0","description":"ICD-KGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNB1","description":"ICD-OKNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99 tilmanocept diag 0.5mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9520","description":"Tc99 tilmanocept diag 0.5mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23480","description":"Revision of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXD0","description":"ICD-BFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES341","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARF0","description":"ICD-CARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANE0","description":"ICD-KANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICD0","description":"ICD-EICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal monitor/interpret only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59051","description":"Fetal monitor/interpret only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scleral cover shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2627","description":"Scleral cover shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGD1","description":"ICD-GEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCF1","description":"ICD-IBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWD1","description":"ICD-CGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC31","description":"ICD-4DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acyclovir injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0133","description":"Acyclovir injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTB1","description":"ICD-MHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQD0","description":"ICD-CIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair venous anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33724","description":"Repair venous anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D9914","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9914","description":"CDT-D9914","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vibrate quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0107T","description":"Vibrate quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATC0","description":"ICD-AATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVF0","description":"ICD-GAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67039","description":"Laser treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB55","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8D","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee Ankle Foot Device_ Any Material_ Single Or Double Upright_ Swing And/Or Stance Phase Microprocessor Control With Adjustability_ Includes All Components (E.G._ Sensors_ Ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2006","description":"Knee Ankle Foot Device_ Any Material_ Single Or Double Upright_ Swing And/Or Stance Phase Microprocessor Control With Adjustability_ Includes All Components (E.G._ Sensors_ Ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRB0","description":"ICD-PIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVC0","description":"ICD-KCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech sound lang comprehen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92523","description":"Speech sound lang comprehen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28A","description":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKD0","description":"ICD-GAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amalgam three surfaces perma","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2160","description":"Amalgam three surfaces perma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0020","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Micro exam prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0473","description":"Micro exam prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0A","description":"High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMB1","description":"ICD-OHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change stent via transureth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50385","description":"Change stent via transureth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder flexion-abduction j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6645","description":"Shoulder flexion-abduction j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAC1","description":"ICD-GIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Factor viii fc fusion recomb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7205","description":"Factor viii fc fusion recomb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTF1","description":"ICD-ICTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMC1","description":"ICD-GHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDE0","description":"ICD-KBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAF0","description":"ICD-FBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISD1","description":"ICD-DISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALB0","description":"ICD-IALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFE1","description":"ICD-BGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic spirometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0487","description":"Electronic spirometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYC1","description":"ICD-LCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSD1","description":"ICD-HGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIC1","description":"ICD-GHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADB0","description":"ICD-BADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWE1","description":"ICD-CHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXE0","description":"ICD-BDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv)_ includes hiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0011","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv)_ includes hiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ven thrombosis images bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78458","description":"Ven thrombosis images bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJB1","description":"ICD-OIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJD0","description":"ICD-BBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ transluminal intravascular lesion preparation device_ bladed_ sheathed (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1600","description":"Catheter_ transluminal intravascular lesion preparation device_ bladed_ sheathed (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYD0","description":"ICD-DBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJB0","description":"ICD-NCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone imaging 3 phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78315","description":"Bone imaging 3 phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWB0","description":"ICD-CHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB32","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1804","description":"HCPCS-A1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBD0","description":"ICD-IIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKC0","description":"ICD-NHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQA0","description":"ICD-PLQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4394","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","description":"HCPCS-Q4394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8F","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCD1","description":"ICD-EBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDD0","description":"ICD-NHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Misc dialysis supplies noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4913","description":"Misc dialysis supplies noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ready gradient glove","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8427","description":"Ready gradient glove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNE0","description":"ICD-KFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOB1","description":"ICD-PGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20250","description":"Open bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28660","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ full gene sequence (List separately in addition to code for primary procedu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ full gene sequence (List separately in addition to code for primary procedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLE0","description":"ICD-IHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHED1","description":"ICD-BHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGB1","description":"ICD-GBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWE1","description":"ICD-CFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respirator motion mgmt simul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77293","description":"Respirator motion mgmt simul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multiaxial ankle w dorsiflex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5968","description":"Multiaxial ankle w dorsiflex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPA1","description":"ICD-CHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGA0","description":"ICD-OAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOA0","description":"ICD-KAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18B","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQB0","description":"ICD-HIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYE0","description":"ICD-KDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0839","description":"Pwc gp2 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eribulin mesylate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9179","description":"Eribulin mesylate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smpd1 gene common variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81330","description":"Smpd1 gene common variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE101","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of breast open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19101","description":"Biopsy of breast open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37242","description":"Vasc embolize/occlude artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep b ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90371","description":"Hep b ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXD1","description":"ICD-KIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCE1","description":"ICD-CDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIF0","description":"ICD-GIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNB0","description":"ICD-NHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC116","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICB1","description":"ICD-EICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Above knee hydracadence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5610","description":"Above knee hydracadence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX45","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMA0","description":"ICD-ECMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt ref pulm fx test/peakflow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3758F","description":"Pt ref pulm fx test/peakflow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQC0","description":"ICD-HHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJC1","description":"ICD-GGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75746","description":"Artery x-rays lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8E","description":"Medium Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOC0","description":"ICD-CIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped size pull-on sm/med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4531","description":"Ped size pull-on sm/med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAA0","description":"ICD-MHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPD1","description":"ICD-GCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEB0","description":"ICD-OEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEA0","description":"ICD-CDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAA1","description":"ICD-MAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hc pro phone call 5-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98966","description":"Hc pro phone call 5-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEC0","description":"ICD-BBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEA1","description":"ICD-OHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMB0","description":"ICD-FIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01464","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","description":"CPT-01464","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFC1","description":"ICD-NFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIE1","description":"ICD-MJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBE0","description":"ICD-NIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUE0","description":"ICD-KCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert pulse gen dual leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33213","description":"Insert pulse gen dual leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAF0","description":"ICD-KFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVE1","description":"ICD-KIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rural health clinic or federally qualified health center (RHC/FQHC) only_ psychiatric collaborative care model (psychiatric COCM)_ 60 minutes or more of clinical staff time fo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0512","description":"Rural health clinic or federally qualified health center (RHC/FQHC) only_ psychiatric collaborative care model (psychiatric COCM)_ 60 minutes or more of clinical staff time fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBD0","description":"ICD-AIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCND1","description":"ICD-BCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB11","description":"ICD-3JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"deep sedation/general anesthesia each subsequent 15 minute increment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9223","description":"deep sedation/general anesthesia each subsequent 15 minute increment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYC0","description":"ICD-LAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLF0","description":"ICD-JCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHB0","description":"ICD-BAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compressor nondispos filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7014","description":"Compressor nondispos filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult day care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5102","description":"Adult day care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCC0","description":"ICD-AHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBC0","description":"ICD-EGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15D","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand restoration multiple fi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6905","description":"Hand restoration multiple fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21137","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial valve remov init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31648","description":"Bronchial valve remov init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap remove rectum w/pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45397","description":"Lap remove rectum w/pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB244","description":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA10","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES350","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture typing glc/hplc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87143","description":"Culture typing glc/hplc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vertebral body tethering_ anterior; 8 or more vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0657T","description":"Vertebral body tethering_ anterior; 8 or more vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSF1","description":"ICD-LFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8F","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extended steel shank","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2360","description":"Extended steel shank","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBA0","description":"ICD-ODBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHID1","description":"ICD-IHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31635","description":"Bronchoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meg evoked single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95966","description":"Meg evoked single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ eptinezumab-jjmr_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3032","description":"Injection_ eptinezumab-jjmr_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASC0","description":"ICD-PASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSA1","description":"ICD-PBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pms2 gene full seq analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81317","description":"Pms2 gene full seq analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA134","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25A","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBB0","description":"ICD-JDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0A","description":"Very High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pm device eval in person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93288","description":"Pm device eval in person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15C","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXC0","description":"ICD-CEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATE1","description":"ICD-JATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCD0","description":"ICD-OJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97001","description":"Pt evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYE0","description":"ICD-CHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient pressure wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8429","description":"Gradient pressure wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQC1","description":"ICD-HHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRA1","description":"ICD-CGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLE0","description":"ICD-MBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASD0","description":"ICD-PASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCB1","description":"ICD-IGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulm funct tst plethysmograp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94726","description":"Pulm funct tst plethysmograp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aortic dysfunction/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81411","description":"Aortic dysfunction/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgimend_ neonatal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9360","description":"Surgimend_ neonatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUD1","description":"ICD-CHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSA1","description":"ICD-OBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYC1","description":"ICD-KHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJF1","description":"ICD-JGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQC0","description":"ICD-LCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25111","description":"Remove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ESCHERICHIA COLI 0157","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87335","description":"IAAD IA ESCHERICHIA COLI 0157","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albumin (human)_ 25%_ 20 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9046","description":"Albumin (human)_ 25%_ 20 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB26","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interprof phone/online 11-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99447","description":"Interprof phone/online 11-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISD0","description":"ICD-GISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC240","description":"Clinically Complex _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below knee flex cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5962","description":"Below knee flex cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGC1","description":"ICD-JFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGF0","description":"ICD-JGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthoptic/pleoptic training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92065","description":"Orthoptic/pleoptic training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCF1","description":"ICD-ICCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0657U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0657U","description":"CPT-0657U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEC0","description":"ICD-KCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGA0","description":"ICD-GAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHB1","description":"ICD-ABHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPC0","description":"ICD-KDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJC0","description":"ICD-GBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55711","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","description":"CPT-55711","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHF0","description":"ICD-CHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0908T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","description":"CPT-0908T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUE1","description":"ICD-BIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tract equip cervical tract","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0860","description":"Tract equip cervical tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mogamulizumab-kpkc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9204","description":"Injection_ mogamulizumab-kpkc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOF0","description":"ICD-PFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2B","description":"High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient is currently on a daily aspirin or other antiplatelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9793","description":"Patient is currently on a daily aspirin or other antiplatelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total hip arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27132","description":"Total hip arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mild osa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8848","description":"Mild osa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure of split wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12020","description":"Closure of split wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99439","description":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment Of Amblyopia Using An Online Digital Program; Assessment Of Patient Performance And Program Data By Physician Or Other Qualified Health Care Professional_ With Repor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0688T","description":"Treatment Of Amblyopia Using An Online Digital Program; Assessment Of Patient Performance And Program Data By Physician Or Other Qualified Health Care Professional_ With Repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11600","description":"Exc tr-ext mal+marg 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHF0","description":"ICD-OGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prothrombin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85611","description":"Prothrombin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23D","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit new age 18-39","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99385","description":"Prev visit new age 18-39","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVA0","description":"ICD-FCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of progesterone 20-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83499","description":"Assay of progesterone 20-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-2 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87537","description":"Hiv-2 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTE1","description":"ICD-MCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj ocular telescope prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0308T","description":"Insj ocular telescope prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMC1","description":"ICD-EHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote therapeutic monitoring (eg_ therapy adherence_ therapy response); device(s) supply with scheduled (eg_ daily) recording(s) and/or programmed alert(s) transmission to mo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98978","description":"Remote therapeutic monitoring (eg_ therapy adherence_ therapy response); device(s) supply with scheduled (eg_ daily) recording(s) and/or programmed alert(s) transmission to mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGF1","description":"ICD-BCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dolasetron mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1260","description":"Dolasetron mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fitting of diaphragm/cap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57170","description":"Fitting of diaphragm/cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection alemtuzumab 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9979","description":"Injection alemtuzumab 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDB0","description":"ICD-EIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKE0","description":"ICD-FFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmic mitomycin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7315","description":"Ophthalmic mitomycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJA0","description":"ICD-ODJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRB0","description":"ICD-CBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEB1","description":"ICD-GAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDA0","description":"ICD-IBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYA1","description":"ICD-GDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISC0","description":"ICD-HISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOF0","description":"ICD-GHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAE1","description":"ICD-ICAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBA1","description":"ICD-JIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28I","description":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iop measurement not documented_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1226","description":"Iop measurement not documented_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oasis tri-layer wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4124","description":"Oasis tri-layer wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51570","description":"Removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psy evaluation of records","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90885","description":"Psy evaluation of records","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGC1","description":"ICD-JBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA30","description":"High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAF0","description":"ICD-GIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluocinol acet intravit imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7313","description":"Fluocinol acet intravit imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening performed and positive and provision of recommendations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9919","description":"Screening performed and positive and provision of recommendations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply r&l pulm art bands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33620","description":"Apply r&l pulm art bands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult size pull-on xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4528","description":"Adult size pull-on xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of arm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24310","description":"Revision of arm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTA0","description":"ICD-OJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALD1","description":"ICD-FALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUA0","description":"ICD-GBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYD1","description":"ICD-PDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIC0","description":"ICD-NAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICC0","description":"ICD-EICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIE0","description":"ICD-EBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient  compression glove_ custom_ heavy weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6580","description":"Gradient  compression glove_ custom_ heavy weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/tumr remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45338","description":"Sigmoidoscopy w/tumr remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC24","description":"Medium Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSA0","description":"ICD-OLSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKD1","description":"ICD-OEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWC1","description":"ICD-CFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37266","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","description":"CPT-37266","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYA0","description":"ICD-DGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive mastoid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69511","description":"Extensive mastoid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUB1","description":"ICD-OIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External beam to prost only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4200F","description":"External beam to prost only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTA1","description":"ICD-ICTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33411","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy vag lesions complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57065","description":"Destroy vag lesions complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp iliorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35634","description":"Art byp iliorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Follow up pulm nod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9345","description":"Follow up pulm nod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKE0","description":"ICD-BDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUC1","description":"ICD-AAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26415","description":"Excision hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE254","description":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heterophile antibody titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86309","description":"Heterophile antibody titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1457","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","description":"HCPCS-M1457","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIB0","description":"ICD-GCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8I","description":"Very High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML32","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUF0","description":"ICD-AAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/4.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2305","description":"Lens sphcy trifocal 4.0/4.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal angioplasty with intravascular ultrasound (initial noncoro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7531","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal angioplasty with intravascular ultrasound (initial noncoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 5 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP05","description":"Auto.test pane pricing code_ 5 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEC1","description":"ICD-IAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/in 2yr dxa not order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9471","description":"W/in 2yr dxa not order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/90d mrs >2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9648","description":"Pt w/90d mrs >2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Isoetharine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7649","description":"Isoetharine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDC0","description":"ICD-GDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXE0","description":"ICD-NHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51590","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Not pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8712","description":"Not pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7564","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7564","description":"HCPCS-C7564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1703","description":"HCPCS-B1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLE0","description":"ICD-FDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0599U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","description":"CPT-0599U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAF1","description":"ICD-CFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/band ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45398","description":"Colonoscopy w/band ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8I","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHA1","description":"ICD-FDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVA0","description":"ICD-GFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKF1","description":"ICD-NHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SUPRATHEL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2012","description":"SUPRATHEL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAED1","description":"ICD-EAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below/above elbow lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6698","description":"Below/above elbow lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24665","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67820","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHB1","description":"ICD-GDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0601","description":"HCPCS-C0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of major vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37650","description":"Revision of major vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVC0","description":"ICD-BCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIC0","description":"ICD-KEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice routine home care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2042","description":"Hospice routine home care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thaw preserved stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38208","description":"Thaw preserved stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:2 to 1:3)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1729","description":"Employment - Employment Skills Development (1:2 to 1:3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAE1","description":"ICD-ADAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACE0","description":"ICD-FACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEE0","description":"ICD-CEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAE0","description":"ICD-KAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECF0","description":"ICD-JECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEB1","description":"ICD-EDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBA0","description":"ICD-NBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33845","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28F","description":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKD0","description":"ICD-FDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBF0","description":"ICD-AFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOF0","description":"ICD-CFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDE1","description":"ICD-MKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRD1","description":"ICD-OIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLE1","description":"ICD-BFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle-skin graft trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15734","description":"Muscle-skin graft trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYF1","description":"ICD-GFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBF1","description":"ICD-NBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQC0","description":"ICD-HGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEA1","description":"ICD-BBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18D","description":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALF1","description":"ICD-KALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELC0","description":"ICD-OELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKC0","description":"ICD-GIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI brain stem w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70553","description":"MRI brain stem w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIND1","description":"ICD-CIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEED0","description":"ICD-KEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVE1","description":"ICD-GDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUB0","description":"ICD-NDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWF1","description":"ICD-KHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB31","description":"ICD-1IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRF0","description":"ICD-LBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (Vas)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2137","description":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (Vas)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB206","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUE0","description":"ICD-OHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient recorded spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94014","description":"Patient recorded spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmprsburngarment glove-elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6505","description":"Cmprsburngarment glove-elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAA1","description":"ICD-OCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9816","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9816","description":"HCPCS-C9816","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer skin pedicle flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15650","description":"Transfer skin pedicle flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imp neurosti pls gn any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8679","description":"Imp neurosti pls gn any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETD1","description":"ICD-IETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15D","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQE0","description":"ICD-HIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0163","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","description":"HCPCS-J0163","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tacrol envarsus ex rel oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7503","description":"Tacrol envarsus ex rel oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dna analysis deafness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3844","description":"Dna analysis deafness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 21 Or More Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99423","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 21 Or More Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt ref for speech lang path","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4552F","description":"Pt ref for speech lang path","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98002","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","description":"CPT-98002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Salmonella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86768","description":"Salmonella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9697","description":"Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBD0","description":"ICD-BEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prostate ca screening; dre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0102","description":"Prostate ca screening; dre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63046","description":"Remove spine lamina 1 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUA1","description":"ICD-GEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABA0","description":"ICD-MABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic passive restor cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6370","description":"Thoracic passive restor cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALE1","description":"ICD-EALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1053T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1053T","description":"CPT-1053T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHD0","description":"ICD-FIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1051T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1051T","description":"CPT-1051T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ibandronate sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1740","description":"Ibandronate sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place device/marker_ non pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9728","description":"Place device/marker_ non pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx w/fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21346","description":"Opn tx nasomax fx w/fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5169","description":"HCPCS-Q5169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair nonunion hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26546","description":"Repair nonunion hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXD0","description":"ICD-KAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQF0","description":"ICD-GAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28B","description":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXB0","description":"ICD-NCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albumin; urine (eg_ microalbumin)_ semiquantitative (eg_ reagent strip assay)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82044","description":"Albumin; urine (eg_ microalbumin)_ semiquantitative (eg_ reagent strip assay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPD0","description":"ICD-CDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64821","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAC1","description":"ICD-IGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA11","description":"ICD-1CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression gauntlet_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6582","description":"Gradient compression gauntlet_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7040","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJB1","description":"ICD-BAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBC0","description":"ICD-IBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care prof for COVID-19_ ages under 21_ 16-30 minutes time (This code is used for the Medicaid EPSDT)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0314","description":"Imm counseling by a physician or other qualified health care prof for COVID-19_ ages under 21_ 16-30 minutes time (This code is used for the Medicaid EPSDT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB236","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBD0","description":"ICD-JHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12A","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kelch-like protein 11 (KLHL11) antibody_ serum or cerebrospinal fluid (CSF)_ cell-binding assay_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0432U","description":"Kelch-like protein 11 (KLHL11) antibody_ serum or cerebrospinal fluid (CSF)_ cell-binding assay_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB31","description":"ICD-4IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1039T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1039T","description":"CPT-1039T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXD0","description":"ICD-CBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES135","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip adj flex ext abduct cont","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2624","description":"Hip adj flex ext abduct cont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1301","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSF1","description":"ICD-CCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERE0","description":"ICD-DERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE113","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXF0","description":"ICD-BIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGE0","description":"ICD-OFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt no ref oto reas no spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8563","description":"Pt no ref oto reas no spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFD1","description":"ICD-GHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autograft Suspension_ Including Cell Processing And Application_ And All System Components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1832","description":"Autograft Suspension_ Including Cell Processing And Application_ And All System Components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDB1","description":"ICD-ADDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Droperidol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1790","description":"Droperidol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24A","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUC1","description":"ICD-JAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8G","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMF1","description":"ICD-JIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLB0","description":"ICD-MBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (papillary thyroid cancer)_ gene-expression profiling via targeted hybrid capture–enrichment RNA sequencing of 82 content genes and 10 housekeeping genes_ formalin-fi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0362U","description":"Oncology (papillary thyroid cancer)_ gene-expression profiling via targeted hybrid capture–enrichment RNA sequencing of 82 content genes and 10 housekeeping genes_ formalin-fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOA1","description":"ICD-GAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWE0","description":"ICD-HFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0834T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unplnd hosp readm in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9310","description":"Unplnd hosp readm in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNE1","description":"ICD-NGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ercp lesion ablate w/dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43278","description":"Ercp lesion ablate w/dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTF0","description":"ICD-BBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Folding ped wc adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1236","description":"Folding ped wc adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00928","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","description":"CPT-00928","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVD0","description":"ICD-OHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARE1","description":"ICD-OARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAB1","description":"ICD-GEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDD0","description":"ICD-IDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stenger test pure tone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92565","description":"Stenger test pure tone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTD1","description":"ICD-EFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYE0","description":"ICD-LEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1097","description":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q6h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9503","description":"Hit antibiotic q6h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJA0","description":"ICD-BIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of big toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28240","description":"Release of big toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29846","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGED0","description":"ICD-EGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOD1","description":"ICD-HDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIC1","description":"ICD-GBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAC0","description":"ICD-MDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 VAC AD26 .5ML B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0034A","description":"ADM SARSCOV2 VAC AD26 .5ML B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBC1","description":"ICD-KCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1043T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1043T","description":"CPT-1043T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBD0","description":"ICD-BDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCA1","description":"ICD-CGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMC1","description":"ICD-ADMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ micafungin in sodium (Baxter)_ not therapeutically equivalent to J2248_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2246","description":"Injection_ micafungin in sodium (Baxter)_ not therapeutically equivalent to J2248_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath place cardio brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92974","description":"Cath place cardio brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRA1","description":"ICD-HIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACA1","description":"ICD-EACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUE1","description":"ICD-IFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEA1","description":"ICD-GDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAE0","description":"ICD-NEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTC1","description":"ICD-CCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEF1","description":"ICD-MKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTF1","description":"ICD-MHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA55","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWE0","description":"ICD-KDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostoma valve w diaphra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7501","description":"Tracheostoma valve w diaphra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIA0","description":"ICD-OIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair prosth valve clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33496","description":"Repair prosth valve clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHA1","description":"ICD-AHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removable soft interface le","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0672","description":"Removable soft interface le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen IV bin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0280U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen IV bin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6028","description":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHB1","description":"ICD-JAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSA0","description":"ICD-OGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33361","description":"Replace aortic valve perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thyroglobulin antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86800","description":"Thyroglobulin antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78608","description":"Brain imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDD0","description":"ICD-OCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOC1","description":"ICD-HAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHF0","description":"ICD-OKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0848","description":"Pwc gp 3 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28A","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUF1","description":"ICD-EEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acylcarnitines quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82017","description":"Acylcarnitines quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst metastic/ recur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9075","description":"Onc dx brst metastic/ recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUA0","description":"ICD-ODUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBC1","description":"ICD-OJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA121","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inter limb compress dev nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0676","description":"Inter limb compress dev nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50561","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12C","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMA0","description":"ICD-CCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKA1","description":"ICD-NBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep donor liver lobe split","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47145","description":"Prep donor liver lobe split","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of 65 common drugs by LC-MS/MS_ urine_ each drug reported detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0093U","description":"Prescription drug monitoring_ evaluation of 65 common drugs by LC-MS/MS_ urine_ each drug reported detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCC1","description":"ICD-EDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHD0","description":"ICD-MGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERF0","description":"ICD-DERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant total heart system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051T","description":"Implant total heart system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33688","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMD0","description":"ICD-MBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; each additional 15 minutes (List separately in addition to code fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92623","description":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; each additional 15 minutes (List separately in addition to code fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOB1","description":"ICD-PCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDD1","description":"ICD-NEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cervical semi-rigid adjustab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0140","description":"Cervical semi-rigid adjustab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVC1","description":"ICD-NLVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt biliary drainage cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47534","description":"Plmt biliary drainage cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal vaccine admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8864","description":"Pneumococcal vaccine admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRB1","description":"ICD-LBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray frnt lat lordotc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71021","description":"Chest x-ray frnt lat lordotc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTA1","description":"ICD-GBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEC1","description":"ICD-AFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARD0","description":"ICD-GARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDD1","description":"ICD-MHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71030","description":"Chest x-ray 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr wc drivewheel gear repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2369","description":"Pwr wc drivewheel gear repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0491","description":"Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of throat abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42720","description":"Drainage of throat abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAB1","description":"ICD-OLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQD0","description":"ICD-DAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABF0","description":"ICD-GABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cur meds not document","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8428","description":"Cur meds not document","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUA0","description":"ICD-CHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10B","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chin cup interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2324","description":"Chin cup interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDF0","description":"ICD-FDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pancreas surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48999","description":"Pancreas surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemical cauterization of granulation tissue (ie_ proud flesh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17250","description":"Chemical cauterization of granulation tissue (ie_ proud flesh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC14","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVF0","description":"ICD-OGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBF0","description":"ICD-ABBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIC1","description":"ICD-FHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62320","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Community health integration services performed by certified or trained auxiliary personnel_ including a community health worker_ under the direction of a physician or other p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0019","description":"Community health integration services performed by certified or trained auxiliary personnel_ including a community health worker_ under the direction of a physician or other p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computerized Dynamic Posturography Sensory Organization Test (Cdp-Sot)_ 6 Conditions (Ie_ Eyes Open_ Eyes Closed_ Visual Sway_ Platform Sway_ Eyes Closed Platform Sway_ Platfo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92549","description":"Computerized Dynamic Posturography Sensory Organization Test (Cdp-Sot)_ 6 Conditions (Ie_ Eyes Open_ Eyes Closed_ Visual Sway_ Platform Sway_ Eyes Closed Platform Sway_ Platfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXD0","description":"ICD-NIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adhesive_ liquid or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4364","description":"Adhesive_ liquid or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGE1","description":"ICD-FCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gas system stationary compre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0425","description":"Gas system stationary compre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGB1","description":"ICD-GAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pros_ urinary sph_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1815","description":"Pros_ urinary sph_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2105","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMD0","description":"ICD-FIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27892","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4413","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","description":"HCPCS-Q4413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21183","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEB0","description":"ICD-BBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13B","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam of head and neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76536","description":"Us exam of head and neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITA1","description":"ICD-EITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIC1","description":"ICD-OFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITF0","description":"ICD-KITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5245","description":"Hearing aid_ prog_ mon_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ phenobarbital sodium (sezaby)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2561","description":"Injection_ phenobarbital sodium (sezaby)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDE1","description":"ICD-MIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brca1&2 185&5385&6174 var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81212","description":"Brca1&2 185&5385&6174 var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26727","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAA1","description":"ICD-GHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stimulants synthetic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80371","description":"Stimulants synthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27610","description":"Explore/treat ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine osmolality","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83935","description":"Assay of urine osmolality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acetaminophen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6039","description":"Acetaminophen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22D","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA114","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise excess skin fat pad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15838","description":"Excise excess skin fat pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDA1","description":"ICD-ICDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31290","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKD1","description":"ICD-GDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1486","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","description":"HCPCS-M1486","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18D","description":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc death after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9256","description":"Doc death after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPC0","description":"ICD-BIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body-worn hearing aid air","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5030","description":"Body-worn hearing aid air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analys amniotic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88269","description":"Chromosome analys amniotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonemergency transport bus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0110","description":"Nonemergency transport bus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQB1","description":"ICD-KIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICC1","description":"ICD-KICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUF1","description":"ICD-OKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRA0","description":"ICD-CIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBA1","description":"ICD-KEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0940T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","description":"CPT-0940T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIA1","description":"ICD-EGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plasma fresh frozen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86927","description":"Plasma fresh frozen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEA0","description":"ICD-JBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUC1","description":"ICD-ICUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQC0","description":"ICD-KCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing complete lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81372","description":"Hla i typing complete lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt recvng antivir txmnt hepc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4150F","description":"Pt recvng antivir txmnt hepc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOD0","description":"ICD-CBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEB0","description":"ICD-FFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCF0","description":"ICD-MCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECF1","description":"ICD-CECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Metacarp fx orthosis pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3917","description":"Metacarp fx orthosis pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse upper gi structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47721","description":"Fuse upper gi structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX42","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYD0","description":"ICD-KCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anticoagulant mgmt initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99363","description":"Anticoagulant mgmt initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA41","description":"High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBF1","description":"ICD-BHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFD0","description":"ICD-OAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMA1","description":"ICD-GEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACE0","description":"ICD-MACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVC0","description":"ICD-OHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRD1","description":"ICD-PCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for cholangiogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47532","description":"Injection for cholangiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch for bar w lk fl/fltr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4423","description":"Ost pch for bar w lk fl/fltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPD0","description":"ICD-FDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1809","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","description":"HCPCS-J1809","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSD0","description":"ICD-KHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAB1","description":"ICD-BFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tumor cell deplete of harvst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38211","description":"Tumor cell deplete of harvst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pet imaging initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0252","description":"Pet imaging initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB256","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chore services per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5120","description":"Chore services per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Sequencing Of Paired Malignant And Normal Dna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marrow_ Comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0297U","description":"Oncology (Pan Tumor)_ Whole Genome Sequencing Of Paired Malignant And Normal Dna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marrow_ Comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl batt silver oxide 1.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0601","description":"Repl batt silver oxide 1.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam propulsion tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2218","description":"Foam propulsion tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1 pc ost pouch w filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5056","description":"1 pc ost pouch w filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nose allergy test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95065","description":"Nose allergy test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDF1","description":"ICD-KBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc thigh/knee tum deep <5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27328","description":"Exc thigh/knee tum deep <5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15944","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCD1","description":"ICD-NDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAF1","description":"ICD-GAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht arm adult plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4009","description":"Cast sup sht arm adult plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIE0","description":"ICD-MBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace g-j tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49452","description":"Replace g-j tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC05","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXE0","description":"ICD-KAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36011","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHC0","description":"ICD-FHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diazepam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3360","description":"Diazepam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cftr gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81223","description":"Cftr gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srsf2 (Serine And Arginine-Rich Splicing Factor 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ P95H_ P95L)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81348","description":"Srsf2 (Serine And Arginine-Rich Splicing Factor 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ P95H_ P95L)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD225","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAA1","description":"ICD-EGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGME0","description":"ICD-BGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCF0","description":"ICD-NFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMF0","description":"ICD-FHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63702","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQD1","description":"ICD-LGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0542U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","description":"CPT-0542U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUD0","description":"ICD-IGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope procedure liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47379","description":"Laparoscope procedure liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68811","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gefitinib oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8565","description":"Gefitinib oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4340","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","description":"HCPCS-Q4340","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSF0","description":"ICD-PCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pressure pneum appl full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0671","description":"Pressure pneum appl full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXD0","description":"ICD-KEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEE0","description":"ICD-IFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rheumatoid factor quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86431","description":"Rheumatoid factor quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med ind for induction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9361","description":"Med ind for induction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited occlusal adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9951","description":"Limited occlusal adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1A","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo radical nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50545","description":"Laparo radical nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Statin med pres at disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8816","description":"Statin med pres at disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate t1no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9077","description":"Onc dx prostate t1no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26645","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPB1","description":"ICD-CIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1085","description":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10B","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indwelling catheter special","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4340","description":"Indwelling catheter special","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0029","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc ref upper gi endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3132F","description":"Doc ref upper gi endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLB0","description":"ICD-KCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEC0","description":"ICD-BEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAC0","description":"ICD-AHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth procedure on mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17051","description":"Anesth procedure on mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPB1","description":"ICD-JFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician_ reason not","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1002","description":"Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician_ reason not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Device evaluation and interrogation of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ including reprogramming and visual training_ when performed_ wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0473T","description":"Device evaluation and interrogation of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ including reprogramming and visual training_ when performed_ wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prep cadaver renal allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50323","description":"Prep cadaver renal allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1197","description":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us guide intraop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76998","description":"Us guide intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSF1","description":"ICD-GDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKD1","description":"ICD-JHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar derotation pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1240","description":"Lumbar derotation pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBA1","description":"ICD-EBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUC1","description":"ICD-IFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8H","description":"Low Rehab_ ADL Index 0-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reopen fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58345","description":"Reopen fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Powered air flotation bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0193","description":"Powered air flotation bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45051","description":"Anesth surgery of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTB1","description":"ICD-MJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap ins device for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49327","description":"Lap ins device for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43360","description":"Gastrointestinal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Central dexa ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3096F","description":"Central dexa ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYE1","description":"ICD-HEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9941","description":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7554","description":"Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADF0","description":"ICD-IADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert epicard eltrd endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33203","description":"Insert epicard eltrd endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUC0","description":"ICD-CGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ non-cor_ tem w/o del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2617","description":"Stent_ non-cor_ tem w/o del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6058","description":"Abutment supported crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg_ cryopreservation_ storage)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0538T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg_ cryopreservation_ storage)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYB0","description":"ICD-GHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOF0","description":"ICD-LFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHF1","description":"ICD-NHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat elevation sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2300","description":"Pwr seat elevation sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBB1","description":"ICD-OGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00170","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","description":"CPT-00170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional_ per calendar month. (list separately in additio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3003","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional_ per calendar month. (list separately in additio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBD0","description":"ICD-CFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTA0","description":"ICD-AGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVF1","description":"ICD-GGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mech hip extension assist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5855","description":"Mech hip extension assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE146","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASE1","description":"ICD-LASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL12","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interdental wiring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21497","description":"Interdental wiring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQC1","description":"ICD-PIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28630","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8X","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albumin ischemia modified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82045","description":"Albumin ischemia modified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBA1","description":"ICD-KFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCF1","description":"ICD-NGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pms2 gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81319","description":"Pms2 gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISB0","description":"ICD-OISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUA0","description":"ICD-JGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRD0","description":"ICD-DDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Omeza Collagen Matrix_ per 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2014","description":"Omeza Collagen Matrix_ per 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGC1","description":"ICD-NLGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18D","description":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29720","description":"Repair of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0301","description":"HCPCS-A0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19294","description":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEF1","description":"ICD-KEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi-precision attachment - placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6192","description":"Semi-precision attachment - placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWE1","description":"ICD-PLWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icd counseling provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4470F","description":"Icd counseling provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJF0","description":"ICD-KDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQE0","description":"ICD-DEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILE1","description":"ICD-GILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physical medicine procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97799","description":"Physical medicine procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bevacizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9035","description":"Bevacizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx dprsd zygomatic arch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21356","description":"Opn tx dprsd zygomatic arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59320","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAB1","description":"ICD-OEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01180","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01180","description":"CPT-01180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMB0","description":"ICD-GCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQE0","description":"ICD-LHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1552","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","description":"HCPCS-J1552","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50280","description":"Removal of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without contrast material; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77047","description":"Magnetic resonance imaging_ breast_ without contrast material; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOD1","description":"ICD-CBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSC0","description":"ICD-HGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBA1","description":"ICD-MLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 3 xhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0855","description":"Pwc gp 3 xhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBF0","description":"ICD-IIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray bile/panc endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74330","description":"X-ray bile/panc endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj for sacroiliac jt anesth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0260","description":"Inj for sacroiliac jt anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGB0","description":"ICD-BEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETB0","description":"ICD-CETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB41","description":"High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHE1","description":"ICD-GAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80420","description":"Dexamethasone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSB0","description":"ICD-DCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPE1","description":"ICD-KEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWF1","description":"ICD-LGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe heel thomas extend to b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3470","description":"Shoe heel thomas extend to b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Loxapine_ inhalation powder_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9497","description":"Loxapine_ inhalation powder_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part hand thumb rem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6000","description":"Part hand thumb rem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 20.1-30.0","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12056","description":"Intmd rpr face/mm 20.1-30.0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHE0","description":"ICD-JBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Who nontorsion jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3916","description":"Who nontorsion jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHD1","description":"ICD-OHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraop colon lavage add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44701","description":"Intraop colon lavage add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMC1","description":"ICD-NHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1424","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","description":"HCPCS-M1424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of psa complexed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84152","description":"Assay of psa complexed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB231","description":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67025","description":"Replace eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHB0","description":"ICD-JBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXA1","description":"ICD-KEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig geno no antvir tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8458","description":"Pt inelig geno no antvir tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53415","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frame typ sock above elb/dis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6688","description":"Frame typ sock above elb/dis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thorax stereo rad targetw/tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32701","description":"Thorax stereo rad targetw/tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0517U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","description":"CPT-0517U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ue triple control harness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6677","description":"Ue triple control harness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKB0","description":"ICD-JFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sleeve pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32442","description":"Sleeve pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHE0","description":"ICD-GHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj melphalan hydrochl 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9245","description":"Inj melphalan hydrochl 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKC1","description":"ICD-BHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHA1","description":"ICD-BAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHF0","description":"ICD-GHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12B","description":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHB0","description":"ICD-ACHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC216","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion_ subcutaneous cardiac rhythm monitor_ including programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33285","description":"Insertion_ subcutaneous cardiac rhythm monitor_ including programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEA1","description":"ICD-EBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFND0","description":"ICD-JFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRC1","description":"ICD-PKRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPA1","description":"ICD-NFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQC0","description":"ICD-PBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHD1","description":"ICD-MEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown 3/4 porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2783","description":"Crown 3/4 porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp axillary-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35621","description":"Art byp axillary-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Butorphanol tartrate 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0595","description":"Butorphanol tartrate 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3C","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75726","description":"Artery x-rays abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLF0","description":"ICD-BDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLF0","description":"ICD-OGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKA1","description":"ICD-FFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10C","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMA0","description":"ICD-GFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ translumin angio laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1885","description":"Cath_ translumin angio laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKF1","description":"ICD-KAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGE1","description":"ICD-FBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTD0","description":"ICD-NFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise/drain eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68020","description":"Incise/drain eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACD0","description":"ICD-BACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNC1","description":"ICD-FCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFC1","description":"ICD-BGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARE0","description":"ICD-KARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA250","description":"Reduced Physical Function _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of upper eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15823","description":"Revision of upper eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHED1","description":"ICD-MHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of wrist prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25251","description":"Removal of wrist prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21082","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSD0","description":"ICD-OJSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMA0","description":"ICD-EIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFA0","description":"ICD-OAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBC0","description":"ICD-AFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVA0","description":"ICD-NGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99243","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55710","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","description":"CPT-55710","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWE1","description":"ICD-CBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal fluid drainage w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59074","description":"Fetal fluid drainage w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25C","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg strap h style each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0039","description":"Leg strap h style each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCB0","description":"ICD-NFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES310","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Beta pres or already taking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9189","description":"Beta pres or already taking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMA0","description":"ICD-IAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMA1","description":"ICD-BEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQE0","description":"ICD-DFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHE0","description":"ICD-OBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWE1","description":"ICD-PGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63045","description":"Remove spine lamina 1 crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29900","description":"Mcp joint arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHF0","description":"ICD-AGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIC1","description":"ICD-KHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vag hyst w/urinary repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58267","description":"Vag hyst w/urinary repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJB1","description":"ICD-GDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAF1","description":"ICD-KGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Family stabilization 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9482","description":"Family stabilization 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWB0","description":"ICD-KDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBF0","description":"ICD-FDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15B","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Calculus spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82365","description":"Calculus spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33999","description":"Cardiac surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAF1","description":"ICD-BGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBD1","description":"ICD-KGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2110","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFA0","description":"ICD-BIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRD0","description":"ICD-PHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Azathioprine parenteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7501","description":"Azathioprine parenteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB43","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corf skilled nursing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0128","description":"Corf skilled nursing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Min hd traum gcs=15 w/ct ed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9530","description":"Min hd traum gcs=15 w/ct ed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJC0","description":"ICD-JEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTF0","description":"ICD-MFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand with single or double upright(s)_ includes microproce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8701","description":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand with single or double upright(s)_ includes microproce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDE0","description":"ICD-KIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDF0","description":"ICD-KIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTB1","description":"ICD-EGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I & d vaginal hematoma pp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57022","description":"I & d vaginal hematoma pp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNF0","description":"ICD-OJNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flowcytometry/read 2-8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88187","description":"Flowcytometry/read 2-8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone/skin graft iliac crest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20970","description":"Bone/skin graft iliac crest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_yttrium-90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2616","description":"Brachytx_ non-str_yttrium-90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAC0","description":"ICD-AFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE251","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLB1","description":"ICD-ADLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7176","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7176","description":"HCPCS-J7176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDD0","description":"ICD-IEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOF1","description":"ICD-DDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL21","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3273F","description":"High risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99212","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD216","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJC1","description":"ICD-NCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBE1","description":"ICD-GBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46999","description":"Anus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPA0","description":"ICD-NHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIB0","description":"ICD-IDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPD0","description":"ICD-NDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHME1","description":"ICD-KHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA05","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB31","description":"ICD-4LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9465","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAID1","description":"ICD-BAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWB1","description":"ICD-ODWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDB1","description":"ICD-GDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy implant stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52282","description":"Cystoscopy implant stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Augmentation lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21127","description":"Augmentation lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACC1","description":"ICD-CACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bendamustine HCl (Bendeka)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9034","description":"Injection_ bendamustine HCl (Bendeka)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct lip with flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40527","description":"Reconstruct lip with flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAC1","description":"ICD-EEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMD1","description":"ICD-MHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHE0","description":"ICD-ECHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHD1","description":"ICD-IBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIA1","description":"ICD-ICIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42400","description":"Biopsy of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIB1","description":"ICD-MLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00792","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","description":"CPT-00792","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31610","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADA0","description":"ICD-JADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPD1","description":"ICD-OLPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ guselkumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9029","description":"Injection_ guselkumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDB0","description":"ICD-AGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDC1","description":"ICD-MBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28202","description":"Repair/graft of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERC1","description":"ICD-GERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mapcp demo state","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9151","description":"Mapcp demo state","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3A","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXC1","description":"ICD-GEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNB0","description":"ICD-ODNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGF1","description":"ICD-BIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJD1","description":"ICD-OJJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDB0","description":"ICD-EBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOB1","description":"ICD-HDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93018","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEC0","description":"ICD-FDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27532","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXC1","description":"ICD-OCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Puraply_ puraply antimic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9349","description":"Puraply_ puraply antimic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDD1","description":"ICD-CHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stoma absorptive cover","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5083","description":"Stoma absorptive cover","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20694","description":"Remove bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression wrap with adjustable straps_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6584","description":"Gradient compression wrap with adjustable straps_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHE0","description":"ICD-NAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ genital region_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6571","description":"Gradient compression garment_ genital region_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap colectomy part w/ileum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44205","description":"Lap colectomy part w/ileum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDC0","description":"ICD-BDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDD1","description":"ICD-EDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abortion (mpr)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59866","description":"Abortion (mpr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18F","description":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap proctopexy w/sig resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45402","description":"Lap proctopexy w/sig resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIA1","description":"ICD-EHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWF1","description":"ICD-DBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMA0","description":"ICD-OGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTB0","description":"ICD-BDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRC1","description":"ICD-HDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No unheal etoh user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9622","description":"No unheal etoh user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt disch home day #2 cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8834","description":"Pt disch home day #2 cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0611U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","description":"CPT-0611U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXF1","description":"ICD-ODXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supprelin la implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9226","description":"Supprelin la implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE212","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRA0","description":"ICD-DGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity medical tubing/lines enclosure or covering device_ restricts elbow range of motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0711","description":"Upper extremity medical tubing/lines enclosure or covering device_ restricts elbow range of motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALB1","description":"ICD-EALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFF1","description":"ICD-BEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFE1","description":"ICD-NCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA46","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEC0","description":"ICD-EGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWC0","description":"ICD-DIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQA0","description":"ICD-PJQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPF0","description":"ICD-NIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUF1","description":"ICD-GBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8I","description":"Medium Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEA0","description":"ICD-KBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Addition to lower extremity prosthesis_ endoskeletal_ knee disarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5926","description":"Addition to lower extremity prosthesis_ endoskeletal_ knee disarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUB1","description":"ICD-EGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of hip socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27120","description":"Reconstruction of hip socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intens cardiac rehab no exer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0423","description":"Intens cardiac rehab no exer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15931","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nutritional counseling_ diet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9470","description":"Nutritional counseling_ diet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject for lymphatic x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38790","description":"Inject for lymphatic x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHA1","description":"ICD-GHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmv antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86645","description":"Cmv antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy by infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0084","description":"Chemotherapy by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBME0","description":"ICD-GBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; initial single probe stain p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0851T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; initial single probe stain p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove part thorax vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22101","description":"Remove part thorax vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove femur lesion/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27356","description":"Remove femur lesion/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFB0","description":"ICD-NBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cltx post ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27767","description":"Cltx post ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCB0","description":"ICD-FCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDE0","description":"ICD-NFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ fresh or frozen tissue or cells_ report of specific gene rearra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013U","description":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ fresh or frozen tissue or cells_ report of specific gene rearra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Restore/remodel ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33548","description":"Restore/remodel ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unsched dialysis esrd pt hos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0257","description":"Unsched dialysis esrd pt hos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of rib fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21812","description":"Treatment of rib fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical prostatectomy_ simple subtotal (including control of postoperative bleeding_ vasectomy_ meatotomy_ urethral calibration and/or dilation_ and internal ure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55867","description":"Laparoscopy_ surgical prostatectomy_ simple subtotal (including control of postoperative bleeding_ vasectomy_ meatotomy_ urethral calibration and/or dilation_ and internal ure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBE0","description":"ICD-MDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMB0","description":"ICD-GHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWB0","description":"ICD-OAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDE0","description":"ICD-OFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRE1","description":"ICD-LDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRB1","description":"ICD-HIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx cml dx status unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9139","description":"Onc dx cml dx status unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair bearings","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2210","description":"Wheelchair bearings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDC0","description":"ICD-GHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEA1","description":"ICD-NGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change of windpipe airway","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31502","description":"Change of windpipe airway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLF0","description":"ICD-CFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colon ca scrn; barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0120","description":"Colon ca scrn; barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0617U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","description":"CPT-0617U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brow wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15826","description":"Removal of brow wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric mucosa imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78261","description":"Gastric mucosa imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt doc no events on discharg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8907","description":"Pt doc no events on discharg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26185","description":"Remove finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTE0","description":"ICD-CFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) (Nuwiq)_ 1 I.U.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9138","description":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) (Nuwiq)_ 1 I.U.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGD0","description":"ICD-OEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES325","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopic sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92614","description":"Laryngoscopic sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGC0","description":"ICD-NCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Number of patients not screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1208","description":"Number of patients not screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADD1","description":"ICD-IADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meniscal trnspl knee w/scpe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29868","description":"Meniscal trnspl knee w/scpe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00625","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","description":"CPT-00625","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWA1","description":"ICD-ODWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27151","description":"Incision of hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0789T","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S)_ (Remote) Up To 30 Days; Implantable Cardiovascular Physiologic Monitor System_ Implantable Loop Recorder System_ Or Subcutaneous Cardiac Rh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2066","description":"Interrogation Device Evaluation(S)_ (Remote) Up To 30 Days; Implantable Cardiovascular Physiologic Monitor System_ Implantable Loop Recorder System_ Or Subcutaneous Cardiac Rh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMA0","description":"ICD-MKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urethrlys transvag w/ scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53500","description":"Urethrlys transvag w/ scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDE0","description":"ICD-IGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBA0","description":"ICD-BCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin peel therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17360","description":"Skin peel therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct interprete tmj","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0368","description":"Cone beam ct interprete tmj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise submaxillary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42440","description":"Excise submaxillary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAB0","description":"ICD-OGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRB1","description":"ICD-GIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPA0","description":"ICD-CCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA22","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQC1","description":"ICD-KEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Technetium tc99m arcitumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9568","description":"Technetium tc99m arcitumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSF0","description":"ICD-DHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES351","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cefepime hcl for injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0692","description":"Cefepime hcl for injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A5101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5101","description":"HCPCS-A5101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sleeve lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32486","description":"Sleeve lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVC0","description":"ICD-GEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit tpn 3 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9367","description":"Hit tpn 3 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMA0","description":"ICD-BAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARC0","description":"ICD-KARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6061","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUB0","description":"ICD-BBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJC0","description":"ICD-CDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPE1","description":"ICD-OKPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICC0","description":"ICD-KICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVD0","description":"ICD-GAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screen depression performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3725F","description":"Screen depression performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGD0","description":"ICD-NDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALF1","description":"ICD-FALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKD1","description":"ICD-BIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSE1","description":"ICD-LCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEA1","description":"ICD-CIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHE1","description":"ICD-MIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEB0","description":"ICD-GGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 8 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP08","description":"Auto.test pane pricing code_ 8 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht inj antiemetic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9370","description":"Ht inj antiemetic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITA0","description":"ICD-NITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elevated or hypertensive blood pressure reading documented_ indicated follow-up not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1279","description":"Elevated or hypertensive blood pressure reading documented_ indicated follow-up not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKE0","description":"ICD-FCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26750","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frozen blood thaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86931","description":"Frozen blood thaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2204","description":"Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC217","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNB1","description":"ICD-ODNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDC1","description":"ICD-ICDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx pancreatic unknwn nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9108","description":"Onc dx pancreatic unknwn nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKD0","description":"ICD-NAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ genomic analysis panel_ variant analysis of 25 genes with reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0434U","description":"Drug metabolism (adverse drug reactions and drug response)_ genomic analysis panel_ variant analysis of 25 genes with reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA07","description":"Ultra High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; review_ interpretation_ report by physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0478T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; review_ interpretation_ report by physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1261","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpnt stay radiolabeled item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9898","description":"Inpnt stay radiolabeled item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0858","description":"Pwc gp3 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSC0","description":"ICD-HBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - periapical radiographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0374","description":"intraoral tomosynthesis - periapical radiographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFB1","description":"ICD-OGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGC1","description":"ICD-NAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKC1","description":"ICD-NIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBD0","description":"ICD-MJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEA0","description":"ICD-MCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYC0","description":"ICD-CGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICB1","description":"ICD-NICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWE0","description":"ICD-HEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57720","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tib/per revasc stnt & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37235","description":"Tib/per revasc stnt & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC246","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0931T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","description":"CPT-0931T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Posturography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92548","description":"Posturography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC11","description":"ICD-2KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22830","description":"Exploration of spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-rays at surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74301","description":"X-rays at surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBC1","description":"ICD-BEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90695","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","description":"CPT-90695","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lice treatment_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9180","description":"Lice treatment_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adalimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0135","description":"Adalimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8I","description":"High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breath recording infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94772","description":"Breath recording infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCE1","description":"ICD-ADCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUA1","description":"ICD-MCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88305","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB21","description":"ICD-3BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploratory shoulder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23040","description":"Exploratory shoulder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25C","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIF0","description":"ICD-CCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28C","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJF0","description":"ICD-KEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQE1","description":"ICD-LBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; 25 Cc Or Less Injectate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15773","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; 25 Cc Or Less Injectate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB260","description":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAB0","description":"ICD-BBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp vhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0827","description":"Pwc gp vhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap enterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44202","description":"Lap enterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEA0","description":"ICD-CFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adenosine inj 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0153","description":"Adenosine inj 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33476","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC126","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration carotid artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35701","description":"Exploration carotid artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSA1","description":"ICD-HCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67924","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBF0","description":"ICD-AIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDE1","description":"ICD-EGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECA0","description":"ICD-AECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQA0","description":"ICD-OEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTB0","description":"ICD-NBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator chi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3206","description":"Hightop w/ supp/pronator chi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB155","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVC1","description":"ICD-JCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denileukin diftitox inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9160","description":"Denileukin diftitox inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIE0","description":"ICD-OBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 1","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA26","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKB0","description":"ICD-NLKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAD0","description":"ICD-AAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLB0","description":"ICD-CFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNC0","description":"ICD-KHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Balloon dilate urtrl strix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50706","description":"Balloon dilate urtrl strix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYF0","description":"ICD-OAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44320","description":"Colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRE1","description":"ICD-OLRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTC1","description":"ICD-MJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA15","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHE0","description":"ICD-FDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAD1","description":"ICD-CEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Most Recent Hemoglobin A1C (Hba1C) Level 7.0 To 9.0%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2089","description":"Most Recent Hemoglobin A1C (Hba1C) Level 7.0 To 9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot inhibit prot s total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85305","description":"Clot inhibit prot s total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score hip < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8652","description":"Fun stat score hip < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHB0","description":"ICD-OIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of thigh muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27385","description":"Repair of thigh muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52300","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOA1","description":"ICD-KCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of lymph channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38308","description":"Incision of lymph channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove maxilla cyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21048","description":"Remove maxilla cyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64837","description":"Repair nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12C","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDD1","description":"ICD-KHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair artery rupture spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35112","description":"Repair artery rupture spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9746","description":"Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHD1","description":"ICD-BCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1074T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1074T","description":"CPT-1074T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEB0","description":"ICD-CEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54065","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26770","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIME0","description":"ICD-IIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWB0","description":"ICD-DEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE150","description":"Clinically Complex _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23C","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rerepair ing hernia reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49520","description":"Rerepair ing hernia reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYA0","description":"ICD-OHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24545","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4593","description":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (e.g._ monkeypox virus_ cowpox virus_ vaccinia virus)_ amplified probe technique_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87593","description":"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (e.g._ monkeypox virus_ cowpox virus_ vaccinia virus)_ amplified probe technique_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Degarelix injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9155","description":"Degarelix injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEE1","description":"ICD-OIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHC0","description":"ICD-NBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast prosthes w/o adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8030","description":"Breast prosthes w/o adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Protozoa antibody nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86753","description":"Protozoa antibody nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSC0","description":"ICD-OFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1735","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1735","description":"HCPCS-C1735","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC155","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJA0","description":"ICD-JEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAE1","description":"ICD-KAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove carotid body lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60600","description":"Remove carotid body lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUF0","description":"ICD-EFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAA1","description":"ICD-CEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECB0","description":"ICD-NECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDF1","description":"ICD-CFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBF1","description":"ICD-NLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLD1","description":"ICD-NBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPD0","description":"ICD-CAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHF0","description":"ICD-ABHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures immediat mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5140","description":"Dentures immediat mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8X","description":"Medium Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPC0","description":"ICD-KIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHB0","description":"ICD-OFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGE1","description":"ICD-CGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTA1","description":"ICD-NBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLC0","description":"ICD-ACLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKF1","description":"ICD-KIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDD0","description":"ICD-NJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test 2 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95861","description":"Muscle test 2 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUF1","description":"ICD-FEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12B","description":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95719","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part hand no fingers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6020","description":"Part hand no fingers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt inelig rna no antvir tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8460","description":"Pt inelig rna no antvir tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Single lens spectacle mount","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2610","description":"Single lens spectacle mount","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKC1","description":"ICD-ODKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBB0","description":"ICD-BIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hkafo torsion unilat rot str","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2070","description":"Hkafo torsion unilat rot str","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myringotomy laser-assist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2225","description":"Myringotomy laser-assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ moxetumomab pasudotox-tdfx_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9045","description":"Injection_ moxetumomab pasudotox-tdfx_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnioamp-mp_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4250","description":"Amnioamp-mp_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0B","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB21","description":"ICD-4CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58563","description":"Hysteroscopy ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECD0","description":"ICD-CECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound prep trk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15002","description":"Wound prep trk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFD1","description":"ICD-CHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Install spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63741","description":"Install spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open tx nose fx uncomplicatd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21325","description":"Open tx nose fx uncomplicatd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRE0","description":"ICD-DFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGE0","description":"ICD-NHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0301","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0301","description":"CDT-D0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attempted vbac delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59618","description":"Attempted vbac delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDED1","description":"ICD-GDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVA1","description":"ICD-CCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg monitor technol attended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95956","description":"Eeg monitor technol attended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIED0","description":"ICD-KIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ pacing_ transesoph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1756","description":"Cath_ pacing_ transesoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIF0","description":"ICD-GCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9909","description":"Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compres burngarment chinstrp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6502","description":"Compres burngarment chinstrp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystometrogram w/vp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51728","description":"Cystometrogram w/vp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 3 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP03","description":"Auto.test pane pricing code_ 3 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAF1","description":"ICD-EGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHME0","description":"ICD-MHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFB0","description":"ICD-OJFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJE1","description":"ICD-CEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBA0","description":"ICD-EBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"American amnion ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4306","description":"American amnion ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below knee wood socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5639","description":"Below knee wood socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8A","description":"High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood methemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83045","description":"Blood methemoglobin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Appro rad ds dvcs techs docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6040F","description":"Appro rad ds dvcs techs docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10D","description":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFE1","description":"ICD-OFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body-worn bilat hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5100","description":"Body-worn bilat hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Toxoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86777","description":"Toxoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo spiral molded to pt plas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1950","description":"Afo spiral molded to pt plas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFA0","description":"ICD-FIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATC0","description":"ICD-NATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAB0","description":"ICD-MJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost skn barr extnd >4 sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4410","description":"Ost skn barr extnd >4 sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETD1","description":"ICD-NETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scintimammography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8080","description":"Scintimammography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sps forearm device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1818","description":"Sps forearm device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHE1","description":"ICD-NCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHE1","description":"ICD-OIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Voice d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9173","description":"Voice d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTD1","description":"ICD-BHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Commode chair with detacharm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0165","description":"Commode chair with detacharm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Riboflavin 5_-phosphate_ ophthalmic solution_ up to 3 mL","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2787","description":"Riboflavin 5_-phosphate_ ophthalmic solution_ up to 3 mL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0504U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","description":"CPT-0504U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen skin test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3031","description":"Collagen skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24586","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRF1","description":"ICD-LCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKA0","description":"ICD-CFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Thoracoscopic_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33269","description":"Exclusion Of Left Atrial Appendage_ Thoracoscopic_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTA0","description":"ICD-KBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHA0","description":"ICD-EIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVC1","description":"ICD-GCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUC0","description":"ICD-ODUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOD1","description":"ICD-LGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTF1","description":"ICD-BCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMD1","description":"ICD-KGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOA0","description":"ICD-DGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m sulfur colloid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9541","description":"Tc99m sulfur colloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRE0","description":"ICD-GHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HER2/neu positive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9830","description":"HER2/neu positive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJD0","description":"ICD-GFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incid ct liver/kid/adre fdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9547","description":"Incid ct liver/kid/adre fdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOE1","description":"ICD-LGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSC0","description":"ICD-CHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOA0","description":"ICD-GGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA211","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imp/abut fixed dent part max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6116","description":"Imp/abut fixed dent part max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACD0","description":"ICD-OACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oct brst/node i&r per spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0352T","description":"Oct brst/node i&r per spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDME1","description":"ICD-IDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject for sacroiliac joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0259","description":"Inject for sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMF1","description":"ICD-MHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41010","description":"Incision of tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj aspiration joint fluid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7870","description":"Tmj aspiration joint fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1108T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1108T","description":"CPT-1108T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUE1","description":"ICD-NHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc order anti-plat or p2y12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9609","description":"Doc order anti-plat or p2y12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36245","description":"Ins cath abd/l-ext art 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC217","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRE0","description":"ICD-CDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYB0","description":"ICD-KEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No syst antimicrobial thx rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4132F","description":"No syst antimicrobial thx rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJC1","description":"ICD-GAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46740","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCA1","description":"ICD-KGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQF1","description":"ICD-PAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01740","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","description":"CPT-01740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Health Help_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1017","description":"Clinical decision support mechanism Health Help_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Follow-Up And Mrs Score Not Assessed At 90 Days Following Endovascular Stroke Intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0046","description":"Clinical Follow-Up And Mrs Score Not Assessed At 90 Days Following Endovascular Stroke Intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluocinolone acetonide implt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7311","description":"Fluocinolone acetonide implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKE0","description":"ICD-ODKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10C","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLC0","description":"ICD-NLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine fusion combined","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22633","description":"Lumbar spine fusion combined","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENC1","description":"ICD-NENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLE1","description":"ICD-CCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMA1","description":"ICD-JIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELF0","description":"ICD-FELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endocrine nuclear procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78099","description":"Endocrine nuclear procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy tubal cautery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58670","description":"Laparoscopy tubal cautery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24A","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC21","description":"ICD-1IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leg perthes orth toronto typ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1700","description":"Leg perthes orth toronto typ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAF1","description":"ICD-MFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABE0","description":"ICD-AABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69644","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGD0","description":"ICD-NKGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMC0","description":"ICD-MIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61536","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAD1","description":"ICD-OIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLD1","description":"ICD-EDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDA0","description":"ICD-MBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical opening of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43500","description":"Surgical opening of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLB0","description":"ICD-EFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMC0","description":"ICD-JDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC250","description":"Special Care High _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with stress im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9763","description":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with stress im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYE1","description":"ICD-KDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radical resection of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24149","description":"Radical resection of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANF0","description":"ICD-CANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound closure by adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0168","description":"Wound closure by adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABE0","description":"ICD-IABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIF0","description":"ICD-FIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd us transmural injxn/mark","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43253","description":"Egd us transmural injxn/mark","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA31","description":"ICD-4CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARF0","description":"ICD-OARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALC0","description":"ICD-FALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPE0","description":"ICD-KGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73501","description":"X-ray exam hip uni 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHE1","description":"ICD-JAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAD0","description":"ICD-MKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETA0","description":"ICD-BETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUC0","description":"ICD-IAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE230","description":"Clinically Complex _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18I","description":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISD1","description":"ICD-CISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47539","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTC0","description":"ICD-OBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on facial bones or skull; radical surgery (includ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0127U","description":"Anesthesia for procedures on facial bones or skull; radical surgery (includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; partial (anterior)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31254","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; partial (anterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthrodesis sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27279","description":"Arthrodesis sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject trigger points 3/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20553","description":"Inject trigger points 3/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI w/o fol w/cont_ brst_ un","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8905","description":"MRI w/o fol w/cont_ brst_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA14","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27552","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AstraZeneca COVID-19 vaccine administration — second dose","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1706","description":"AstraZeneca COVID-19 vaccine administration — second dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87389","description":"IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHC0","description":"ICD-KGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTA1","description":"ICD-EBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGE0","description":"ICD-GDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42890","description":"Partial removal of pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytogenetics dna probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88271","description":"Cytogenetics dna probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0682","description":"Non-pneumatic sequential compression garment_ full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc spermatic cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55559","description":"Laparo proc spermatic cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28X","description":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung transplant with bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32852","description":"Lung transplant with bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEE1","description":"ICD-EBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); each additional 30 minutes of technicians","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0374T","description":"Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); each additional 30 minutes of technicians","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARD0","description":"ICD-PARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77280","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLD1","description":"ICD-ECLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0D","description":"Medium Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pentastarch 10% solution","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2513","description":"Pentastarch 10% solution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFC1","description":"ICD-OEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping)_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0314U","description":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping)_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cylinder tank carrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2208","description":"Cylinder tank carrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBF0","description":"ICD-MBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHD1","description":"ICD-CHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Realignment of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27455","description":"Realignment of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJF1","description":"ICD-NIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove skin tags add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11201","description":"Remove skin tags add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCD1","description":"ICD-CBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percut ablate liver rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47382","description":"Percut ablate liver rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGD1","description":"ICD-FFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nicotine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6055","description":"Nicotine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGF0","description":"ICD-JHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ank-foot sys dors-plant flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5973","description":"Ank-foot sys dors-plant flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALD1","description":"ICD-MALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group behave couns 2-10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0473","description":"Group behave couns 2-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYB1","description":"ICD-OHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQD1","description":"ICD-GBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYC0","description":"ICD-ODYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB50","description":"Ultra High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFD0","description":"ICD-CAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPC1","description":"ICD-JIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLF1","description":"ICD-EBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0128U","description":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYC0","description":"ICD-DCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"removal of implant body not requiring bone removal or flap elevation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6105","description":"removal of implant body not requiring bone removal or flap elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLC1","description":"ICD-KDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCC0","description":"ICD-KFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFC0","description":"ICD-NJFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQE1","description":"ICD-KBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEE0","description":"ICD-EBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pin knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26706","description":"Pin knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove lamina/facets lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63012","description":"Remove lamina/facets lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rx tst def 09+ rx/sbsts ur reprt pres/abs ea rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0082U","description":"Rx tst def 09+ rx/sbsts ur reprt pres/abs ea rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIED0","description":"ICD-OIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8914","description":"Mra w/o fol w/cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUB1","description":"ICD-FCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"New lenses in pts old frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0595","description":"New lenses in pts old frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25151","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0955T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","description":"CPT-0955T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2109","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35081","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27519","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Most recent BP is less than or equal to 140/90 mm Hg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9788","description":"Most recent BP is less than or equal to 140/90 mm Hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNA1","description":"ICD-CFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVC1","description":"ICD-FHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sales tax","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9985","description":"Sales tax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8X","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4393","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","description":"HCPCS-Q4393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB144","description":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATB0","description":"ICD-IATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYD0","description":"ICD-LBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cromolyn sodium comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7632","description":"Cromolyn sodium comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJE1","description":"ICD-JEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHA0","description":"ICD-GAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58152","description":"Total hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 60 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0149U","description":"Drug assay_ definitive_ 60 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40820","description":"Treatment of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 1 visit p mo <2yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90953","description":"Esrd serv 1 visit p mo <2yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67412","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILA0","description":"ICD-FILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYC0","description":"ICD-HIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47130","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCF0","description":"ICD-CDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lyme dis dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87477","description":"Lyme dis dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percut bx lung/mediastinum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32405","description":"Percut bx lung/mediastinum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADB1","description":"ICD-NADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0232","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0232","description":"HCPCS-M0232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITB0","description":"ICD-FITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical boot each junior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3211","description":"Surgical boot each junior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNF1","description":"ICD-JCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCA1","description":"ICD-NBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJC0","description":"ICD-BEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUE0","description":"ICD-MDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKD1","description":"ICD-JDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73085","description":"Contrast x-ray of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIE0","description":"ICD-KEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGB1","description":"ICD-FFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0988T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","description":"CPT-0988T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording and storage_ data scanning with signal extraction_ technical analysis and result","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0475T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording and storage_ data scanning with signal extraction_ technical analysis and result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHB1","description":"ICD-ODHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYB1","description":"ICD-CEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC251","description":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHC0","description":"ICD-ABHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASD1","description":"ICD-GASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nail plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11730","description":"Removal of nail plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE245","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10D","description":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art pancreas system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1034","description":"Art pancreas system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCD1","description":"ICD-GHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove anal fist subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46270","description":"Remove anal fist subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXE1","description":"ICD-NKXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0A","description":"Very High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Renal abscess open drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50020","description":"Renal abscess open drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGD1","description":"ICD-JIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNF1","description":"ICD-FFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADB1","description":"ICD-FADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27758","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3D","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKF1","description":"ICD-CBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAF1","description":"ICD-KIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWD1","description":"ICD-CAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj heparin sodium per 1000u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1644","description":"Inj heparin sodium per 1000u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automatic bp monitor_ dial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4670","description":"Automatic bp monitor_ dial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKA0","description":"ICD-OIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICF1","description":"ICD-EICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54700","description":"Drainage of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28G","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCC1","description":"ICD-EFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIB1","description":"ICD-ICIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAC1","description":"ICD-IAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOE0","description":"ICD-PGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAE1","description":"ICD-NFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIC1","description":"ICD-EBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29876","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSC1","description":"ICD-LCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNF1","description":"ICD-BFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7553","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNE1","description":"ICD-JGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEC0","description":"ICD-MJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3502","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/replace knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27486","description":"Revise/replace knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYA0","description":"ICD-LAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O shoe add standard toe tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3550","description":"O shoe add standard toe tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOA0","description":"ICD-PHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFID0","description":"ICD-MFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGF1","description":"ICD-BHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAB1","description":"ICD-IHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA240","description":"Reduced Physical Function _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIC1","description":"ICD-OCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA11","description":"ICD-4AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQA1","description":"ICD-HGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraor complete film series","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0210","description":"Intraor complete film series","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNC1","description":"ICD-BHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tmj condyle","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7840","description":"Removal of tmj condyle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB34","description":"Very High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPC1","description":"ICD-BDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pegaptanib sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2503","description":"Pegaptanib sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4C","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWB0","description":"ICD-HHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIA1","description":"ICD-NBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74260","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathogen Test For Platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9987","description":"Pathogen Test For Platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAA1","description":"ICD-EEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFA1","description":"ICD-JIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Portable 02 contents_ gas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0443","description":"Portable 02 contents_ gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient is dysarthric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3762F","description":"Patient is dysarthric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC55","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47135","description":"Transplantation of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGA0","description":"ICD-GEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12A","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophageal capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91111","description":"Esophageal capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHID1","description":"ICD-BHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dimethyl sulfoxide 50% 50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1212","description":"Dimethyl sulfoxide 50% 50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODID1","description":"ICD-ODID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYB1","description":"ICD-OEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNB0","description":"ICD-FFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6540","description":"Gc stocking waistlngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEE0","description":"ICD-JHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYF0","description":"ICD-PKYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDF1","description":"ICD-IBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACD0","description":"ICD-EACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANA0","description":"ICD-FANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft fem-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35556","description":"Art byp grft fem-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWC0","description":"ICD-PGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBC1","description":"ICD-EFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25635","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLE1","description":"ICD-MFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJA1","description":"ICD-FCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWE1","description":"ICD-ODWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPC1","description":"ICD-FEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVA1","description":"ICD-JGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDE0","description":"ICD-BFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMF0","description":"ICD-ODMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVA1","description":"ICD-JCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mandible graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7950","description":"Mandible graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rna tstng hep c docd done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3218F","description":"Rna tstng hep c docd done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOB1","description":"ICD-HEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHD1","description":"ICD-NEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJE1","description":"ICD-JCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEE0","description":"ICD-EIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVE0","description":"ICD-JBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQF0","description":"ICD-CFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58559","description":"Hysteroscopy lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENA1","description":"ICD-OENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown full cast base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2791","description":"Crown full cast base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTA0","description":"ICD-MBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (RIV4)_ derived from recombinant DNA_ hemagglutinin (HA) protein only_ preservative and antibiotic free_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90682","description":"Influenza virus vaccine_ quadrivalent (RIV4)_ derived from recombinant DNA_ hemagglutinin (HA) protein only_ preservative and antibiotic free_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disability examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99456","description":"Disability examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAED1","description":"ICD-JAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNF1","description":"ICD-FCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE105","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUB0","description":"ICD-OBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEC1","description":"ICD-ADEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plasma volume multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78111","description":"Plasma volume multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tail bone ulcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15922","description":"Removal of tail bone ulcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMF0","description":"ICD-IFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKE1","description":"ICD-CHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0906T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","description":"CPT-0906T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA145","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHE0","description":"ICD-NFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLE0","description":"ICD-AHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGB1","description":"ICD-CHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMC0","description":"ICD-IAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1033","description":"Nonpneumatic sequential compression garment_ half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA254","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing warfarin or another FDA-approved anticoagulant (e.g._ atrial appendage device in place)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8968","description":"Documentation of medical reason(s) for not prescribing warfarin or another FDA-approved anticoagulant (e.g._ atrial appendage device in place)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement breastpump adpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4282","description":"Replacement breastpump adpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO lumbar intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an ade","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9733","description":"Patient unable to complete the FOTO lumbar intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an ade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMD1","description":"ICD-CDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUC1","description":"ICD-EHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEF0","description":"ICD-GGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc cncr 0/ia melan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3321F","description":"Ajcc cncr 0/ia melan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pouch absorbent material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4422","description":"Ost pouch absorbent material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment mouth roof lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42160","description":"Treatment mouth roof lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ho abduction hip adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1650","description":"Ho abduction hip adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQB1","description":"ICD-PIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61522","description":"Removal of brain abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYC0","description":"ICD-PKYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antipsychotics nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80344","description":"Antipsychotics nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seat lift for pt furn-non-el","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0629","description":"Seat lift for pt furn-non-el","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Incomplete Abortion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X2060","description":"Hospital Special Treatment Room Support Component (Hstrsc) Incomplete Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBB0","description":"ICD-IFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJB0","description":"ICD-OBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25D","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repeat drainage of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33011","description":"Repeat drainage of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHE0","description":"ICD-OGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIE0","description":"ICD-CFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPF0","description":"ICD-BGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSF0","description":"ICD-PFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNE1","description":"ICD-FGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0928T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","description":"CPT-0928T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTE1","description":"ICD-MKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSC0","description":"ICD-KCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33767","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIA1","description":"ICD-BHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADB1","description":"ICD-KADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE121","description":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ prothrombin complex concentrate_ human-lans_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7165","description":"Injection_ prothrombin complex concentrate_ human-lans_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXF0","description":"ICD-GIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESD1","description":"ICD-DESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEE0","description":"ICD-OJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB10","description":"High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHA0","description":"ICD-NGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2196","description":"Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ho w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3919","description":"Ho w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA24","description":"Medium Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXA1","description":"ICD-KHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLD0","description":"ICD-BBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA11","description":"ICD-3AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6557","description":"Gradient compression stocking_ thigh length_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWD0","description":"ICD-OKWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA21","description":"ICD-3JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVB0","description":"ICD-JGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUF1","description":"ICD-KFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc thigh/knee tum dep 5cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27339","description":"Exc thigh/knee tum dep 5cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thiethylperazine maleate10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0174","description":"Thiethylperazine maleate10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHD1","description":"ICD-EEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUB0","description":"ICD-NBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEC0","description":"ICD-MIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBD1","description":"ICD-ICBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leuprolide acetate suspnsion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9217","description":"Leuprolide acetate suspnsion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD113","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLD0","description":"ICD-EBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTF1","description":"ICD-BDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCC0","description":"ICD-NGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of feces/urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84577","description":"Assay of feces/urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained with concurrent CT examination of any structure contained in the c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0722T","description":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained with concurrent CT examination of any structure contained in the c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0615U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","description":"CPT-0615U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBE1","description":"ICD-OBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUB0","description":"ICD-OFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCD0","description":"ICD-JGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHF0","description":"ICD-OAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99350","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEF0","description":"ICD-KBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt screened for depression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1220F","description":"Pt screened for depression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCE0","description":"ICD-GCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67916","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay metallic 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2542","description":"Dental onlay metallic 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open/perq place stent ea add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37239","description":"Open/perq place stent ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEE0","description":"ICD-JIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTB1","description":"ICD-BGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLF1","description":"ICD-KGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB114","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJD0","description":"ICD-CDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKB1","description":"ICD-OCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 1 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64493","description":"Inj paravert f jnt l/s 1 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2409","description":"Fetal surg noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILC1","description":"ICD-JILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPE0","description":"ICD-GAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBD0","description":"ICD-MBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQC1","description":"ICD-HCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB146","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMB1","description":"ICD-AFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hymenotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56442","description":"Hymenotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYE1","description":"ICD-PIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00212","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","description":"CPT-00212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA11","description":"ICD-1AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCF0","description":"ICD-MDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phenotype infect agent drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87900","description":"Phenotype infect agent drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sgd prerec msg > 40 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2506","description":"Sgd prerec msg > 40 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIF0","description":"ICD-BBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLE1","description":"ICD-NJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUB1","description":"ICD-NEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQD0","description":"ICD-CHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB51","description":"Medium Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGF0","description":"ICD-NKGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVD0","description":"ICD-GCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJF1","description":"ICD-ODJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBA1","description":"ICD-BEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYD1","description":"ICD-LDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22C","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73080","description":"X-ray exam of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ ep_ cool-tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2630","description":"Cath_ ep_ cool-tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dyspnea mngmnt plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0535F","description":"Dyspnea mngmnt plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB10","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below knee surgical stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4500","description":"Below knee surgical stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Habil prevoc waiver per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2015","description":"Habil prevoc waiver per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWF1","description":"ICD-OJWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMF1","description":"ICD-GHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCC1","description":"ICD-GFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electron elbow child switch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7186","description":"Electron elbow child switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8X","description":"Low Rehab_ ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","description":"HCPCS-M1406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVD1","description":"ICD-KEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37286","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","description":"CPT-37286","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAE0","description":"ICD-NGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diet counsel at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9474","description":"Diet counsel at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXC1","description":"ICD-NEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYC1","description":"ICD-DAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA113","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Creation of arteriovenous fistula_ percutaneous; direct_ any site_ including all imaging and radiologic supervision and interpr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9754","description":"Creation of arteriovenous fistula_ percutaneous; direct_ any site_ including all imaging and radiologic supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy & polypectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44392","description":"Colonoscopy & polypectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXC0","description":"ICD-JDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGE1","description":"ICD-JDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull for surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61450","description":"Incise skull for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAD0","description":"ICD-EHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTB0","description":"ICD-ECTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18X","description":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMB1","description":"ICD-KFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cangrelor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9460","description":"Injection_ cangrelor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27177","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMB1","description":"ICD-IBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraop cyst eval trac inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9606","description":"Intraop cyst eval trac inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exam of vagina w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57420","description":"Exam of vagina w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGA0","description":"ICD-CIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periodontal medicament carrier with peripheral seal - laboratory processed - mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5996","description":"Periodontal medicament carrier with peripheral seal - laboratory processed - mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUF0","description":"ICD-KEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFD1","description":"ICD-KAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDD1","description":"ICD-OKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVF1","description":"ICD-OEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5143","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","description":"HCPCS-Q5143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQD0","description":"ICD-CFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_ without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_ without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00350","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","description":"CPT-00350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coude tip urinary catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4352","description":"Coude tip urinary catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26590","description":"Repair finger deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lead wires_ pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4557","description":"Lead wires_ pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICC0","description":"ICD-IICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQA0","description":"ICD-OLQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFD0","description":"ICD-GIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABD0","description":"ICD-OABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHE0","description":"ICD-IIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPE0","description":"ICD-BBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87449","description":"IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHD1","description":"ICD-GGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX56","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62327","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pinworm examinations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0113","description":"Pinworm examinations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWB1","description":"ICD-LCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vent mgmt inpat subq day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94003","description":"Vent mgmt inpat subq day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUA0","description":"ICD-JCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQE1","description":"ICD-PIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34471","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKD0","description":"ICD-KBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCB1","description":"ICD-NJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBC0","description":"ICD-JBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC130","description":"Special Care Low _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2193","description":"Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJE0","description":"ICD-JGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary pouch w/barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5071","description":"Urinary pouch w/barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUD0","description":"ICD-AGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQE0","description":"ICD-KAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXA0","description":"ICD-OAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIF1","description":"ICD-KIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGD1","description":"ICD-GIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIED1","description":"ICD-IIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1806","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1806","description":"CDT-D1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epilepsy Genomic Sequence Analysis Panel_ Must Include Analyses For Aldh7A1_ Cacna1A_ Cdkl5_ Chd2_ Gabrg2_ Grin2A_ Kcnq2_ Mecp2_ Pcdh19_ Polg_ Prrt2_ Scn1A_ Scn1B_ Scn2A_ Scn8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81419","description":"Epilepsy Genomic Sequence Analysis Panel_ Must Include Analyses For Aldh7A1_ Cacna1A_ Cdkl5_ Chd2_ Gabrg2_ Grin2A_ Kcnq2_ Mecp2_ Pcdh19_ Polg_ Prrt2_ Scn1A_ Scn1B_ Scn2A_ Scn8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of lingual tonsil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42870","description":"Excision of lingual tonsil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stomach surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43999","description":"Stomach surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGB0","description":"ICD-BIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQE0","description":"ICD-CAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess negative docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3341F","description":"Mammo assess negative docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ONC SOLID TUMOR 30 PRTN TRGT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174U","description":"ONC SOLID TUMOR 30 PRTN TRGT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81457","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGB0","description":"ICD-GAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIA1","description":"ICD-KAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAE1","description":"ICD-CGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUF1","description":"ICD-CFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC211","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1005T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","description":"CPT-1005T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVE0","description":"ICD-JIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronch thermoplsty 1 lobe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31660","description":"Bronch thermoplsty 1 lobe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFF1","description":"ICD-CDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0616U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","description":"CPT-0616U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq revasc byp graft addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92938","description":"Prq revasc byp graft addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35102","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUE0","description":"ICD-NEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare sh","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA16","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTB0","description":"ICD-JHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial thyroid excision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60212","description":"Partial thyroid excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tibial tubercle hgt w/ toe f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5020","description":"Tibial tubercle hgt w/ toe f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB145","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth insert penis device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93851","description":"Anesth insert penis device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIE0","description":"ICD-OEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMC1","description":"ICD-GAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Structured Day Habilitation Group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0104","description":"Structured Day Habilitation Group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUC0","description":"ICD-CHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB52","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXD0","description":"ICD-BHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Habil ed waiver_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2012","description":"Habil ed waiver_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHE1","description":"ICD-CBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYA1","description":"ICD-KCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial foot exam pt lops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0245","description":"Initial foot exam pt lops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBE0","description":"ICD-FCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPF1","description":"ICD-CCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOD1","description":"ICD-GEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHE0","description":"ICD-BFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPD0","description":"ICD-BAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"F5 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81241","description":"F5 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVD1","description":"ICD-OCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8G","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBB0","description":"ICD-CCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD236","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Right heart cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93451","description":"Right heart cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGD1","description":"ICD-KAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23155","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWD1","description":"ICD-PJWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sex transformation m to f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55970","description":"Sex transformation m to f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMC1","description":"ICD-BCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"G-esoph reflx tst w/electrod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91035","description":"G-esoph reflx tst w/electrod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSE1","description":"ICD-OJSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB221","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0702","description":"HCPCS-B0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB160","description":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intradermal Cancer Immunotherapy; Each Additional Injection (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0709T","description":"Intradermal Cancer Immunotherapy; Each Additional Injection (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPA1","description":"ICD-KGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCB0","description":"ICD-JCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation)_ full sequence analysis_ including small sequence changes in exonic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0230U","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation)_ full sequence analysis_ including small sequence changes in exonic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gluc monitor purchase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1030","description":"Gluc monitor purchase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHD1","description":"ICD-NLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation of speech fluency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92521","description":"Evaluation of speech fluency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Term device_ multi art digit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6715","description":"Term device_ multi art digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd w/transmural drain cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43240","description":"Egd w/transmural drain cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYD0","description":"ICD-PBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAD1","description":"ICD-BCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery of great vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33916","description":"Surgery of great vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rhythm ecg with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93040","description":"Rhythm ecg with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c component-accessory nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0108","description":"W/c component-accessory nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDF1","description":"ICD-IDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1105T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1105T","description":"CPT-1105T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18A","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNB0","description":"ICD-CFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAD0","description":"ICD-BCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for bone marrow_ smear interpretation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0855T","description":"Digitization of glass microscope slides for bone marrow_ smear interpretation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/remove neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61880","description":"Revise/remove neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABC0","description":"ICD-JABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vascular Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4038","description":"Vascular Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx med space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32606","description":"Thoracoscopy w/bx med space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCD0","description":"ICD-EFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVE0","description":"ICD-BFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22842","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14A","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0094A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUD1","description":"ICD-NHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cftr gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81222","description":"Cftr gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLA1","description":"ICD-IDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEA0","description":"ICD-JFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHC0","description":"ICD-IHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert ureteral support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50605","description":"Insert ureteral support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBB0","description":"ICD-EDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXE1","description":"ICD-GBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDA0","description":"ICD-NEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFE1","description":"ICD-OGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test for chlorohydrocarbons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82441","description":"Test for chlorohydrocarbons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1401","description":"HCPCS-C1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA11","description":"ICD-3DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDA1","description":"ICD-ADDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKE1","description":"ICD-BAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILF0","description":"ICD-CILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8D","description":"Very High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ isavuconazonium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1833","description":"Injection_ isavuconazonium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILD1","description":"ICD-IILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Larynscop w/tumr exc + scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31541","description":"Larynscop w/tumr exc + scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLE1","description":"ICD-NHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSF1","description":"ICD-PCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine_ on or after their 60th birthday and before or during measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1179","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine_ on or after their 60th birthday and before or during measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUB1","description":"ICD-FDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWB0","description":"ICD-LDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOC1","description":"ICD-HDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMD0","description":"ICD-CDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53460","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJE1","description":"ICD-FGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNE0","description":"ICD-OFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYF0","description":"ICD-CIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D6-2D7 hybrid gene) (List separately in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D6-2D7 hybrid gene) (List separately in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ent procedure/service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92700","description":"Ent procedure/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYB0","description":"ICD-PJYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAE1","description":"ICD-JGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDE1","description":"ICD-ECDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIA1","description":"ICD-ABIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMF0","description":"ICD-GBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTF1","description":"ICD-JGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFE1","description":"ICD-GBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA45","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMF0","description":"ICD-NJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHA1","description":"ICD-JHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release forearm/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26449","description":"Release forearm/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD145","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDE0","description":"ICD-GEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32220","description":"Release of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRE0","description":"ICD-KIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLA0","description":"ICD-MCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSE1","description":"ICD-DCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC256","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of topiramate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80201","description":"Assay of topiramate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj dexamethasone acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1094","description":"Inj dexamethasone acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computed tomography scan taken for the purpose of biomechanical computed tomography analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0558T","description":"Computed tomography scan taken for the purpose of biomechanical computed tomography analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDC1","description":"ICD-MJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso flexion control custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0634","description":"Lso flexion control custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of histamine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83088","description":"Assay of histamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEC0","description":"ICD-ODEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQE0","description":"ICD-LAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCB0","description":"ICD-EHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43622","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Forearm crutch platform atta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0153","description":"Forearm crutch platform atta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOD0","description":"ICD-CHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins lt atrl press monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0293T","description":"Ins lt atrl press monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUF0","description":"ICD-BBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Personal care ser per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1020","description":"Personal care ser per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUC0","description":"ICD-KFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBB0","description":"ICD-BCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem mntr pulm flu mntr alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0608T","description":"Rem mntr pulm flu mntr alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXE0","description":"ICD-FDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPB0","description":"ICD-GCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rx ace or arb therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8935","description":"Rx ace or arb therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Habilitation_ prevocational_ waiver; per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2047","description":"Habilitation_ prevocational_ waiver; per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFD0","description":"ICD-OEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBF0","description":"ICD-IDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHE0","description":"ICD-NEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDD0","description":"ICD-CDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKC1","description":"ICD-GHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Anifrolumab-Fnia_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9086","description":"Injection_ Anifrolumab-Fnia_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD141","description":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVE0","description":"ICD-NLVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath report non routine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0551F","description":"Cytopath report non routine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5A","description":"Default_ /PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01962","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","description":"CPT-01962","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete occlusal adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9952","description":"Complete occlusal adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARE0","description":"ICD-CARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSA0","description":"ICD-PFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closure ureter/skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50920","description":"Closure ureter/skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRB0","description":"ICD-HHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERE1","description":"ICD-HERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0569U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","description":"CPT-0569U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracorp shockwv tx hi enrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0101T","description":"Extracorp shockwv tx hi enrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJE1","description":"ICD-NJJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMF1","description":"ICD-EAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay tumor other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86316","description":"Immunoassay tumor other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ carboxydextran-coated superparamagnetic iron oxide_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9697","description":"Injection_ carboxydextran-coated superparamagnetic iron oxide_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBA1","description":"ICD-IGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELC0","description":"ICD-KELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61860","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDA0","description":"ICD-GBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDB0","description":"ICD-IGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23A","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMD0","description":"ICD-ABMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58660","description":"Laparoscopy lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHB0","description":"ICD-MEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTC1","description":"ICD-GDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clearance of airways","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31725","description":"Clearance of airways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB206","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFF1","description":"ICD-BCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transpl allograft pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48554","description":"Transpl allograft pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNE0","description":"ICD-OCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown full noble metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6792","description":"Crown full noble metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC234","description":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAB0","description":"ICD-BHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0765T","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","description":"HCPCS-J1807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seat lift mechanism toilet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0172","description":"Seat lift mechanism toilet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 25 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0348U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 25 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGF1","description":"ICD-NDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKA0","description":"ICD-NJKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUB0","description":"ICD-ODUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEF0","description":"ICD-CAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC121","description":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXA1","description":"ICD-BDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meperidine hydrochl /100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2175","description":"Meperidine hydrochl /100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBC1","description":"ICD-BFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15A","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHD0","description":"ICD-MEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bacterium antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86609","description":"Bacterium antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUB1","description":"ICD-KBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza dna amp prob 1+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87501","description":"Influenza dna amp prob 1+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoplasty_ medialization_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31591","description":"Laryngoplasty_ medialization_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sperm antibody test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89325","description":"Sperm antibody test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD250","description":"Clinically Complex _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Somatrem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2940","description":"Somatrem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB53","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot inhibit prot c activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85303","description":"Clot inhibit prot c activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADD0","description":"ICD-GADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caries preventive medicament application - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1355","description":"Caries preventive medicament application - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC11","description":"ICD-2DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHA0","description":"ICD-BAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTC1","description":"ICD-IDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES234","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55831","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUB0","description":"ICD-EBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIC1","description":"ICD-CFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATA0","description":"ICD-CATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correct rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45541","description":"Correct rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01630","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","description":"CPT-01630","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOD1","description":"ICD-DDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPE1","description":"ICD-NBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLD0","description":"ICD-CCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNB1","description":"ICD-CFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXF0","description":"ICD-OLXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2639","description":"Brachytx_ non-stranded_i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove mastoid air cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69670","description":"Remove mastoid air cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCC0","description":"ICD-EBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIID1","description":"ICD-IIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHB1","description":"ICD-EHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIF0","description":"ICD-OJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOE1","description":"ICD-HEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQD1","description":"ICD-KGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician_ including a written report to the patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99451","description":"Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician_ including a written report to the patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL17","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUB1","description":"ICD-IBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change of nephrostomy or pyelostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50398","description":"Change of nephrostomy or pyelostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61585","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQD0","description":"ICD-KCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Air pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0186","description":"Air pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXA1","description":"ICD-CHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ftl cgen abnor four anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81511","description":"Ftl cgen abnor four anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADC0","description":"ICD-GADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJD0","description":"ICD-JCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKA1","description":"ICD-NFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKB0","description":"ICD-FEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHF1","description":"ICD-MIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disp home glucose monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9275","description":"Disp home glucose monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac drug stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93024","description":"Cardiac drug stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracic vertebral body tethering_ including thoracoscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22838","description":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracic vertebral body tethering_ including thoracoscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal neck/armpit lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38555","description":"Removal neck/armpit lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOE1","description":"ICD-CHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERB0","description":"ICD-DERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flexible keel foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5972","description":"Flexible keel foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIC0","description":"ICD-AIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ant fusion 8/> vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22812","description":"Ant fusion 8/> vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Activity therapy_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2032","description":"Activity therapy_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABC1","description":"ICD-OABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDD1","description":"ICD-GBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44021","description":"Decompress small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood gases w/o2 saturation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82805","description":"Blood gases w/o2 saturation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo rig ant tib prefab tcf/=","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1932","description":"Afo rig ant tib prefab tcf/=","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOC0","description":"ICD-LGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFC0","description":"ICD-JAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8D","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ankle control ortho pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4350","description":"Ankle control ortho pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49429","description":"Removal of shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEE0","description":"ICD-CAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surg redct fibrous tuberosit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7972","description":"Surg redct fibrous tuberosit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Curette/treat cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65435","description":"Curette/treat cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat vagina infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57150","description":"Treat vagina infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQD1","description":"ICD-GDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB136","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 2-3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73502","description":"X-ray exam hip uni 2-3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Memory current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9168","description":"Memory current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69636","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNC0","description":"ICD-ODNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTE0","description":"ICD-GFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elevating whlchair leg rests","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0195","description":"Elevating whlchair leg rests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1033T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1033T","description":"CPT-1033T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other pt/ot current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8990","description":"Other pt/ot current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Approp ace/arb tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4188F","description":"Approp ace/arb tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N-et; encounter/trip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2003","description":"N-et; encounter/trip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDE0","description":"ICD-MBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRB1","description":"ICD-PIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0822","description":"Pwc gp 2 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJE0","description":"ICD-NAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFD1","description":"ICD-BIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVF1","description":"ICD-NDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg awake and drowsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95816","description":"Eeg awake and drowsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary proce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0839T","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHA0","description":"ICD-FAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBC0","description":"ICD-KIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDF0","description":"ICD-KCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELC0","description":"ICD-JELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSC0","description":"ICD-PGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00938","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","description":"CPT-00938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ vaginal pathogen panel_ identification of 27 organisms_ amplified probe technique_ vaginal swab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0330U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ vaginal pathogen panel_ identification of 27 organisms_ amplified probe technique_ vaginal swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBA1","description":"ICD-CGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQF1","description":"ICD-HIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDC0","description":"ICD-OFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLE0","description":"ICD-EDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB60","description":"Low Rehab_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of tear duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70170","description":"X-ray exam of tear duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALE0","description":"ICD-IALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQB0","description":"ICD-PHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ neck/head_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6566","description":"Gradient compression garment_ neck/head_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alginate drsg wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6199","description":"Alginate drsg wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQE0","description":"ICD-PCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCD1","description":"ICD-IDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace afo soft interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4392","description":"Replace afo soft interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9708","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMC0","description":"ICD-NIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5D","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0999T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","description":"CPT-0999T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOB1","description":"ICD-KEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCB1","description":"ICD-BGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDA1","description":"ICD-OIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mohs 1 stage h/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17311","description":"Mohs 1 stage h/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEE1","description":"ICD-JBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDC1","description":"ICD-OFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Symes met fr leath socket ar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5060","description":"Symes met fr leath socket ar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMA0","description":"ICD-CGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht inj noc per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9542","description":"Ht inj noc per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAB0","description":"ICD-MHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rn telephone calls to dmp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0320","description":"Rn telephone calls to dmp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0076","description":"Prolotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVC0","description":"ICD-NKVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetoscop laser ther ttts","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2411","description":"Fetoscop laser ther ttts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUD1","description":"ICD-IHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATB1","description":"ICD-NATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0901","description":"HCPCS-C0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKE1","description":"ICD-KGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJD0","description":"ICD-FEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerebrospinal fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78647","description":"Cerebrospinal fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUD1","description":"ICD-BDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21A","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJA0","description":"ICD-FGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0912T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","description":"CPT-0912T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelets_ pheresis_ pathogen-reduced_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9073","description":"Platelets_ pheresis_ pathogen-reduced_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMC1","description":"ICD-IHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interferon alfa-2b inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9214","description":"Interferon alfa-2b inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 4/5 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72083","description":"X-ray exam entire spi 4/5 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC35","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOB1","description":"ICD-PKOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLC0","description":"ICD-BGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33465","description":"Replace tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ neck/head_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6567","description":"Gradient compression garment_ neck/head_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAF1","description":"ICD-BAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDD0","description":"ICD-NCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diab manage trn  per indiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0108","description":"Diab manage trn  per indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1094","description":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEA1","description":"ICD-CCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect arm/elbow tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24079","description":"Resect arm/elbow tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise vag graft via vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57295","description":"Revise vag graft via vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABF1","description":"ICD-JABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETE0","description":"ICD-AETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIME1","description":"ICD-GIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emer response sys instal&tst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5160","description":"Emer response sys instal&tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSA0","description":"ICD-KCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOE0","description":"ICD-HCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjust toe ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1830","description":"Adjust toe ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx prostate t2no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9078","description":"Onc dx prostate t2no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOE0","description":"ICD-LAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3473","description":"Surgical repair of root resorption - molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36568","description":"Insert picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nocardia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86744","description":"Nocardia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGB0","description":"ICD-KDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76828","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unexplained constitutional or other heritable disorders or syndromes_ tissue-specific gene expression by whole-transcriptome and next-generation sequencing_ blood_ formalin-fi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0266U","description":"Unexplained constitutional or other heritable disorders or syndromes_ tissue-specific gene expression by whole-transcriptome and next-generation sequencing_ blood_ formalin-fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPA1","description":"ICD-FDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMC0","description":"ICD-CCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of corticosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82528","description":"Assay of corticosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWC1","description":"ICD-OEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1381","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","description":"HCPCS-M1381","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ustekinumab Intravenous Inj 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9989","description":"Ustekinumab Intravenous Inj 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJME0","description":"ICD-NJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFE0","description":"ICD-BEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAA1","description":"ICD-BHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADA1","description":"ICD-OADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone_ lacrimal opthalamic insert_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9048","description":"Dexamethasone_ lacrimal opthalamic insert_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXB1","description":"ICD-GCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBB0","description":"ICD-MHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10C","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE255","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAE0","description":"ICD-JHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKC0","description":"ICD-OEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAE0","description":"ICD-MEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8G","description":"High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post fusion </6 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22800","description":"Post fusion </6 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTB1","description":"ICD-EDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNB1","description":"ICD-BBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55713","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","description":"CPT-55713","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of major peripheral nerve neuroma_ except sciatic_ with implantation of nerve end into bone or muscle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7551","description":"Excision of major peripheral nerve neuroma_ except sciatic_ with implantation of nerve end into bone or muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUC1","description":"ICD-JBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE150","description":"Special Care Low _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0659","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","description":"HCPCS-E0659","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDC1","description":"ICD-NIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2C","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLF1","description":"ICD-BDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7356","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","description":"HCPCS-J7356","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHD0","description":"ICD-CCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01996","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","description":"CPT-01996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay thyroid stim hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84443","description":"Assay thyroid stim hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEID1","description":"ICD-BEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENE1","description":"ICD-CENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; simple filter method with interpretation (List separatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0828T","description":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; simple filter method with interpretation (List separatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behind ear hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5060","description":"Behind ear hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-electronic spirometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9284","description":"Non-electronic spirometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) (list separately in addition to code for primary procedure(s))","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31620","description":"Endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) (list separately in addition to code for primary procedure(s))","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligate leg veins radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37760","description":"Ligate leg veins radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHD1","description":"ICD-CEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHED0","description":"ICD-GHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5931","description":"Surgical obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90483","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","description":"CPT-90483","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOE1","description":"ICD-CBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJE1","description":"ICD-FHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatobiliary system imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78226","description":"Hepatobiliary system imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWD1","description":"ICD-LAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap esoph lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43283","description":"Lap esoph lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQC1","description":"ICD-DHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMB1","description":"ICD-EGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phototherapy light w/ photom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0202","description":"Phototherapy light w/ photom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suction susp ak/knee disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5652","description":"Suction susp ak/knee disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUC1","description":"ICD-BCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home injectable therapy_ immunotherapy_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies and equipment (drugs a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9563","description":"Home injectable therapy_ immunotherapy_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies and equipment (drugs a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14D","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYE1","description":"ICD-KHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKA0","description":"ICD-JHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUC1","description":"ICD-AFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther hrvst onl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0265T","description":"Im b1 mrw cel ther hrvst onl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALA0","description":"ICD-CALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTA1","description":"ICD-GDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27392","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCD0","description":"ICD-OKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 2 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64494","description":"Inj paravert f jnt l/s 2 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcutaneous auricular neurostimulation_ set-up_ calibration_ and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0783T","description":"Transcutaneous auricular neurostimulation_ set-up_ calibration_ and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES235","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKD1","description":"ICD-JFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28820","description":"Amputation of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELB1","description":"ICD-IELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUF0","description":"ICD-OHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI lower extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73719","description":"MRI lower extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRE1","description":"ICD-HCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01936","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01936","description":"CPT-01936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0677","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0677","description":"HCPCS-G0677","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8F","description":"Medium Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX25","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIB0","description":"ICD-NLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skn splt a-grft f/n/hf/g add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15121","description":"Skn splt a-grft f/n/hf/g add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOE0","description":"ICD-HEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTF0","description":"ICD-NJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27232","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVA0","description":"ICD-CDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJF1","description":"ICD-JFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBC1","description":"ICD-CDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Separate Self-Measurements Of Two Readings One Minute Apart_ Twice Daily Over A 30-Day Period (Min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99474","description":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Separate Self-Measurements Of Two Readings One Minute Apart_ Twice Daily Over A 30-Day Period (Min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIA0","description":"ICD-NAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sgd prerec msg>20min <=40min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2504","description":"Sgd prerec msg>20min <=40min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replcmnt breast pump shield","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4284","description":"Replcmnt breast pump shield","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA42","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACF0","description":"ICD-GACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYB1","description":"ICD-DDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIB0","description":"ICD-FDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETF0","description":"ICD-AETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepa vaccine adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90632","description":"Hepa vaccine adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC11","description":"ICD-3BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCF0","description":"ICD-IFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOA0","description":"ICD-GHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Janssen Covid-19 Vaccine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91303","description":"Janssen Covid-19 Vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ant fusion 2-3 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22808","description":"Ant fusion 2-3 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEB0","description":"ICD-BHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGID1","description":"ICD-KGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spleen imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78185","description":"Spleen imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL60","description":"High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHF1","description":"ICD-MEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"OPH AMD ALYS 3 GENE VARIANTS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0205U","description":"OPH AMD ALYS 3 GENE VARIANTS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBD1","description":"ICD-AGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADC1","description":"ICD-FADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE260","description":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of midfoot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28260","description":"Release of midfoot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGA1","description":"ICD-GGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLB1","description":"ICD-KCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8912","description":"Mra w/cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOC1","description":"ICD-GIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCE0","description":"ICD-CCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No knee joint with artic ali","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5220","description":"No knee joint with artic ali","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNC0","description":"ICD-NHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx duod intub w/asp spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43756","description":"Dx duod intub w/asp spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13100","description":"Cmplx rpr trunk 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9760","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAB1","description":"ICD-BEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AmnioArmor_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4188","description":"AmnioArmor_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHD1","description":"ICD-GDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add le poly knee custom kafo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2387","description":"Add le poly knee custom kafo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXD1","description":"ICD-ODXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cogenex Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4229","description":"Cogenex Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPD1","description":"ICD-OBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo proc uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58578","description":"Laparo proc uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGA0","description":"ICD-CDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTE0","description":"ICD-CHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8E","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit pain imp pump diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9328","description":"Hit pain imp pump diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADB0","description":"ICD-MADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Twist drill hole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61105","description":"Twist drill hole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9626","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISD0","description":"ICD-PISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breath test analysis c-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78268","description":"Breath test analysis c-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRE0","description":"ICD-GCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMA0","description":"ICD-OBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBB1","description":"ICD-AIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc thigh/knee les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27337","description":"Exc thigh/knee les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fev<60% pred & no copd sym","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8925","description":"Fev<60% pred & no copd sym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUF1","description":"ICD-EFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; each additional vessel (list separately in addition t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37251","description":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; each additional vessel (list separately in addition t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablation of malignant prostate tissue by magnetic field induction_ including all intraprocedural_ transperineal needle/catheter placement for nanoparticle installation and int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0739T","description":"Ablation of malignant prostate tissue by magnetic field induction_ including all intraprocedural_ transperineal needle/catheter placement for nanoparticle installation and int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal foreign body mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40805","description":"Removal foreign body mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No conformal radn thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4182F","description":"No conformal radn thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUC0","description":"ICD-NDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIF0","description":"ICD-GDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXC0","description":"ICD-CDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIF1","description":"ICD-KCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIA1","description":"ICD-EDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0739","description":"Injection_ cabotegravir_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvef >/=40% systolic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3022F","description":"Lvef >/=40% systolic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIA1","description":"ICD-CHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28G","description":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Range of motion measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95852","description":"Range of motion measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUB1","description":"ICD-JGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9813","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9813","description":"HCPCS-C9813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBD0","description":"ICD-BCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE226","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moisture exchanger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4483","description":"Moisture exchanger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRA1","description":"ICD-KDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJF1","description":"ICD-FCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epidrm autogrft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15110","description":"Epidrm autogrft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAC0","description":"ICD-GCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (central nervous system)_ analysis of 30000 DNA methylation loci by methylation array_ utilizing DNA extracted from tumor tissue_ diagnostic algorithm reported as pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0020M","description":"Oncology (central nervous system)_ analysis of 30000 DNA methylation loci by methylation array_ utilizing DNA extracted from tumor tissue_ diagnostic algorithm reported as pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQD1","description":"ICD-CHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX13","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANC0","description":"ICD-OANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology/Hematology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4019","description":"Oncology/Hematology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBC1","description":"ICD-MKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism EvidenceCare imaging advisor_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1013","description":"Clinical decision support mechanism EvidenceCare imaging advisor_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICE0","description":"ICD-NICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAD1","description":"ICD-IIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair skull cavity lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62120","description":"Repair skull cavity lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD210","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX22","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGE0","description":"ICD-JHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE250","description":"Clinically Complex _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision and repair of eyelid_ involving lid margin_ tarsus_ conjunctiva_ canthus_ or full thickness_ may include preparation for skin graft or pedicle flap with adjacent tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67961","description":"Excision and repair of eyelid_ involving lid margin_ tarsus_ conjunctiva_ canthus_ or full thickness_ may include preparation for skin graft or pedicle flap with adjacent tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Lynch syndrome)_ genomic DNA sequence analysis of MLH1_ MSH2_ MSH6_ PMS2_ and EPCAM_ including small sequence changes in exonic and intronic regions_ deletions_ dupl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0238U","description":"Oncology (Lynch syndrome)_ genomic DNA sequence analysis of MLH1_ MSH2_ MSH6_ PMS2_ and EPCAM_ including small sequence changes in exonic and intronic regions_ deletions_ dupl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","description":"HCPCS-J9038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA07","description":"High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEB1","description":"ICD-AGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAB0","description":"ICD-MFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARA0","description":"ICD-OARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of hydroxyapatite regeneration medicament - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2991","description":"Application of hydroxyapatite regeneration medicament - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ olipudase alfa-rpcp_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0218","description":"Injection_ olipudase alfa-rpcp_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFA1","description":"ICD-KDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAF0","description":"ICD-FIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Furosemide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1940","description":"Furosemide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMC1","description":"ICD-GBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mycobacteria dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87552","description":"Mycobacteria dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prenatalcare enhanced srv pk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1005","description":"Prenatalcare enhanced srv pk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOD0","description":"ICD-CGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mannitol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2150","description":"Mannitol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor xii hageman","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85280","description":"Clot factor xii hageman","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr s/n/a/gen/trk12.6-20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12005","description":"Rpr s/n/a/gen/trk12.6-20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens/es other type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2599","description":"Contact lens/es other type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adenoma detected screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3775F","description":"Adenoma detected screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOC1","description":"ICD-LCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49591","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYD0","description":"ICD-KFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYE1","description":"ICD-CFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine infusion device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62365","description":"Remove spine infusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLB1","description":"ICD-FCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01214","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","description":"CPT-01214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain lower leg lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27603","description":"Drain lower leg lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Identify sperm tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89264","description":"Identify sperm tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90613","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","description":"CPT-90613","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Walker wheel attachment_pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0155","description":"Walker wheel attachment_pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Durable medical equipment mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1399","description":"Durable medical equipment mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo ia push tecnique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96420","description":"Chemo ia push tecnique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUE1","description":"ICD-KHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHB0","description":"ICD-NKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of arm infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73092","description":"X-ray exam of arm infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobacco-use counsel>10min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0437","description":"Tobacco-use counsel>10min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDC0","description":"ICD-IIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX21","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFC1","description":"ICD-FDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGC1","description":"ICD-FDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ascent_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4213","description":"Ascent_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHA1","description":"ICD-KEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUA1","description":"ICD-MEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTC0","description":"ICD-KBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSB1","description":"ICD-KHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser inc for pkp/lkp donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0289T","description":"Laser inc for pkp/lkp donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB146","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNA1","description":"ICD-OHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQF0","description":"ICD-DAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVF0","description":"ICD-FAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWF0","description":"ICD-PGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8I","description":"High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC235","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-programble infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0782","description":"Non-programble infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) ongoing maintenance se ss ions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9882","description":"Two Medica re Diabetes Prevention Program (MDPP) ongoing maintenance se ss ions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Air elevator for heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0370","description":"Air elevator for heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRE0","description":"ICD-DBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKB1","description":"ICD-NFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIF1","description":"ICD-FGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29874","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVE1","description":"ICD-FDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILD1","description":"ICD-BILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had a suicide safety plan initiated_ reviewed_ or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1351","description":"Patients who had a suicide safety plan initiated_ reviewed_ or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0103","description":"HCPCS-A0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endometr ablate thermal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58353","description":"Endometr ablate thermal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPE1","description":"ICD-JHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99310","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1093T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1093T","description":"CPT-1093T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8C","description":"High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXA1","description":"ICD-GDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAE0","description":"ICD-CFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7518","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 3 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91318","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 3 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23B","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXC1","description":"ICD-FIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMF1","description":"ICD-EGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHME0","description":"ICD-OHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHA0","description":"ICD-BFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway pressure cpap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94660","description":"Pos airway pressure cpap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBME1","description":"ICD-JBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGB1","description":"ICD-KIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No electrodiag polyneuro 6mn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3752F","description":"No electrodiag polyneuro 6mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc mntl tst b/4 bk trxmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2044F","description":"Doc mntl tst b/4 bk trxmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXC1","description":"ICD-JBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQD1","description":"ICD-LBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKE1","description":"ICD-GFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWE1","description":"ICD-KFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14D","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCE1","description":"ICD-CCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood glucose level test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0412","description":"Blood glucose level test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQA0","description":"ICD-LAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct head/brain w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70470","description":"Ct head/brain w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRB1","description":"ICD-PLRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Risperidone_ long acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2794","description":"Risperidone_ long acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKC0","description":"ICD-NEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1302","description":"HCPCS-B1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25443","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABA1","description":"ICD-FABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67314","description":"Revise eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGB0","description":"ICD-OFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLC1","description":"ICD-AGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVE0","description":"ICD-KIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDB1","description":"ICD-OBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABME1","description":"ICD-ABME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dem severity classified mod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1491F","description":"Dem severity classified mod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLE1","description":"ICD-MBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84578","description":"Test urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLD1","description":"ICD-IHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC11","description":"ICD-3HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56630","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAC1","description":"ICD-BAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNF0","description":"ICD-OKNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reverse osmosis h2o puri sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1610","description":"Reverse osmosis h2o puri sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES114","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLB1","description":"ICD-FHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SYPHILIS TST ANTB IA QUAN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0210U","description":"SYPHILIS TST ANTB IA QUAN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGB1","description":"ICD-NLGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQC0","description":"ICD-LFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJE1","description":"ICD-BCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOA0","description":"ICD-KFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAND0","description":"ICD-NAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEF0","description":"ICD-EFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerebrospinal fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78630","description":"Cerebrospinal fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBF0","description":"ICD-KGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCC1","description":"ICD-CCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complement fixation each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86171","description":"Complement fixation each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of forearm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25031","description":"Drainage of forearm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMB1","description":"ICD-KGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adj chem pres ajcc iii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8927","description":"Adj chem pres ajcc iii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRF0","description":"ICD-HBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","description":"HCPCS-M1376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFF0","description":"ICD-KBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gauze <=16 in no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6222","description":"Gauze <=16 in no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablate pulm tumors extnsn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0340T","description":"Ablate pulm tumors extnsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00862","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","description":"CPT-00862","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAA0","description":"ICD-OHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGF1","description":"ICD-NJGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of arm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24200","description":"Removal of arm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt talk psychsoc&rx oh dpnd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4320F","description":"Pt talk psychsoc&rx oh dpnd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQD1","description":"ICD-HGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJF1","description":"ICD-OCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"2 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4207","description":"2 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scalp cooling_ mechanical; placement of device_ monitoring_ and removal of device (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0663T","description":"Scalp cooling_ mechanical; placement of device_ monitoring_ and removal of device (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYD0","description":"ICD-PKYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"repair cast partial framework_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5622","description":"repair cast partial framework_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1340","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBC1","description":"ICD-FGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ercp remove duct calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43264","description":"Ercp remove duct calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98001","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","description":"CPT-98001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANF1","description":"ICD-OANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDD1","description":"ICD-BFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0913T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","description":"CPT-0913T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37269","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","description":"CPT-37269","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMD1","description":"ICD-AHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLE1","description":"ICD-MKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospitalists Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4009","description":"Hospitalists Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCA0","description":"ICD-BFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC21","description":"ICD-3IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBE1","description":"ICD-CGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13B","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOD0","description":"ICD-KHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCE0","description":"ICD-ICCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam infant hips dynamic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76885","description":"Us exam infant hips dynamic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal stent placement(s)_ includes angioplasty within the same v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7535","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal stent placement(s)_ includes angioplasty within the same v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18I","description":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPB1","description":"ICD-FBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBA1","description":"ICD-NKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Handgrip for cane etc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4636","description":"Handgrip for cane etc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEA0","description":"ICD-GDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSE1","description":"ICD-OLSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIA1","description":"ICD-FDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACF1","description":"ICD-EACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGE1","description":"ICD-NDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (cardiovascular disease)_ analysis of 4 proteins (NT-proBNP_ osteopontin_ tissue inhibitor of metalloproteinase-1 [TIMP-1]_ and kidney injury molecule-1 [KIM-1])_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0309U","description":"Cardiology (cardiovascular disease)_ analysis of 4 proteins (NT-proBNP_ osteopontin_ tissue inhibitor of metalloproteinase-1 [TIMP-1]_ and kidney injury molecule-1 [KIM-1])_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKA1","description":"ICD-JIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients admitted to a skilled nursing facility (snf)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1266","description":"Patients admitted to a skilled nursing facility (snf)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQE1","description":"ICD-HEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup hip spica fiberglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4026","description":"Cast sup hip spica fiberglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc t cabg b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9605","description":"Perc d-e cor revasc t cabg b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKC0","description":"ICD-KGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB205","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68815","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAC1","description":"ICD-NCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLC0","description":"ICD-IHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma plan of care documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1223","description":"Glaucoma plan of care documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSA1","description":"ICD-DBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJA1","description":"ICD-KHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0649U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0649U","description":"CPT-0649U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20D","description":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQC1","description":"ICD-PDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC32","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2181","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIE1","description":"ICD-NEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplant/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26483","description":"Transplant/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGE1","description":"ICD-OAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKA1","description":"ICD-KDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAF0","description":"ICD-NEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVA0","description":"ICD-JIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPB1","description":"ICD-NFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMA0","description":"ICD-KFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28576","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJB0","description":"ICD-FHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECE0","description":"ICD-GECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular photodynamic ther","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67221","description":"Ocular photodynamic ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rotary wing air mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0436","description":"Rotary wing air mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med record copy admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9981","description":"Med record copy admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Fpd - Porcelain Fused To Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6099","description":"Implant Supported Retainer For Fpd - Porcelain Fused To Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ mosunetuzumab-axgb_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9350","description":"Injection_ mosunetuzumab-axgb_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLF1","description":"ICD-IFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUA0","description":"ICD-ACUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKE1","description":"ICD-OGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSE0","description":"ICD-CHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOC0","description":"ICD-KCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERD0","description":"ICD-LERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNC0","description":"ICD-KGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEA1","description":"ICD-KAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intro gastrointestinal tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44500","description":"Intro gastrointestinal tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt tlk psych & rx opd addic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4306F","description":"Pt tlk psych & rx opd addic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPC1","description":"ICD-NGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUB1","description":"ICD-NGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENF0","description":"ICD-GENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treprostinil injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3285","description":"Treprostinil injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOC1","description":"ICD-LDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin w/ base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2721","description":"Crown resin w/ base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRF0","description":"ICD-OGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGD1","description":"ICD-GCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97551","description":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair wrist joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25447","description":"Repair wrist joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63655","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam sacrum tailbone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72220","description":"X-ray exam sacrum tailbone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGF1","description":"ICD-OCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD136","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVC1","description":"ICD-NDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEA0","description":"ICD-KAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYA1","description":"ICD-DIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPB0","description":"ICD-GBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLD1","description":"ICD-EFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWE1","description":"ICD-DFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6740","description":"Crown porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sacituzumab govitecan-hziy_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9317","description":"Injection_ sacituzumab govitecan-hziy_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54205","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24579","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIA1","description":"ICD-GDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0244","description":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA11","description":"ICD-2GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMD0","description":"ICD-GFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGC1","description":"ICD-NBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWE1","description":"ICD-CEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE246","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aneurysm press sensor add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34806","description":"Aneurysm press sensor add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCC0","description":"ICD-ICCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX05","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enteral feed supp pump per d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4035","description":"Enteral feed supp pump per d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complete phys skin exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2029F","description":"Complete phys skin exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway press chinstrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7036","description":"Pos airway press chinstrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILB0","description":"ICD-EILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE145","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUF0","description":"ICD-IGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYA0","description":"ICD-PAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42220","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIA0","description":"ICD-BAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glucagon tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80422","description":"Glucagon tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIF1","description":"ICD-JIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE134","description":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip bone les deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27066","description":"Remove hip bone les deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHA1","description":"ICD-OIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)_ face-to-face w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97157","description":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)_ face-to-face w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantable access syst perc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4301","description":"Implantable access syst perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWB1","description":"ICD-PLWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJD0","description":"ICD-KAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVA1","description":"ICD-NJVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD146","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0781T","description":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDD0","description":"ICD-NLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24925","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWD1","description":"ICD-PCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lacer molded to patient mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2330","description":"Lacer molded to patient mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIE1","description":"ICD-CBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of jaw <4views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70100","description":"X-ray exam of jaw <4views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20600","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysis equipment noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1699","description":"Dialysis equipment noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Probe/needle_ cryo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2618","description":"Probe/needle_ cryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0558","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","description":"HCPCS-G0558","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIE0","description":"ICD-GIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PSYC GEN ALYS PANEL 15 GENES","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0175U","description":"PSYC GEN ALYS PANEL 15 GENES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEA0","description":"ICD-CGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVC1","description":"ICD-GDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Derm-Maxx_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4238","description":"Derm-Maxx_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALB0","description":"ICD-MALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIC0","description":"ICD-FBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMF0","description":"ICD-OBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemiluminescent assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82397","description":"Chemiluminescent assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATF0","description":"ICD-IATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPE1","description":"ICD-NLPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLID1","description":"ICD-OLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10B","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"P2y inhib presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9438","description":"P2y inhib presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sterile cefuroxime injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0697","description":"Sterile cefuroxime injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phosphatase forensic exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84061","description":"Phosphatase forensic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1202","description":"HCPCS-A1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1082T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1082T","description":"CPT-1082T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUE1","description":"ICD-OEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRE0","description":"ICD-HIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFC0","description":"ICD-NDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKA0","description":"ICD-KAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recement supp crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6092","description":"Recement supp crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHA0","description":"ICD-KDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPB0","description":"ICD-JEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behav hlth day treat_ per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2012","description":"Behav hlth day treat_ per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIC0","description":"ICD-EFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand restoration replacmnt g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6915","description":"Hand restoration replacmnt g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMF1","description":"ICD-OCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIE0","description":"ICD-AGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21087","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion or replacement of permanent leadless pacemaker_ ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0387T","description":"Transcatheter insertion or replacement of permanent leadless pacemaker_ ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAF0","description":"ICD-EBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECD1","description":"ICD-NECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emergency tracheotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7990","description":"Emergency tracheotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCB0","description":"ICD-IBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHE0","description":"ICD-GEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGA1","description":"ICD-JCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0173A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Sublocade)_ greater than 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9992","description":"Injection_ buprenorphine extended-release (Sublocade)_ greater than 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVA1","description":"ICD-FIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHB0","description":"ICD-GAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Paramed intrcept nonvol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0208","description":"Paramed intrcept nonvol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFE0","description":"ICD-CIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFC0","description":"ICD-OLFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit interim cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5502","description":"Hit interim cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYD0","description":"ICD-DCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33369","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt post facet implt lumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0221T","description":"Plmt post facet implt lumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDC1","description":"ICD-IGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9982","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOA0","description":"ICD-PKOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHB1","description":"ICD-BFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8A","description":"Very High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total lung lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32997","description":"Total lung lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLF1","description":"ICD-NDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Voriconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80285","description":"Voriconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-96041","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","description":"CPT-96041","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stent_ non-coat/cov w/o del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1877","description":"Stent_ non-coat/cov w/o del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAF1","description":"ICD-BHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87484","description":"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Somatropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2941","description":"Somatropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASC0","description":"ICD-LASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc neck les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21555","description":"Exc neck les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging without contrast_ breast; unilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8904","description":"Magnetic resonance imaging without contrast_ breast; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp ilioiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35663","description":"Art byp ilioiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRD1","description":"ICD-CCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABF1","description":"ICD-KABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQA1","description":"ICD-OLQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSF1","description":"ICD-PFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWC0","description":"ICD-OGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTD0","description":"ICD-ADTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFA1","description":"ICD-FGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSC1","description":"ICD-OFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00832","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","description":"CPT-00832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTD1","description":"ICD-ECTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lead_ aicd_ non sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1896","description":"Lead_ aicd_ non sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWE1","description":"ICD-DAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGA0","description":"ICD-BCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDA1","description":"ICD-IGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2A","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen dua non","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8688","description":"Implt nrostm pls gen dua non","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBD0","description":"ICD-CGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUF0","description":"ICD-JHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGE0","description":"ICD-FFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0216T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAC0","description":"ICD-EGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJC0","description":"ICD-NJJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"F2 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81240","description":"F2 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOB0","description":"ICD-PDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 2/3 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72082","description":"X-ray exam entire spi 2/3 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYB0","description":"ICD-GBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPD1","description":"ICD-FBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXC1","description":"ICD-JGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen based wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6010","description":"Collagen based wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by infraclavicular or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34716","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by infraclavicular or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLF0","description":"ICD-NJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0480U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","description":"CPT-0480U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHD0","description":"ICD-NCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumatic appliance full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0660","description":"Pneumatic appliance full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKB0","description":"ICD-NAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBC1","description":"ICD-NHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Varicella-zoster antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86787","description":"Varicella-zoster antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIF0","description":"ICD-NCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACC0","description":"ICD-EACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATF1","description":"ICD-IATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trastuzumab not administered within 12 months of diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9837","description":"Trastuzumab not administered within 12 months of diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87626","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","description":"CPT-87626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYF1","description":"ICD-GDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACF0","description":"ICD-EACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAF1","description":"ICD-FCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bcg vaccine intravesical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90586","description":"Bcg vaccine intravesical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDC1","description":"ICD-IHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flow cyto done b/4 tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3170F","description":"Flow cyto done b/4 tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDD1","description":"ICD-AIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy soft tissue of back","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21920","description":"Biopsy soft tissue of back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLE1","description":"ICD-KBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMC1","description":"ICD-AFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cbt each addl hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94645","description":"Cbt each addl hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood glucose monitor home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0607","description":"Blood glucose monitor home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAC1","description":"ICD-OCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYC1","description":"ICD-GEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAND1","description":"ICD-NAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEF0","description":"ICD-MEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB07","description":"Low Rehab_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Term dev auto grasp feature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6881","description":"Term dev auto grasp feature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYB0","description":"ICD-CEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavior management","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9920","description":"Behavior management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCC1","description":"ICD-JCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVC1","description":"ICD-GGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQA0","description":"ICD-HAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplants of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27397","description":"Transplants of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX35","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWF1","description":"ICD-PAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPC0","description":"ICD-NKPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITE0","description":"ICD-BITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB224","description":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22D","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGC0","description":"ICD-GAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21432","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4B","description":"Default_ /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWB0","description":"ICD-OJWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB17","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth lung chest wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54651","description":"Anesth lung chest wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJB1","description":"ICD-NCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOB0","description":"ICD-LHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAB0","description":"ICD-BFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUB1","description":"ICD-CCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEB1","description":"ICD-MLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture bacterial urine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P7001","description":"Culture bacterial urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYB0","description":"ICD-HFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUD0","description":"ICD-IHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHB1","description":"ICD-MFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPA1","description":"ICD-NGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deb subq tissue add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11045","description":"Deb subq tissue add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0A","description":"Default_ /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGC0","description":"ICD-FIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHA1","description":"ICD-NIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLE0","description":"ICD-EFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onsite nursing facility conference_ that is separate and distinct from an Evaluation and Management visit_ including qualified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9686","description":"Onsite nursing facility conference_ that is separate and distinct from an Evaluation and Management visit_ including qualified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE217","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLC0","description":"ICD-NHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay bld/serum cholesterol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82465","description":"Assay bld/serum cholesterol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of System Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Other System Reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2095","description":"Documentation Of System Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Other System Reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (hospira)_ not therapeutically equivalent to j0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0877","description":"Injection_ daptomycin (hospira)_ not therapeutically equivalent to j0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAE1","description":"ICD-MAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep b core antibody total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86704","description":"Hep b core antibody total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKB0","description":"ICD-CAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shingrix vaccine not documented as administered_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1066","description":"Shingrix vaccine not documented as administered_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAD0","description":"ICD-CDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastrointestinal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43361","description":"Gastrointestinal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATA0","description":"ICD-KATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEF0","description":"ICD-OHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63706","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTD1","description":"ICD-OBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELD1","description":"ICD-JELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB231","description":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDE0","description":"ICD-MIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an RHC or FQHC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0071","description":"Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an RHC or FQHC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69100","description":"Biopsy of external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ank symes mold sckt sach ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5050","description":"Ank symes mold sckt sach ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22A","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi (Lyme disease)_ OspA protein evaluation_ urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0316U","description":"Borrelia burgdorferi (Lyme disease)_ OspA protein evaluation_ urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARD0","description":"ICD-CARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB144","description":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYD1","description":"ICD-OAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen imp urinary 2.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8603","description":"Collagen imp urinary 2.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX02","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply finger cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29086","description":"Apply finger cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seg pneumatic appli half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0669","description":"Seg pneumatic appli half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Provisional pontic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6253","description":"Provisional pontic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC15","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo sing bar clasp attach sh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1910","description":"Afo sing bar clasp attach sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22C","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHB0","description":"ICD-BDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pedicle soft tissue graft pr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4270","description":"Pedicle soft tissue graft pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rad exc lesion up to 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7410","description":"Rad exc lesion up to 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27496","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATE0","description":"ICD-IATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADF1","description":"ICD-GADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJC0","description":"ICD-OAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27306","description":"Incision of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thi/glut/ischia wgt bearing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2500","description":"Thi/glut/ischia wgt bearing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEB1","description":"ICD-MBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFA0","description":"ICD-GIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"B cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86355","description":"B cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSC1","description":"ICD-HDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMB0","description":"ICD-IBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd home pt srv p day 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90969","description":"Esrd home pt srv p day 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mh health assess by non-md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0031","description":"Mh health assess by non-md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repl cushions for jaw motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1701","description":"Repl cushions for jaw motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKE0","description":"ICD-FDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHB1","description":"ICD-OGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crutch underarm each no wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0116","description":"Crutch underarm each no wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sperm pouch lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55680","description":"Remove sperm pouch lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lamaze class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9436","description":"Lamaze class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting proced","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0135U","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting proced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERF1","description":"ICD-CERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antinuclear antibodies (ana)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86039","description":"Antinuclear antibodies (ana)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4206","description":"1 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot lamin/prepreg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3031","description":"Foot lamin/prepreg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKF0","description":"ICD-KFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4297","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","description":"HCPCS-A4297","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPD0","description":"ICD-BHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBB1","description":"ICD-FEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYE0","description":"ICD-OGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair elbow deb/attch open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24359","description":"Repair elbow deb/attch open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter therapy_ infusion_ any method (eg_ thrombolysis other than coronary)_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75896","description":"Transcatheter therapy_ infusion_ any method (eg_ thrombolysis other than coronary)_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLF0","description":"ICD-FCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0685U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685U","description":"CPT-0685U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUC0","description":"ICD-OBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWB0","description":"ICD-DHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance used to reduce upper airway collapsibility_ without fixed mechanical hinge_ custom fabricated_ includes fitting and adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1027","description":"Oral device/appliance used to reduce upper airway collapsibility_ without fixed mechanical hinge_ custom fabricated_ includes fitting and adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo mech stance ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5716","description":"Knee-shin exo mech stance ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMC0","description":"ICD-EFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQB0","description":"ICD-DEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGE0","description":"ICD-OHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHE1","description":"ICD-CHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Embolization protect syst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1884","description":"Embolization protect syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of troponin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84512","description":"Assay of troponin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ padded foam_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6605","description":"Gradient compression bandaging supply_ padded foam_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEE0","description":"ICD-OGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3B","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMB0","description":"ICD-EGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDC1","description":"ICD-KGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTD0","description":"ICD-MKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIC1","description":"ICD-NBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB235","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strattice tm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4130","description":"Strattice tm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAF0","description":"ICD-GBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove impacted ear wax uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69210","description":"Remove impacted ear wax uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGC0","description":"ICD-BIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bile acids total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82239","description":"Bile acids total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88020","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58180","description":"Partial hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE206","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mthfr gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81291","description":"Mthfr gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWA1","description":"ICD-HIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML56","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release inner ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69960","description":"Release inner ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEB0","description":"ICD-ABEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHA1","description":"ICD-OLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUA1","description":"ICD-MGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sales tax","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9999","description":"Sales tax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0603","description":"HCPCS-A0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHA1","description":"ICD-EAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pros sock single ply bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8470","description":"Pros sock single ply bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asser com tx face-face/15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0039","description":"Asser com tx face-face/15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; interpretation and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0557T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; interpretation and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYA0","description":"ICD-ODYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJB0","description":"ICD-NLJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJC0","description":"ICD-KFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27675","description":"Repair lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputee adapter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0959","description":"Amputee adapter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOB1","description":"ICD-DCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPC1","description":"ICD-OKPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXF1","description":"ICD-FAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37261","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","description":"CPT-37261","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phentolaine mesylate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2760","description":"Phentolaine mesylate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0D","description":"Very High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Quadrilateral brim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2188","description":"Quadrilateral brim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55720","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 17-18 test","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP18","description":"Auto test panel pricing code_ 17-18 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQA0","description":"ICD-CHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDD0","description":"ICD-GEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIB0","description":"ICD-KDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc sinus ct 28d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9349","description":"Doc sinus ct 28d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSE1","description":"ICD-PDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGD0","description":"ICD-GCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBC1","description":"ICD-FCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC110","description":"Special Care High _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC22","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Macroscopic exam parasite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87169","description":"Macroscopic exam parasite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Duplex scan of hemodialysis fistula_ computer-aided_ limited (volume flow_ diameter_ and depth_ including only body of fistula)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0876T","description":"Duplex scan of hemodialysis fistula_ computer-aided_ limited (volume flow_ diameter_ and depth_ including only body of fistula)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPE0","description":"ICD-BAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24655","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit est age 40-64","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99396","description":"Prev visit est age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6700","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","description":"HCPCS-L6700","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65093","description":"Revise eye with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISF1","description":"ICD-HISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHA0","description":"ICD-JFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTD0","description":"ICD-GFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dinutuximab_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1246","description":"Injection_ dinutuximab_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4C","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUB0","description":"ICD-BDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANC1","description":"ICD-JANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVC1","description":"ICD-KFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92990","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQB1","description":"ICD-LFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELC1","description":"ICD-AELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITA1","description":"ICD-GITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUF0","description":"ICD-NGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAC1","description":"ICD-MKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEF0","description":"ICD-JCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHC1","description":"ICD-CDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multipo locking shoulder jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6646","description":"Multipo locking shoulder jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iv inj ra drug dx study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78808","description":"Iv inj ra drug dx study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj foramen epidural l/s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64483","description":"Inj foramen epidural l/s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sincalide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2805","description":"Sincalide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIC1","description":"ICD-JHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKB1","description":"ICD-JHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD117","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGB1","description":"ICD-NAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Storage/year sperm/semen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89343","description":"Storage/year sperm/semen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1601","description":"HCPCS-A1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKE1","description":"ICD-BBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMA0","description":"ICD-BGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIND1","description":"ICD-FIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMA1","description":"ICD-GDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEA0","description":"ICD-IBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove interim implant component","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6198","description":"Remove interim implant component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA01","description":"High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95145","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement nasal pillows","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7033","description":"Replacement nasal pillows","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alatrofloxacin mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0200","description":"Alatrofloxacin mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRE1","description":"ICD-HIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level V_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0754T","description":"Digitization of glass microscope slides for level V_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBD1","description":"ICD-KIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45332","description":"Sigmoidoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGD0","description":"ICD-GIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWF0","description":"ICD-DCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5252","description":"Hearing aid_ prog_ bin_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWF1","description":"ICD-KAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX30","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD151","description":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54250","description":"Penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic image bone marrow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77084","description":"Magnetic image bone marrow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Case management_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2022","description":"Case management_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagus surgery for veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43401","description":"Esophagus surgery for veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABE0","description":"ICD-BABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMA0","description":"ICD-MBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIB0","description":"ICD-MJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHF1","description":"ICD-EBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL43","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPC1","description":"ICD-GIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; Each Additional Vertebral Body_ Lumbar Or Sacral (List Separately In Addition To Code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64629","description":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; Each Additional Vertebral Body_ Lumbar Or Sacral (List Separately In Addition To Code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Typhoid vaccine_ acetone-killed_ dried (akd)_ for subcutaneous or jetinjection use (u.s. military)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90693","description":"Typhoid vaccine_ acetone-killed_ dried (akd)_ for subcutaneous or jetinjection use (u.s. military)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFME0","description":"ICD-BFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUD0","description":"ICD-OKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWA1","description":"ICD-PAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCD0","description":"ICD-KCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23D","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tub stool or bench","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0245","description":"Tub stool or bench","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTA1","description":"ICD-KFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBF0","description":"ICD-IBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray of lower spine disk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72295","description":"X-ray of lower spine disk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ guselkumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1628","description":"Injection_ guselkumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRD0","description":"ICD-LBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11A","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA144","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tibia & fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27709","description":"Incision of tibia & fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEB0","description":"ICD-AAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLF0","description":"ICD-NKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18G","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMB1","description":"ICD-FCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chimerism anal w/cell select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81268","description":"Chimerism anal w/cell select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFA1","description":"ICD-KHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza immunization administered or previously received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1299","description":"Influenza immunization administered or previously received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9460","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDE1","description":"ICD-KBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEED1","description":"ICD-GEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost sknbar w/o conv<=4 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4414","description":"Ost sknbar w/o conv<=4 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skull base/brainstem surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61576","description":"Skull base/brainstem surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWC0","description":"ICD-KDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Synthetic sentence test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92576","description":"Synthetic sentence test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFE0","description":"ICD-OJFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shortening of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27465","description":"Shortening of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES330","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGC1","description":"ICD-NHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCD0","description":"ICD-IFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIA1","description":"ICD-MKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0134A","description":"IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD216","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef complet w/intact nutrient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4150","description":"Ef complet w/intact nutrient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tiss exam molecular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88387","description":"Tiss exam molecular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0411U","description":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy with ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44401","description":"Colonoscopy with ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct thorax w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71260","description":"Ct thorax w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech audiometry complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92556","description":"Speech audiometry complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; Without Continuous Oximetry Monitoring (Per Session)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94625","description":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; Without Continuous Oximetry Monitoring (Per Session)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCC0","description":"ICD-FCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 xhd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0864","description":"Pwc gp3 xhd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiokymography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0035","description":"Cardiokymography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPC1","description":"ICD-BAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRD0","description":"ICD-HGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVC1","description":"ICD-FEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67516","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab and hyaluronidase_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9467","description":"Injection_ rituximab and hyaluronidase_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20C","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSF0","description":"ICD-LGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYD1","description":"ICD-ODYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anes spine transthor w/vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62651","description":"Anes spine transthor w/vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNA0","description":"ICD-OCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTC1","description":"ICD-FCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bitolterol mesylate comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7628","description":"Bitolterol mesylate comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69720","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVD1","description":"ICD-CAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Barium swallow test ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3142F","description":"Barium swallow test ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC104","description":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXC1","description":"ICD-CCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOF1","description":"ICD-KFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Standard control cable extra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6655","description":"Standard control cable extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSF0","description":"ICD-CDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytp urne 3-5 probes ea spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88120","description":"Cytp urne 3-5 probes ea spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOB0","description":"ICD-GAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHD1","description":"ICD-JCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip clevis type 2 posit jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2570","description":"Hip clevis type 2 posit jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEA0","description":"ICD-MLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOB0","description":"ICD-HAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy bronch stents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31636","description":"Bronchoscopy bronch stents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRA0","description":"ICD-KHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrinolytic plasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85400","description":"Fibrinolytic plasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAF0","description":"ICD-AGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47362","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9141","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHC1","description":"ICD-AEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPE1","description":"ICD-BDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC06","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1136","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","description":"HCPCS-J1171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86551","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/90d mrs 0-2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9646","description":"Pt w/90d mrs 0-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Csf ventriculography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78635","description":"Csf ventriculography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1742","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1742","description":"HCPCS-C1742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTF0","description":"ICD-ADTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXC1","description":"ICD-KIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound warming wound cover","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6000","description":"Wound warming wound cover","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAE1","description":"ICD-IIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBB0","description":"ICD-GIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rig fram pelvic pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0468","description":"Tlso rig fram pelvic pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTF0","description":"ICD-JCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC31","description":"ICD-2HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUA1","description":"ICD-CGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA235","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Root canal therapy 2 canals","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3320","description":"Root canal therapy 2 canals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB135","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBE0","description":"ICD-JGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRE1","description":"ICD-CGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXE0","description":"ICD-JDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAD1","description":"ICD-NCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81362","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77772","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE144","description":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYF0","description":"ICD-PJYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB214","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22845","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Midface flap (ie_ zygomaticofacial flap) with preservation of vascular pedicle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15730","description":"Midface flap (ie_ zygomaticofacial flap) with preservation of vascular pedicle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD145","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMC1","description":"ICD-OFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Situximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9455","description":"Injection_ Situximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERA0","description":"ICD-PERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of artery/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35761","description":"Exploration of artery/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCF1","description":"ICD-NBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBE0","description":"ICD-FBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0505U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","description":"CPT-0505U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGE0","description":"ICD-GAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls initiation artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33947","description":"Ecmo/ecls initiation artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBE0","description":"ICD-NKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQF0","description":"ICD-PKQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin barrier_ wipe or swab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5120","description":"Skin barrier_ wipe or swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26615","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0580U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","description":"CPT-0580U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHB1","description":"ICD-CCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intratubal occlusion device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4264","description":"Intratubal occlusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINB1","description":"ICD-KINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXD1","description":"ICD-NLXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVF1","description":"ICD-KIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy & revise urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52275","description":"Cystoscopy & revise urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXB1","description":"ICD-FFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-rays spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75705","description":"Artery x-rays spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fx radial 3+ frag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25609","description":"Treat fx radial 3+ frag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFC1","description":"ICD-GHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj iris prosth sec io lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0618T","description":"Insj iris prosth sec io lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40520","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5100","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","description":"HCPCS-Q5100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18A","description":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOC1","description":"ICD-CFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKD1","description":"ICD-BHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home episodic case 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0272","description":"Home episodic case 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8X","description":"Low Rehab_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"K flow/funct image w/drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78708","description":"K flow/funct image w/drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFC1","description":"ICD-BDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43195","description":"Esophagoscopy rigid balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJE0","description":"ICD-JHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26720","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc count of ct in 12mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9321","description":"Doc count of ct in 12mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic control hip heavy dut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2620","description":"Pelvic control hip heavy dut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIC0","description":"ICD-GIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Buccal/labial frenectomy (frenulectomy)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7961","description":"Buccal/labial frenectomy (frenulectomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDF1","description":"ICD-ICDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQF0","description":"ICD-OJQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYC0","description":"ICD-LHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of calcitonin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82308","description":"Assay of calcitonin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst stg1-2 noprogres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9072","description":"Onc dx brst stg1-2 noprogres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAB1","description":"ICD-MCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAC1","description":"ICD-AHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJF0","description":"ICD-CCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fees w/laryngeal sense test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92616","description":"Fees w/laryngeal sense test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIB0","description":"ICD-AHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICE0","description":"ICD-GICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Micafungin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2248","description":"Micafungin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srch for ct w in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9341","description":"Srch for ct w in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28F","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDE0","description":"ICD-IHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clotting assay whole blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85396","description":"Clotting assay whole blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTE1","description":"ICD-BBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEC0","description":"ICD-JAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOA1","description":"ICD-KBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway pressure tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7037","description":"Pos airway pressure tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB21","description":"ICD-3DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extracorp shockwv tx anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0102T","description":"Extracorp shockwv tx anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation upper jaw artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30920","description":"Ligation upper jaw artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFB1","description":"ICD-NGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUA1","description":"ICD-EDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28H","description":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99192","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15B","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJD0","description":"ICD-GAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-90382","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","description":"CPT-90382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJE1","description":"ICD-BIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56640","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Belatacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0485","description":"Belatacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no sleep apnea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8840","description":"Doc reas no sleep apnea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOF0","description":"ICD-LGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD251","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWF1","description":"ICD-LBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLE1","description":"ICD-KFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFC1","description":"ICD-CAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGF1","description":"ICD-KIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thumb fusion with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26842","description":"Thumb fusion with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFC0","description":"ICD-GAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJD0","description":"ICD-NIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBD1","description":"ICD-EIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOF0","description":"ICD-HHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAD0","description":"ICD-ECAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGC1","description":"ICD-BBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21C","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relocate pocket for defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33223","description":"Relocate pocket for defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOD0","description":"ICD-KBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMA0","description":"ICD-CBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRE0","description":"ICD-LHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18F","description":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flutter device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8185","description":"Flutter device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo bk ultra-light material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5940","description":"Endo bk ultra-light material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHF1","description":"ICD-AHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of arm muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24331","description":"Revision of arm muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGF0","description":"ICD-JAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINC1","description":"ICD-CINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHD1","description":"ICD-MLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hx bld transf b/f 1992","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9449","description":"Hx bld transf b/f 1992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYF1","description":"ICD-GEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPE1","description":"ICD-BIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dexamethasone comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7637","description":"Dexamethasone comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOF0","description":"ICD-DBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29879","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBD0","description":"ICD-BHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disk/foam pad +or- adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5126","description":"Disk/foam pad +or- adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement breastpump tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4281","description":"Replacement breastpump tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOA1","description":"ICD-GIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKE1","description":"ICD-BCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAA1","description":"ICD-GEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJE1","description":"ICD-GHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Md doc_ door to punc tm >2hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9581","description":"Md doc_ door to punc tm >2hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vitamin b-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84252","description":"Assay of vitamin b-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEE1","description":"ICD-JHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFA1","description":"ICD-OAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0403","description":"HCPCS-A0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absorpt drg <=16 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6254","description":"Absorpt drg <=16 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAF0","description":"ICD-AFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMB0","description":"ICD-FDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHA1","description":"ICD-NJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC60","description":"Medium Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSE0","description":"ICD-OBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vis inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9628","description":"Vis inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7543","description":"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYC1","description":"ICD-HIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHC1","description":"ICD-GFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUD1","description":"ICD-MDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand tendon reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26502","description":"Hand tendon reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKA1","description":"ICD-BIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEF0","description":"ICD-MJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTA0","description":"ICD-BDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36510","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDF0","description":"ICD-ODDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALB0","description":"ICD-OALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWB0","description":"ICD-DCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71023","description":"Chest x-ray and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9938","description":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAC0","description":"ICD-BIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22D","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35151","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTB0","description":"ICD-JDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision subvalvular tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33415","description":"Revision subvalvular tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of leg infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73592","description":"X-ray exam of leg infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVE0","description":"ICD-BDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25565","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUC0","description":"ICD-CDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKID0","description":"ICD-OKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSA0","description":"ICD-KBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWB0","description":"ICD-DAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMD1","description":"ICD-EGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ crizanlizumab-tmca_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0791","description":"Injection_ crizanlizumab-tmca_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo partial colectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44204","description":"Laparo partial colectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fmr1 gene characterization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81244","description":"Fmr1 gene characterization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lo rig pos pnl l1-l5 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0641","description":"Lo rig pos pnl l1-l5 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB11","description":"ICD-1JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPF1","description":"ICD-KFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22630","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28008","description":"Incision of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKF1","description":"ICD-NDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETD1","description":"ICD-AETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCED1","description":"ICD-NCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS B SURFACE ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87340","description":"IAAD IA HEPATITIS B SURFACE ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLE1","description":"ICD-OGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASA1","description":"ICD-GASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2186","description":"Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHA0","description":"ICD-GIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt post facet implt thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0220T","description":"Plmt post facet implt thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIE0","description":"ICD-NLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYF1","description":"ICD-HBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGA0","description":"ICD-OHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1011","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFD0","description":"ICD-FCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of sirolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80195","description":"Assay of sirolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69660","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace/irrigate catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62194","description":"Replace/irrigate catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUF0","description":"ICD-KDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagectomy_ distal two-thirds_ with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43287","description":"Esophagectomy_ distal two-thirds_ with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth pharyngeal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17651","description":"Anesth pharyngeal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC41","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESA0","description":"ICD-HESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wedge resect of lung initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32505","description":"Wedge resect of lung initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Strapping of ankle and/or ft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29540","description":"Strapping of ankle and/or ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12D","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurobehavioral status exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96116","description":"Neurobehavioral status exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCA0","description":"ICD-CFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE255","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal foreign body mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40804","description":"Removal foreign body mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITE0","description":"ICD-NITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQE0","description":"ICD-KDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFC1","description":"ICD-NIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54861","description":"Removal of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILC1","description":"ICD-NILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCD1","description":"ICD-JDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICB1","description":"ICD-KICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Near ifr spectrsc of wounds","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0286T","description":"Near ifr spectrsc of wounds","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9376","description":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKD0","description":"ICD-GIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Clinical Problem_ With Limited Review Of Patient_S History And Medical Records And Straightforward Medical Decision Making When Using Ti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80503","description":"Pathology Clinical Consultation; For A Clinical Problem_ With Limited Review Of Patient_S History And Medical Records And Straightforward Medical Decision Making When Using Ti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23650","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITB1","description":"ICD-NITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRE0","description":"ICD-HFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHF0","description":"ICD-AAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00851","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","description":"CPT-00851","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove part thorax vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22112","description":"Remove part thorax vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC140","description":"Special Care High _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj ceftolozane tazobactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0695","description":"Inj ceftolozane tazobactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixation of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27860","description":"Fixation of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILE1","description":"ICD-FILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens bifocal seg width over","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2219","description":"Lens bifocal seg width over","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRC0","description":"ICD-PFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay lipoprotein pla2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83698","description":"Assay lipoprotein pla2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37273","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","description":"CPT-37273","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFE0","description":"ICD-BCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICD0","description":"ICD-CICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artificial saliva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9155","description":"Artificial saliva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72194","description":"Ct pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHB1","description":"ICD-EEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPF0","description":"ICD-GFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO hip intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9729","description":"Patient unable to complete the FOTO hip intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAE0","description":"ICD-BEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE251","description":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECE1","description":"ICD-EECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFA1","description":"ICD-JFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEF0","description":"ICD-FGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSC0","description":"ICD-LGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc surv no stroke after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9259","description":"Doc surv no stroke after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXB1","description":"ICD-GAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52285","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWB0","description":"ICD-CIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01480","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","description":"CPT-01480","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUF1","description":"ICD-MFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHE1","description":"ICD-NKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWF0","description":"ICD-HDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVD1","description":"ICD-BAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIF1","description":"ICD-GGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein six or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33516","description":"Cabg vein six or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLE1","description":"ICD-ECLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBE1","description":"ICD-CEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko single upright pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0901","description":"Ko single upright pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYD1","description":"ICD-PHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray&fluoro 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71034","description":"Chest x-ray&fluoro 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15945","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLF0","description":"ICD-NCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMF0","description":"ICD-BHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESA1","description":"ICD-OESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHF1","description":"ICD-CAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMA0","description":"ICD-IBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNA1","description":"ICD-KFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXA0","description":"ICD-JHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRB0","description":"ICD-DGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEA1","description":"ICD-NKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repriza_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4143","description":"Repriza_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35363","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMB1","description":"ICD-BHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA12","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Services performed by a doula birth worker_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1033","description":"Services performed by a doula birth worker_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep b scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3513F","description":"Hep b scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSF1","description":"ICD-HDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTF0","description":"ICD-JHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTA1","description":"ICD-KCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagosc flex trnsn biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43198","description":"Esophagosc flex trnsn biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95713","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45309","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFB0","description":"ICD-OBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21B","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rsa lower extr exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0350T","description":"Rsa lower extr exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIED0","description":"ICD-NIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUD1","description":"ICD-BAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27824","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUE1","description":"ICD-BAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKE1","description":"ICD-JBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M.avium-intra dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87562","description":"M.avium-intra dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9715","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL40","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJF0","description":"ICD-FBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUC1","description":"ICD-BIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPC0","description":"ICD-KBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including frontal sinus exploration_ with removal of tissue from frontal sinus_ when perfor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31253","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including frontal sinus exploration_ with removal of tissue from frontal sinus_ when perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of humeral externally controlled intramedullary device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0595T","description":"Removal of humeral externally controlled intramedullary device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shlder disart int lock elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6300","description":"Shlder disart int lock elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGE0","description":"ICD-JIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKE1","description":"ICD-OFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bile acids cholylglycine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82240","description":"Bile acids cholylglycine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERD1","description":"ICD-HERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDA1","description":"ICD-MJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prochlorperazine maleate 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0164","description":"Prochlorperazine maleate 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUC1","description":"ICD-MIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66761","description":"Revision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUD0","description":"ICD-OGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1904","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1904","description":"CDT-D1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWE1","description":"ICD-OCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53265","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fentanyl citrate injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3010","description":"Fentanyl citrate injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDB1","description":"ICD-MIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"C-reactive protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86140","description":"C-reactive protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQC0","description":"ICD-KGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEE1","description":"ICD-JFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB241","description":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit est age 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99392","description":"Prev visit est age 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4C","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJC0","description":"ICD-NIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX13","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hallux rigidus correction with cheilectomy_ debridement and capsular release of the first metatarsophalangeal joint; with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28291","description":"Hallux rigidus correction with cheilectomy_ debridement and capsular release of the first metatarsophalangeal joint; with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOD1","description":"ICD-DFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vantas implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9225","description":"Vantas implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJA0","description":"ICD-CFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB22","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of acth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82024","description":"Assay of acth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB213","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Impltj ntrstrml crnl rng seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65785","description":"Impltj ntrstrml crnl rng seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJD0","description":"ICD-CGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8X","description":"Medium Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (breast)_ targeted hybrid-capture genomic sequence analysis panel_ circulating tumor DNA (ctDNA) analysis of 56 or more genes_ interrogation for sequence variants_ ge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0428U","description":"Oncology (breast)_ targeted hybrid-capture genomic sequence analysis panel_ circulating tumor DNA (ctDNA) analysis of 56 or more genes_ interrogation for sequence variants_ ge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSC0","description":"ICD-LDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD216","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFC0","description":"ICD-BBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9769","description":"Cystourethroscopy_ with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBC1","description":"ICD-OBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient transfer system >300","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1036","description":"Patient transfer system >300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of total thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84436","description":"Assay of total thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB154","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHC1","description":"ICD-CFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJC0","description":"ICD-KBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSE0","description":"ICD-OKSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMF0","description":"ICD-NDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Did Not Receive At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period; Or H","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2156","description":"Patient Did Not Receive At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period; Or H","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable nebulizer prefill","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7008","description":"Disposable nebulizer prefill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTA1","description":"ICD-FBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Creation of arteriovenous fistula_ percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9755","description":"Creation of arteriovenous fistula_ percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of elbow bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24105","description":"Removal of elbow bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smear fluorescent/acid stai","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87206","description":"Smear fluorescent/acid stai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject congenital card cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93563","description":"Inject congenital card cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKF1","description":"ICD-KGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIF1","description":"ICD-OCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orbital replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5928","description":"Orbital replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33978","description":"Remove ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDA0","description":"ICD-KEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBA0","description":"ICD-AHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst stg3-hr_ no pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9073","description":"Onc dx brst stg3-hr_ no pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Statin not presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9443","description":"Statin not presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lat thor/lumb addl seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22534","description":"Lat thor/lumb addl seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special eye exam subsequent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92226","description":"Special eye exam subsequent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAC1","description":"ICD-OBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0980T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","description":"CPT-0980T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0085","description":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMF1","description":"ICD-MDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGF0","description":"ICD-NBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUC1","description":"ICD-OCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKE0","description":"ICD-JDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1086T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1086T","description":"CPT-1086T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sterile gauze>16 <= 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6403","description":"Sterile gauze>16 <= 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cataract mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8765","description":"Cataract mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCF1","description":"ICD-CDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26358","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA251","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDD1","description":"ICD-GHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt cran bone flap to abdo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61316","description":"Implt cran bone flap to abdo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0842T","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMF0","description":"ICD-IDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAC0","description":"ICD-BEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANF1","description":"ICD-NANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted case management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1017","description":"Targeted case management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC244","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYB1","description":"ICD-GGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1388","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","description":"HCPCS-M1388","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78306","description":"Bone imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAC1","description":"ICD-IEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCF0","description":"ICD-AHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glassia injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0257","description":"Glassia injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert 2 electrode pm-defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33217","description":"Insert 2 electrode pm-defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0643","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0643","description":"HCPCS-J0643","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esano aca_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4275","description":"Esano aca_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYF1","description":"ICD-HGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFF1","description":"ICD-NKFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMC1","description":"ICD-KFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraop image confirm excise","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8872","description":"Intraop image confirm excise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHB0","description":"ICD-KFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35305","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUB0","description":"ICD-KFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXA1","description":"ICD-FCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELC1","description":"ICD-NELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGE0","description":"ICD-FBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUA1","description":"ICD-OLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1901","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1901","description":"CDT-D1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJB0","description":"ICD-FCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary prostate cancer-related disorders_ genomic sequence analysis panel using next-generation sequencing (NGS)_ Sanger sequencing_ multiplex ligation-dependent probe amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0475U","description":"Hereditary prostate cancer-related disorders_ genomic sequence analysis panel using next-generation sequencing (NGS)_ Sanger sequencing_ multiplex ligation-dependent probe amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASC1","description":"ICD-DASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alarm symp assessed-1+ prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1071F","description":"Alarm symp assessed-1+ prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYE0","description":"ICD-DGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLA0","description":"ICD-KDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTE0","description":"ICD-ODTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOC1","description":"ICD-PGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9171","description":"HCPCS-C9171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGB1","description":"ICD-BGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vim_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4251","description":"Vim_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interim abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6051","description":"Interim abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEF1","description":"ICD-NBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73110","description":"X-ray exam of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ olanzapine_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2359","description":"Injection_ olanzapine_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXF1","description":"ICD-CHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meningococcal conjugate vaccine_ serogroups A_ C_ W_ Y_ quadrivalent_ tetanus toxoid carrier (MenACWY-TT)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90619","description":"Meningococcal conjugate vaccine_ serogroups A_ C_ W_ Y_ quadrivalent_ tetanus toxoid carrier (MenACWY-TT)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOE1","description":"ICD-DHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAC1","description":"ICD-EBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAB1","description":"ICD-JGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD212","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRC0","description":"ICD-PCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Florbetapir f18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9586","description":"Florbetapir f18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDE1","description":"ICD-OKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Systemic corticosteroids rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4135F","description":"Systemic corticosteroids rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCF1","description":"ICD-KFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ercp lithotripsy calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43265","description":"Ercp lithotripsy calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGD0","description":"ICD-OAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20D","description":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter w/bag 3-way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4313","description":"Catheter w/bag 3-way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQC0","description":"ICD-GHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-apgf_ biosimilar_ (nyvepria)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5122","description":"Injection_ pegfilgrastim-apgf_ biosimilar_ (nyvepria)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rib cartilage graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21230","description":"Rib cartilage graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of upper nose/throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42806","description":"Biopsy of upper nose/throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wedge resect of lung diag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32507","description":"Wedge resect of lung diag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLF1","description":"ICD-OLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOD1","description":"ICD-KBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAC0","description":"ICD-IFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Safety concerns screen provided and if positive then documented mitigation recommendations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9922","description":"Safety concerns screen provided and if positive then documented mitigation recommendations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCE0","description":"ICD-CBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC245","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29898","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVE1","description":"ICD-GGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6100","description":"Removal of implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC11","description":"ICD-1KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ binaural_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5249","description":"Hearing aid_ binaural_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB20","description":"Low Rehab_ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add pwr joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0983","description":"Add pwr joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNA0","description":"ICD-OGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKC0","description":"ICD-JAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBE0","description":"ICD-ODBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00534","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","description":"CPT-00534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQB0","description":"ICD-CDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBB0","description":"ICD-BEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDF1","description":"ICD-NJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Htlv/hiv confirmj antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86689","description":"Htlv/hiv confirmj antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEE1","description":"ICD-BFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33774","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA31","description":"Default_ /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUE0","description":"ICD-IFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCA1","description":"ICD-OJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of shoulder cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29055","description":"Application of shoulder cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPB1","description":"ICD-KBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited autopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88037","description":"Limited autopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPB0","description":"ICD-KGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADF0","description":"ICD-BADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNA1","description":"ICD-GBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ect provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4066F","description":"Ect provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLE0","description":"ICD-OFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINE0","description":"ICD-KINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACE0","description":"ICD-CACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1425","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","description":"HCPCS-M1425","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5165","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5165","description":"HCPCS-Q5165","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27138","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXC0","description":"ICD-JFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stnd wt frame power whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0010","description":"Stnd wt frame power whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10051","description":"Anesth salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHA1","description":"ICD-OCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXB0","description":"ICD-BAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJE0","description":"ICD-BEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUE0","description":"ICD-AAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIA1","description":"ICD-MCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Herpes simplex type 2 test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86696","description":"Herpes simplex type 2 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBID0","description":"ICD-IBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXA0","description":"ICD-NHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFE1","description":"ICD-GAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Md certification hha patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0180","description":"Md certification hha patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/.25-2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2111","description":"Spherocylindr 7.25d/.25-2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJC0","description":"ICD-GFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22A","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSF0","description":"ICD-PLSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLC1","description":"ICD-NDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL03","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NFCT DS RNA 4 TARGETS UPPER RESPIRATORY SPECIMEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0241U","description":"NFCT DS RNA 4 TARGETS UPPER RESPIRATORY SPECIMEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0080","description":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0C","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLE1","description":"ICD-NCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51060","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0618","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","description":"HCPCS-J0618","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt referral psych docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4062F","description":"Pt referral psych docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ace/arb therapy rxd/taken","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4010F","description":"Ace/arb therapy rxd/taken","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney & ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50234","description":"Removal of kidney & ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYD0","description":"ICD-PFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKD0","description":"ICD-CFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27594","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSB0","description":"ICD-KFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUA1","description":"ICD-FDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYA1","description":"ICD-CBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43107","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAC0","description":"ICD-IAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPA0","description":"ICD-BGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDA1","description":"ICD-IDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair multi-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54408","description":"Repair multi-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1084T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1084T","description":"CPT-1084T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKC1","description":"ICD-OAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFD1","description":"ICD-KEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBA1","description":"ICD-IIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAA1","description":"ICD-AGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECID0","description":"ICD-ECID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNB1","description":"ICD-GDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUE0","description":"ICD-FDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor_ including system activation and patient training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0446T","description":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor_ including system activation and patient training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECC1","description":"ICD-KECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dementia severity classified_ moderate (DEM)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2033F","description":"Dementia severity classified_ moderate (DEM)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNF0","description":"ICD-NDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nonstnd lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0581","description":"Nonstnd lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77048","description":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy w/bx & op scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31536","description":"Laryngoscopy w/bx & op scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMD1","description":"ICD-FIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43634","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76080","description":"X-ray exam of fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10A","description":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKD1","description":"ICD-CIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4B","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTE0","description":"ICD-EHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFA0","description":"ICD-OLFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBA0","description":"ICD-ABBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGC1","description":"ICD-BDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biphos thxpy vein ord/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4100F","description":"Biphos thxpy vein ord/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFF0","description":"ICD-CBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIID1","description":"ICD-BIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA12","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE116","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lisocabtagene maraleucel_ up to 110 million autologous anti  CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2054","description":"Lisocabtagene maraleucel_ up to 110 million autologous anti  CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0303","description":"HCPCS-A0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Giardia lamblia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86674","description":"Giardia lamblia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKD0","description":"ICD-CCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of body section","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76100","description":"X-ray exam of body section","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administrat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0089","description":"Professional services_ initial visit_ for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c vent tray gimbaled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1030","description":"W/c vent tray gimbaled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRD0","description":"ICD-OGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVD1","description":"ICD-JBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast stacked diep/gap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2067","description":"Breast stacked diep/gap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDB1","description":"ICD-NFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRD0","description":"ICD-CFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCID1","description":"ICD-NCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXF0","description":"ICD-GFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIE1","description":"ICD-IIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGB0","description":"ICD-NHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYF1","description":"ICD-KHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB11","description":"ICD-3LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCD0","description":"ICD-IGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHA0","description":"ICD-ICHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brake for wheeled walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0159","description":"Brake for wheeled walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRC0","description":"ICD-CGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6013","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXA1","description":"ICD-CEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAF1","description":"ICD-BDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEC0","description":"ICD-NHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay myeloperoxidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83876","description":"Assay myeloperoxidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In hospice or using hospice services during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1167","description":"In hospice or using hospice services during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos microalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3060F","description":"Pos microalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording_ data scanning_ with raw electronic signal transfer of data and storage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0476T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording_ data scanning_ with raw electronic signal transfer of data and storage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CAD])_ 9 genes (12 variants)_ targeted variant genotyping_ blood_ saliva_ or buccal swab_ algorithm reported as a genetic risk score for a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0401U","description":"Cardiology (coronary heart disease [CAD])_ 9 genes (12 variants)_ targeted variant genotyping_ blood_ saliva_ or buccal swab_ algorithm reported as a genetic risk score for a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBC0","description":"ICD-FDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surgery of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47451","description":"Anesth surgery of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLF1","description":"ICD-MLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair carpal bone shorten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25394","description":"Repair carpal bone shorten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracic intern lock elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6350","description":"Thoracic intern lock elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTF0","description":"ICD-OLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37160","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermavest_ plurivest sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4153","description":"Dermavest_ plurivest sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50980","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderna Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 3)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1710","description":"Moderna Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"A/d tx program_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2036","description":"A/d tx program_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen-specific nucleic acid (DNA or RNA)_ 22 targets including severe acute respiratory syndrome corona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0223U","description":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen-specific nucleic acid (DNA or RNA)_ 22 targets including severe acute respiratory syndrome corona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIED1","description":"ICD-GIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBD1","description":"ICD-EHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBF0","description":"ICD-JBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB240","description":"Reduced Physical Function _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB146","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl perph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33965","description":"Ecmo/ecls rmvl perph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11B","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ibuprofen injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1741","description":"Ibuprofen injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGA0","description":"ICD-JEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Max sterile barriers flwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6030F","description":"Max sterile barriers flwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIC1","description":"ICD-FEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6063","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24B","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYD1","description":"ICD-KAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed semi-elect w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0295","description":"Hosp bed semi-elect w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVB0","description":"ICD-OEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGB1","description":"ICD-JAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAF1","description":"ICD-MEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2009","description":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TGFBI (transforming growth factor beta-induced) (eg_ corneal dystrophy) gene analysis_ common variants (eg_ R124H_ R124C_ R124L_ R555W_ R555Q)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81333","description":"TGFBI (transforming growth factor beta-induced) (eg_ corneal dystrophy) gene analysis_ common variants (eg_ R124H_ R124C_ R124L_ R555W_ R555Q)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not screening for tobacco use (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9904","description":"Documentation of medical reason(s) for not screening for tobacco use (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJA1","description":"ICD-GFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAD0","description":"ICD-GBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAB0","description":"ICD-CAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66130","description":"Remove eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct abdomen w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74160","description":"Ct abdomen w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXF0","description":"ICD-KBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWF1","description":"ICD-PIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSA1","description":"ICD-LGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fecal blood scrn immunoassay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0328","description":"Fecal blood scrn immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQC1","description":"ICD-HFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUC1","description":"ICD-CFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16071","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16071","description":"CPT-16071","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initial treatment of burn(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16000","description":"Initial treatment of burn(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J9011","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","description":"HCPCS-J9011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who are counseled on connection with a csp and explicitly opt out","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1317","description":"Patients who are counseled on connection with a csp and explicitly opt out","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENB0","description":"ICD-JENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vital signs recorded","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2010F","description":"Vital signs recorded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMB0","description":"ICD-BAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQC0","description":"ICD-GEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATF1","description":"ICD-CATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTB1","description":"ICD-JBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified hea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9037","description":"Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified hea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLB0","description":"ICD-AGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIF1","description":"ICD-MCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 vhd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0863","description":"Pwc gp3 vhd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q2058","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","description":"HCPCS-Q2058","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUE0","description":"ICD-CIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25455","description":"Revision of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHME1","description":"ICD-CHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CoreCyte_ for topical use only_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4240","description":"CoreCyte_ for topical use only_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCD0","description":"ICD-NDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBC1","description":"ICD-EHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEB1","description":"ICD-JGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWB0","description":"ICD-PIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision benign lesion compl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7412","description":"Excision benign lesion compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRC1","description":"ICD-DBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med txmnt options rvwd w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4325F","description":"Med txmnt options rvwd w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcath stent cca w/o eps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37216","description":"Transcath stent cca w/o eps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB105","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANC1","description":"ICD-GANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBD0","description":"ICD-BIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr-staph dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87641","description":"Mr-staph dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of pelvis brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20662","description":"Application of pelvis brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSB0","description":"ICD-PKSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHA1","description":"ICD-KCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGA1","description":"ICD-CDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKE0","description":"ICD-FEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECC1","description":"ICD-BECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLF0","description":"ICD-KCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUF1","description":"ICD-MKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE154","description":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0181","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPE1","description":"ICD-OAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBE0","description":"ICD-MGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual fully reclining back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1226","description":"Manual fully reclining back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLA0","description":"ICD-IBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYA0","description":"ICD-CHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA230","description":"Clinically Complex _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJC1","description":"ICD-BAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brst prsth bra & bilat form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8002","description":"Brst prsth bra & bilat form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of thigh brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20663","description":"Application of thigh brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHC1","description":"ICD-CAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low extemity neur not perfor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8405","description":"Low extemity neur not perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAC0","description":"ICD-GIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscope proc bla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51999","description":"Laparoscope proc bla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAC0","description":"ICD-KFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALD0","description":"ICD-GALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc tempory vessel occl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61623","description":"Endovasc tempory vessel occl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneuma/vac walk boot pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4361","description":"Pneuma/vac walk boot pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLA1","description":"ICD-EDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage ext line_ dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4672","description":"Drainage ext line_ dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray/ct/ultrsnd et al ord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3319F","description":"X-ray/ct/ultrsnd et al ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWE0","description":"ICD-HIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl devital tis addl 20cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97598","description":"Rmvl devital tis addl 20cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHD1","description":"ICD-KGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDE0","description":"ICD-IIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bk/ak locking mechanism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5671","description":"Bk/ak locking mechanism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJB1","description":"ICD-JIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c wdth 20-23 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2340","description":"W/c wdth 20-23 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWF0","description":"ICD-PIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug interven","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0022","description":"Alcohol and/or drug interven","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUB0","description":"ICD-KEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXF0","description":"ICD-OEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc funct no deficiencies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8542","description":"Doc funct no deficiencies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exposure behavior treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0373T","description":"Exposure behavior treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy & revise urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52270","description":"Cystoscopy & revise urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYD1","description":"ICD-GBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATF0","description":"ICD-JATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CT studies not reported to a radiation dose index registry due to medical reasons (eg_ ct studies performed for radiation treatment planning or image-guided radiation trtmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9325","description":"CT studies not reported to a radiation dose index registry due to medical reasons (eg_ ct studies performed for radiation treatment planning or image-guided radiation trtmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42972","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAB0","description":"ICD-AFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITD1","description":"ICD-MITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainable pch w st wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4389","description":"Drainable pch w st wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYA0","description":"ICD-CIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWF1","description":"ICD-CBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAF1","description":"ICD-NBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIF1","description":"ICD-JBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAB0","description":"ICD-JCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE256","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKE0","description":"ICD-KAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCB0","description":"ICD-JFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1102","description":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSF1","description":"ICD-GGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95976","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBA0","description":"ICD-BBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMC0","description":"ICD-OLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of cathepsin-d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82387","description":"Assay of cathepsin-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External ambulatory infus pu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0781","description":"External ambulatory infus pu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPA1","description":"ICD-OHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE217","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLE1","description":"ICD-KCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bed cradle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0280","description":"Bed cradle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAA0","description":"ICD-CEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLA1","description":"ICD-IGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vad different session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33992","description":"Remove vad different session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELF1","description":"ICD-BELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC206","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4346","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","description":"HCPCS-Q4346","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPE0","description":"ICD-BGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9819","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIE1","description":"ICD-FGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flu immuno admind rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4274F","description":"Flu immuno admind rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCA1","description":"ICD-IDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWE0","description":"ICD-PIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCB0","description":"ICD-JDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth esophageal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50051","description":"Anesth esophageal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28A","description":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAA1","description":"ICD-NHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Long chain fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82726","description":"Long chain fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36013","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBA1","description":"ICD-NFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt or manip for maint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8990","description":"Pt or manip for maint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELD1","description":"ICD-NELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVF0","description":"ICD-BAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a certified peer sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0140","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a certified peer sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0608U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","description":"CPT-0608U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99236","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB216","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mold socket bent knee shin s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5160","description":"Mold socket bent knee shin s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0556U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","description":"CPT-0556U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc abd les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22902","description":"Exc abd les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression garment_ bra_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6529","description":"Gradient compression garment_ bra_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUE0","description":"ICD-AIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cysto/uretero stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52344","description":"Cysto/uretero stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply multlay comprs upr arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29583","description":"Apply multlay comprs upr arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPB1","description":"ICD-NJPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKC0","description":"ICD-GCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of pregnanetriol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84138","description":"Assay of pregnanetriol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGC1","description":"ICD-KEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDC0","description":"ICD-GBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGME0","description":"ICD-JGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit stoma care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99505","description":"Home visit stoma care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self care current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8987","description":"Self care current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","description":"HCPCS-M1387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSB0","description":"ICD-ODSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antithrombin iii activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85300","description":"Antithrombin iii activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post 3 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2393","description":"Post 3 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCE1","description":"ICD-FHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB34","description":"High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd tube/cath insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43241","description":"Egd tube/cath insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC125","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTD1","description":"ICD-NFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXE1","description":"ICD-KCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGD1","description":"ICD-CHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria and fungi)_ gram-negative bacterial identification and drug resistance element detection_ DNA (21 gram-negative bacterial targets_ 6 resistance ge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0142U","description":"Infectious disease (bacteria and fungi)_ gram-negative bacterial identification and drug resistance element detection_ DNA (21 gram-negative bacterial targets_ 6 resistance ge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28C","description":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHF0","description":"ICD-CGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vein x-ray neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75860","description":"Vein x-ray neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHA0","description":"ICD-NKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of toe tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28010","description":"Incision of toe tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SanoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4319","description":"SanoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFB0","description":"ICD-JFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammo assess cat in dbase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7020F","description":"Mammo assess cat in dbase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRC1","description":"ICD-PCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAB0","description":"ICD-JIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSD0","description":"ICD-OLSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko immob canvas long pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1830","description":"Ko immob canvas long pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ methylprednisolone acetate_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1010","description":"Injection_ methylprednisolone acetate_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDE0","description":"ICD-BEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMD0","description":"ICD-CFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp comm supp svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2015","description":"Comp comm supp svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCB1","description":"ICD-CCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJD1","description":"ICD-NLJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUF1","description":"ICD-OIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20B","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHC0","description":"ICD-CIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB11","description":"ICD-3AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHF0","description":"ICD-NJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDF0","description":"ICD-BFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIE1","description":"ICD-IDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDA1","description":"ICD-NFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMB1","description":"ICD-OJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Csit on pt any reas 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8962","description":"Csit on pt any reas 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthoptic training; under supervision of a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92066","description":"Orthoptic training; under supervision of a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risperidone (rykindo)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2801","description":"Injection_ risperidone (rykindo)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise epiphyseal bar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20150","description":"Excise epiphyseal bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnt pain noted pain prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1125F","description":"Amnt pain noted pain prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0956T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","description":"CPT-0956T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQD1","description":"ICD-KCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HPYLORI STOOL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87338","description":"IAAD IA HPYLORI STOOL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUB1","description":"ICD-MAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay dipropylacetic acd tot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80164","description":"Assay dipropylacetic acd tot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKA0","description":"ICD-NCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEB0","description":"ICD-CFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASB1","description":"ICD-HASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFA1","description":"ICD-GAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9942","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc system reas adv imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9537","description":"Doc system reas adv imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWE0","description":"ICD-KFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKA0","description":"ICD-NLKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWD0","description":"ICD-GEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHB1","description":"ICD-IGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVC0","description":"ICD-GCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKD0","description":"ICD-OEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFC1","description":"ICD-CEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEF1","description":"ICD-KGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBC0","description":"ICD-ECBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral everolimus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7527","description":"Oral everolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cysto w/ureter stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52341","description":"Cysto w/ureter stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDE1","description":"ICD-AHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTE1","description":"ICD-OHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTF1","description":"ICD-OKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPD1","description":"ICD-KEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ankle ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27695","description":"Repair of ankle ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37293","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","description":"CPT-37293","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0704","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0704","description":"CDT-D0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"L hrt artery/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93458","description":"L hrt artery/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFA0","description":"ICD-OCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWF1","description":"ICD-LHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of pyruvate kinase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84220","description":"Assay of pyruvate kinase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXE1","description":"ICD-CGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBC1","description":"ICD-NLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBF1","description":"ICD-CCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOD0","description":"ICD-PIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9852","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHD0","description":"ICD-FDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27259","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External cannula declotting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36860","description":"External cannula declotting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAD1","description":"ICD-AEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo hip ultra-light materia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5960","description":"Endo hip ultra-light materia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C8008","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8008","description":"HCPCS-C8008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small disposable underpad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4542","description":"Small disposable underpad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not receive at least one well-child visit with PCP during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9965","description":"Patient did not receive at least one well-child visit with PCP during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visual ep acuity screen auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0333T","description":"Visual ep acuity screen auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITF0","description":"ICD-FITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible_ proximal to splenic flexure; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6025","description":"Colonoscopy_ flexible_ proximal to splenic flexure; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28C","description":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCED0","description":"ICD-OCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dermabind dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4287","description":"Dermabind dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUF0","description":"ICD-NDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient transfer to practice after initiation of chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9833","description":"Patient transfer to practice after initiation of chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ltwt portbl power whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0012","description":"Ltwt portbl power whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATA1","description":"ICD-OATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCA0","description":"ICD-MJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental onlay porcelin 3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2643","description":"Dental onlay porcelin 3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPD0","description":"ICD-CGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOD0","description":"ICD-OEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOA1","description":"ICD-CCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOF1","description":"ICD-LEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx isodose complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77318","description":"Brachytx isodose complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYC0","description":"ICD-GBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso corset front","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0970","description":"Tlso corset front","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0660","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","description":"HCPCS-G0660","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETD0","description":"ICD-BETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCE1","description":"ICD-KCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJE0","description":"ICD-GCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCC1","description":"ICD-EGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Pasireotide Long Acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9454","description":"Injection_ Pasireotide Long Acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ans parasymp & symp w/tilt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95924","description":"Ans parasymp & symp w/tilt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDED1","description":"ICD-IDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9891","description":"MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL23","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB136","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPA0","description":"ICD-NFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNB0","description":"ICD-NDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0703","description":"HCPCS-C0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPB1","description":"ICD-KHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHB1","description":"ICD-KBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ferric derisomaltose_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1437","description":"Injection_ ferric derisomaltose_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0662U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0662U","description":"CPT-0662U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIF0","description":"ICD-NFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVC1","description":"ICD-FCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSA0","description":"ICD-GHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHB0","description":"ICD-GHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMF0","description":"ICD-FEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Footrest complete assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0045","description":"Footrest complete assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHE0","description":"ICD-OCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suture complicate wnd > 5 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7912","description":"Suture complicate wnd > 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYB1","description":"ICD-LEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLF0","description":"ICD-ACLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFD1","description":"ICD-CDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJA1","description":"ICD-KDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow imaging ltd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78102","description":"Bone marrow imaging ltd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CoreText or ProText_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4246","description":"CoreText or ProText_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPF0","description":"ICD-BBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDE1","description":"ICD-OBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat scor nek/ts not don","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8674","description":"Fun stat scor nek/ts not don","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBD0","description":"ICD-AHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBE0","description":"ICD-KCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTA0","description":"ICD-OKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYE0","description":"ICD-PLYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1736","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","description":"HCPCS-J1736","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJF1","description":"ICD-BFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tenofovir_ by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ urine_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0025U","description":"Tenofovir_ by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ urine_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 4 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3380F","description":"Ajcc brstcncr stage 4 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCD1","description":"ICD-MBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL02","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastroenterology (irritable bowel syndrome [IBS])_ immunoassay for anti-CdtB and anti-vinculin antibodies_ utilizing plasma_ algorithm for elevated or not elevated qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164U","description":"Gastroenterology (irritable bowel syndrome [IBS])_ immunoassay for anti-CdtB and anti-vinculin antibodies_ utilizing plasma_ algorithm for elevated or not elevated qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC11","description":"ICD-3KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microdissection laser","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88380","description":"Microdissection laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabg vein three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33512","description":"Cabg vein three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14A","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPB0","description":"ICD-JHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3A","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXC0","description":"ICD-KHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8F","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDF0","description":"ICD-ACDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj trigeminal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64400","description":"N block inj trigeminal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDC0","description":"ICD-OHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29850","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt in the home per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9131","description":"Pt in the home per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25490","description":"Reinforce radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99231","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0648U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0648U","description":"CPT-0648U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1A","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGA1","description":"ICD-KAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Deb skin bone at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11012","description":"Deb skin bone at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelv band/spread bar thigh c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1640","description":"Pelv band/spread bar thigh c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNC0","description":"ICD-BFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRB0","description":"ICD-GDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cryosurgery penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54056","description":"Cryosurgery penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB254","description":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Aim Specialty Health_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1007","description":"Clinical Decision Support Mechanism Aim Specialty Health_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDC0","description":"ICD-MGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc fx & test/txmnt for op","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5015F","description":"Doc fx & test/txmnt for op","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECB0","description":"ICD-BECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUF1","description":"ICD-BGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIC1","description":"ICD-GDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transperi needle place pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55875","description":"Transperi needle place pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKE0","description":"ICD-KEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25505","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFA1","description":"ICD-OHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBA0","description":"ICD-MFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std seat elevate cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0831","description":"Pwc gp2 std seat elevate cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMC0","description":"ICD-GBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy lymph node biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38570","description":"Laparoscopy lymph node biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gs mg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9235","description":"Gs mg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIC0","description":"ICD-BEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHC0","description":"ICD-BIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXA1","description":"ICD-JGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70480","description":"Ct orbit/ear/fossa w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLB0","description":"ICD-ADLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEC0","description":"ICD-NLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAC1","description":"ICD-FCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of toe lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28108","description":"Removal of toe lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWF1","description":"ICD-CIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUD0","description":"ICD-BIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAE1","description":"ICD-OHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOA1","description":"ICD-LIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQF1","description":"ICD-CBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDE0","description":"ICD-NJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQF1","description":"ICD-OCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9874","description":"Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEA0","description":"ICD-MJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOA1","description":"ICD-CFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJA0","description":"ICD-OHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVD1","description":"ICD-JCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBE1","description":"ICD-GCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25545","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reset dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21480","description":"Reset dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLB0","description":"ICD-KBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Forceps esoph biopsy done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3150F","description":"Forceps esoph biopsy done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBE1","description":"ICD-OCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIF0","description":"ICD-ABIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQB0","description":"ICD-DDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRD1","description":"ICD-KFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUA1","description":"ICD-JEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90451","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFF0","description":"ICD-NFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit antibiotic q4h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9504","description":"Hit antibiotic q4h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWC0","description":"ICD-LEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAD1","description":"ICD-CGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skn splt a-grft fac/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15120","description":"Skn splt a-grft fac/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18B","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIF0","description":"ICD-NLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enzyme cell activity ra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82658","description":"Enzyme cell activity ra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILD1","description":"ICD-AILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAID0","description":"ICD-KAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGC1","description":"ICD-FBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepcidin-25_ Enzyme-Linked Immunosorbent Assay (Elisa)_ Serum Or Plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0251U","description":"Hepcidin-25_ Enzyme-Linked Immunosorbent Assay (Elisa)_ Serum Or Plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQD0","description":"ICD-GIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFE1","description":"ICD-JIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29873","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABE1","description":"ICD-GABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYE0","description":"ICD-LAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablation_ Benign Thyroid Nodule(S)_ Percutaneous_ Laser_ Including Imaging Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0673T","description":"Ablation_ Benign Thyroid Nodule(S)_ Percutaneous_ Laser_ Including Imaging Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNE0","description":"ICD-KGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVE0","description":"ICD-JHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQF1","description":"ICD-LCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA60","description":"Default_ /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEF0","description":"ICD-FHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUF0","description":"ICD-MEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33951","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARF1","description":"ICD-HARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICD1","description":"ICD-KICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC43","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAC1","description":"ICD-FEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMA0","description":"ICD-JHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAB0","description":"ICD-EHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUB1","description":"ICD-MCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0602","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0602","description":"CDT-D0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTF0","description":"ICD-BCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extra ambulance attendant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0424","description":"Extra ambulance attendant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Maxillary sinusotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7560","description":"Maxillary sinusotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQA0","description":"ICD-HDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCF0","description":"ICD-NCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUE0","description":"ICD-MLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55180","description":"Revision of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pml/raralpha com breakpoints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81315","description":"Pml/raralpha com breakpoints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJD0","description":"ICD-GGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx orbit w/o manipulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21400","description":"Closed tx orbit w/o manipulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITF1","description":"ICD-BITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90961","description":"Esrd srv 2-3 vsts p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77615","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFD1","description":"ICD-BBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Minoxidil_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0139","description":"Minoxidil_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUD0","description":"ICD-CCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp) And Ocular (Ovemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92519","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp) And Ocular (Ovemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAB1","description":"ICD-FFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC250","description":"Reduced Physical Function _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWC0","description":"ICD-HCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47740","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEA0","description":"ICD-KIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQD1","description":"ICD-DEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPE0","description":"ICD-BFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEF1","description":"ICD-MLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical home_ initial plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0280","description":"Medical home_ initial plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pjp proph ordered cd4 low","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9223","description":"Pjp proph ordered cd4 low","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36815","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTA0","description":"ICD-EDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTF0","description":"ICD-FHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1_ Cripto-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0163U","description":"Oncology (colorectal) screening_ biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1_ Cripto-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXF1","description":"ICD-BDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic procd strg endur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0237","description":"Therapeutic procd strg endur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNE0","description":"ICD-BCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATD1","description":"ICD-IATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC130","description":"Reduced Physical Function _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFB1","description":"ICD-BBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75805","description":"Lymph vessel x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject skin lesions >7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11901","description":"Inject skin lesions >7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Av fuse uppr arm cephalic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36818","description":"Av fuse uppr arm cephalic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA230","description":"Reduced Physical Function _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fall risk assessment docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3288F","description":"Fall risk assessment docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ob us follow-up per fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76816","description":"Ob us follow-up per fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Homecare train pt 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5108","description":"Homecare train pt 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPA0","description":"ICD-CFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECE1","description":"ICD-MECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid repair/modifying","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5014","description":"Hearing aid repair/modifying","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0205","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0205","description":"CDT-D0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTA0","description":"ICD-ACTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIF1","description":"ICD-GFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFE0","description":"ICD-KEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99349","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELE1","description":"ICD-BELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYE1","description":"ICD-LBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary plastic pouch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4381","description":"Urinary plastic pouch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXE0","description":"ICD-KBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRF1","description":"ICD-DHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUF1","description":"ICD-FGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation of small int","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2053","description":"Transplantation of small int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose in lactated ringer_s_ 1000 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5011","description":"5% dextrose in lactated ringer_s_ 1000 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Portable peak flow meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8096","description":"Portable peak flow meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJC0","description":"ICD-KCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCB0","description":"ICD-NKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYF0","description":"ICD-GEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXC1","description":"ICD-ODXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tibial length sock fx or equ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2840","description":"Tibial length sock fx or equ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Each additional cervical vertebral body (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2361","description":"Each additional cervical vertebral body (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD115","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAB0","description":"ICD-FDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aminophyllin 250 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0280","description":"Aminophyllin 250 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC34","description":"Very High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental house call","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9410","description":"Dental house call","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA214","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIB0","description":"ICD-OLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nurse practr visit outs cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0274","description":"Nurse practr visit outs cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ ado-trastuzumab emt 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9354","description":"Inj_ ado-trastuzumab emt 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBC1","description":"ICD-EDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIA0","description":"ICD-ACIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCE0","description":"ICD-OFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aflibercept hd_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9161","description":"Injection_ aflibercept hd_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCB0","description":"ICD-CFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast noble metal inlay 2 sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6606","description":"Cast noble metal inlay 2 sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1188","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGC1","description":"ICD-JCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspiration orbital contents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67415","description":"Aspiration orbital contents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation without programming of implanted phrenic nerve stimulator system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93153","description":"Interrogation without programming of implanted phrenic nerve stimulator system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB141","description":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFED1","description":"ICD-OFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLF0","description":"ICD-NLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMA1","description":"ICD-IAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28E","description":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Donor pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32850","description":"Donor pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPD0","description":"ICD-FCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL34","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95714","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq card revasc chronic 1vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92943","description":"Prq card revasc chronic 1vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUE0","description":"ICD-BGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE212","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18B","description":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zidovudine_ oral_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0104","description":"Zidovudine_ oral_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24B","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aor-celiac-msn-renal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35631","description":"Art byp aor-celiac-msn-renal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTF0","description":"ICD-CHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALC1","description":"ICD-GALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14B","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Obstetrics (pre-implantation genetic testing)_ evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray_ embryonic tissue_ algorithm reported as a probabi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0396U","description":"Obstetrics (pre-implantation genetic testing)_ evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray_ embryonic tissue_ algorithm reported as a probabi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest home_ assi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2014","description":"Limited (30 minutes) care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest home_ assi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bladder calculi irrig sol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2004","description":"Bladder calculi irrig sol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1419","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","description":"HCPCS-M1419","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFF0","description":"ICD-KEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg_ spinocerebellar ataxia)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0231U","description":"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg_ spinocerebellar ataxia)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin-based indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2710","description":"Crown resin-based indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligate esophagus veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43400","description":"Ligate esophagus veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDD0","description":"ICD-AEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative near-infrared fluorescence lymphatic mapping of lymp node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in add","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9756","description":"Intraoperative near-infrared fluorescence lymphatic mapping of lymp node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30462","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26045","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of hypotony","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1326","description":"Patients with a diagnosis of hypotony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/dual leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33230","description":"Insrt pulse gen w/dual leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification of 8 RNA markers (GAPDH_ SMAD4_ ACY1_ AREG_ CDH1_ KRAS_ TNFRSF10B_ EGLN2) and fecal hem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0421U","description":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification of 8 RNA markers (GAPDH_ SMAD4_ ACY1_ AREG_ CDH1_ KRAS_ TNFRSF10B_ EGLN2) and fecal hem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIF1","description":"ICD-IIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUF0","description":"ICD-OLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBB1","description":"ICD-OEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRF1","description":"ICD-DIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBE0","description":"ICD-MFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient admitted to the ICU in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9853","description":"Patient admitted to the ICU in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ amisulpride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0184","description":"Injection_ amisulpride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHA0","description":"ICD-CCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scleral lens liquid bandage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0515","description":"Scleral lens liquid bandage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQD0","description":"ICD-DIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma provocative tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92140","description":"Glaucoma provocative tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extra-oral posterior dental radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0705","description":"Extra-oral posterior dental radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERC1","description":"ICD-OERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE156","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oct breast surg cavity i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0354T","description":"Oct breast surg cavity i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67010","description":"Partial removal of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colectomy w/ileoanal anast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44157","description":"Colectomy w/ileoanal anast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPD1","description":"ICD-GGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dysphagia screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5364","description":"Dysphagia screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular Repair Of Iliac Artery At The Time Of Aorto-Iliac Artery Endograft Placement By Deployment Of An Iliac Branched Endograft Including Pre-Procedure Sizing And Devic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34717","description":"Endovascular Repair Of Iliac Artery At The Time Of Aorto-Iliac Artery Endograft Placement By Deployment Of An Iliac Branched Endograft Including Pre-Procedure Sizing And Devic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHC0","description":"ICD-EDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exchange nephrostomy cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50435","description":"Exchange nephrostomy cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCC1","description":"ICD-FGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Locm >= 400 mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9951","description":"Locm >= 400 mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urokinase 5000 iu injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3364","description":"Urokinase 5000 iu injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58925","description":"Removal of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA201","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCA0","description":"ICD-IHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat scapula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23585","description":"Treat scapula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84234","description":"Assay of progesterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp mal+marg 0.5/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11620","description":"Exc h-f-nk-sp mal+marg 0.5/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IV injection_ bebtelovimab_ include injection and post administration monitoring in the patient’s home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0223","description":"IV injection_ bebtelovimab_ include injection and post administration monitoring in the patient’s home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of suture from anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46754","description":"Removal of suture from anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for ureter x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50690","description":"Injection for ureter x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYC1","description":"ICD-DGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spermicide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4269","description":"Spermicide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC11","description":"ICD-2GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHE0","description":"ICD-IBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVE0","description":"ICD-NBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSE0","description":"ICD-PJSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEC1","description":"ICD-MAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGD1","description":"ICD-GGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARC1","description":"ICD-OARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; fu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81175","description":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDED0","description":"ICD-KDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIA0","description":"ICD-OCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIME1","description":"ICD-BIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot external keel sach foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5970","description":"Foot external keel sach foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion/graft of finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26862","description":"Fusion/graft of finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLC1","description":"ICD-OKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eswl for gallstones","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9034","description":"Eswl for gallstones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAED1","description":"ICD-KAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWC1","description":"ICD-HDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEA0","description":"ICD-AIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNC0","description":"ICD-FBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEF1","description":"ICD-GFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med abortion inc all ex drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0199","description":"Med abortion inc all ex drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE205","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25622","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2090","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18H","description":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/12-2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2107","description":"Spherocylinder 4.25d/12-2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1155","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of bladder wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51860","description":"Repair of bladder wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4415","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","description":"HCPCS-Q4415","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOE1","description":"ICD-CCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4398","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","description":"HCPCS-Q4398","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth surg lower abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84051","description":"Anesth surg lower abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilated macular exam performed_ including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degenerat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9974","description":"Dilated macular exam performed_ including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degenerat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ther fx nasal inf turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30930","description":"Ther fx nasal inf turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24675","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCF1","description":"ICD-BFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAF0","description":"ICD-EAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIE1","description":"ICD-OHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDB0","description":"ICD-NEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist joint implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25449","description":"Remove wrist joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXD0","description":"ICD-OLXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMB1","description":"ICD-GFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA11","description":"ICD-2AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYC0","description":"ICD-HEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0902","description":"HCPCS-B0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj protamine sulfate/10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2720","description":"Inj protamine sulfate/10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glasses air conduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5070","description":"Glasses air conduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25A","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise & repair chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32906","description":"Revise & repair chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKC1","description":"ICD-BDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUA0","description":"ICD-OGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1903","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1903","description":"CDT-D1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telehealth facility fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3014","description":"Telehealth facility fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQB1","description":"ICD-CBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSF0","description":"ICD-OFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANB0","description":"ICD-JANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFF0","description":"ICD-OIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of aluminum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82108","description":"Assay of aluminum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOE0","description":"ICD-CEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC31","description":"ICD-1IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTF0","description":"ICD-FDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chylmd trach dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87492","description":"Chylmd trach dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDC0","description":"ICD-KIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IDH2 (isocitrate dehydrogenase 2 [NADP+]_ mitochondrial) (eg_ glioma)_ common variants (eg_ R140W_ R172M)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81121","description":"IDH2 (isocitrate dehydrogenase 2 [NADP+]_ mitochondrial) (eg_ glioma)_ common variants (eg_ R140W_ R172M)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia removal pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54251","description":"Anesthesia removal pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0490T","description":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADME0","description":"ICD-ADME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDF1","description":"ICD-BIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFF0","description":"ICD-OLFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPF0","description":"ICD-KBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHB1","description":"ICD-OBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHF1","description":"ICD-ODHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXA1","description":"ICD-GEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dark field examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87164","description":"Dark field examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tendon transfer with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26492","description":"Tendon transfer with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBB0","description":"ICD-OLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68326","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infusion pump refill kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4220","description":"Infusion pump refill kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIND0","description":"ICD-GIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immntx 2 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95131","description":"Immntx 2 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10C","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLA1","description":"ICD-AGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5168","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5168","description":"HCPCS-Q5168","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95711","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEE1","description":"ICD-FHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUD1","description":"ICD-NCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4105","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE125","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"RHD&RHCE GNTYP NEXT GNRJ SEQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0222U","description":"RHD&RHCE GNTYP NEXT GNRJ SEQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBC0","description":"ICD-OKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34703","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDA1","description":"ICD-EHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLF1","description":"ICD-NKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUE0","description":"ICD-JEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast adjuvant chemotherapy administered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9829","description":"Breast adjuvant chemotherapy administered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHB1","description":"ICD-AEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOF0","description":"ICD-PDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AmnioTX_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4324","description":"AmnioTX_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHF0","description":"ICD-NAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHA0","description":"ICD-MBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban_ 1 mg (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0884","description":"Injection_ argatroban_ 1 mg (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLC0","description":"ICD-MGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBME0","description":"ICD-JBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELF0","description":"ICD-CELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thigh/wght bear lacer non-mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2530","description":"Thigh/wght bear lacer non-mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOD0","description":"ICD-KIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepa vacc ped/adol 2 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90633","description":"Hepa vacc ped/adol 2 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRC1","description":"ICD-DFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITD1","description":"ICD-EITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4D","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKE0","description":"ICD-CAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc pt no ther chg or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9650","description":"Doc pt no ther chg or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0231","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0231","description":"HCPCS-M0231","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWB1","description":"ICD-PGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01215","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","description":"CPT-01215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressant not specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80338","description":"Antidepressant not specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58285","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEA1","description":"ICD-BAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUD0","description":"ICD-GGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D6193","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6193","description":"CDT-D6193","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15A","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal septal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5922","description":"Nasal septal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA11","description":"Default_ /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASB0","description":"ICD-HASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICE1","description":"ICD-CICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJC0","description":"ICD-OEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJB0","description":"ICD-KCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMB0","description":"ICD-ABMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFE0","description":"ICD-KAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dna antibody single strand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86226","description":"Dna antibody single strand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECED0","description":"ICD-ECED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gauze > 48 in no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6224","description":"Gauze > 48 in no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLA0","description":"ICD-ODLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKA1","description":"ICD-FEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALA1","description":"ICD-EALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENC0","description":"ICD-BENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18H","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove part of temporal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69535","description":"Remove part of temporal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQF1","description":"ICD-PJQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHF0","description":"ICD-BIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDID0","description":"ICD-NDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLC0","description":"ICD-ABLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUA0","description":"ICD-GDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5260","description":"Hearing aid_ digit_ bin_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKF1","description":"ICD-JAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUE1","description":"ICD-NJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEA0","description":"ICD-CAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMF0","description":"ICD-EHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43635","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emerge matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4297","description":"Emerge matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Temporal bone surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69979","description":"Temporal bone surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLA0","description":"ICD-IDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEC1","description":"ICD-NGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17261","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"VEKLURY - Injection_ remdesivir_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0248","description":"VEKLURY - Injection_ remdesivir_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECC0","description":"ICD-MECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBA0","description":"ICD-MEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTD1","description":"ICD-NLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Air ambulanc nonemerg fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9960","description":"Air ambulanc nonemerg fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Congo red blood test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2029","description":"Congo red blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE130","description":"Special Care High _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00908","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","description":"CPT-00908","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63017","description":"Remove spine lamina >2 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOC1","description":"ICD-CGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28585","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUD0","description":"ICD-KAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEED0","description":"ICD-CEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSC1","description":"ICD-PLSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cone beam ct capt maxilla","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0382","description":"Cone beam ct capt maxilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neg press ventilation cnp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94662","description":"Neg press ventilation cnp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANF1","description":"ICD-FANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRF0","description":"ICD-PKRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB31","description":"ICD-4CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECC1","description":"ICD-JECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visual acuity screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99173","description":"Visual acuity screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (hikma) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0137","description":"Injection_ acetaminophen (hikma) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert ant segment drain int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0191T","description":"Insert ant segment drain int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKC0","description":"ICD-OLKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUF1","description":"ICD-JEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCB1","description":"ICD-ODCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMF1","description":"ICD-JCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGE1","description":"ICD-FAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDC1","description":"ICD-CGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal septal prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8047","description":"Nasal septal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTA1","description":"ICD-MKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFA0","description":"ICD-FDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVE1","description":"ICD-FEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ inotuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9028","description":"Injection_ inotuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLC0","description":"ICD-OKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEF0","description":"ICD-JFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGA1","description":"ICD-GEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUA0","description":"ICD-FAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBC0","description":"ICD-OHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYB0","description":"ICD-PDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAA0","description":"ICD-ODAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj ganirelix acetat 250 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0132","description":"Inj ganirelix acetat 250 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC156","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDE0","description":"ICD-EEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWD1","description":"ICD-LEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTD1","description":"ICD-OGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML35","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADB0","description":"ICD-IADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQC1","description":"ICD-CBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism curbside clinical augmented workflow_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1020","description":"Clinical decision support mechanism curbside clinical augmented workflow_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHME0","description":"ICD-AHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of csf protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83873","description":"Assay of csf protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQF1","description":"ICD-OEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFB0","description":"ICD-KCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain aneurysm repr complx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61698","description":"Brain aneurysm repr complx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","description":"HCPCS-J1808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2049","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2049","description":"HCPCS-A2049","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASB0","description":"ICD-CASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast diep or siea flap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2068","description":"Breast diep or siea flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy remov fb/fibrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32653","description":"Thoracoscopy remov fb/fibrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ophth us b & quant a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76510","description":"Ophth us b & quant a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACD1","description":"ICD-GACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8A","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE214","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with endoluminal imaging of initial coronar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7516","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with endoluminal imaging of initial coronar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOC0","description":"ICD-DCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High energy neutron radiation treatment delivery_ 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge_ and/or compensator(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77423","description":"High energy neutron radiation treatment delivery_ 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge_ and/or compensator(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv musc migraine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64615","description":"Chemodenerv musc migraine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTF1","description":"ICD-KBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clin sign vol ovrld assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2002F","description":"Clin sign vol ovrld assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDB1","description":"ICD-GEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPA0","description":"ICD-FIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITC0","description":"ICD-NITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISE1","description":"ICD-CISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAD0","description":"ICD-OHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXB0","description":"ICD-CIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIE0","description":"ICD-KHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYF0","description":"ICD-LFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27428","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEB1","description":"ICD-JDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9534","description":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLA0","description":"ICD-NLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of bile duct tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47711","description":"Excision of bile duct tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc hip/pelv tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27048","description":"Exc hip/pelv tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOB1","description":"ICD-GCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrast x-ray of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73040","description":"Contrast x-ray of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMC0","description":"ICD-ECMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDA1","description":"ICD-NIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTB1","description":"ICD-KFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/transplant tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23440","description":"Remove/transplant tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49594","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXC1","description":"ICD-FEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI chest w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71552","description":"MRI chest w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of breath ethanol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82075","description":"Assay of breath ethanol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC31","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAC1","description":"ICD-GEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63744","description":"Revision of spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Culture type immunologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87147","description":"Culture type immunologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9810","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9810","description":"HCPCS-C9810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHE1","description":"ICD-GHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPE1","description":"ICD-JBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4439","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","description":"HCPCS-Q4439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transurethral rf treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53860","description":"Transurethral rf treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQF0","description":"ICD-DFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0634U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0634U","description":"CPT-0634U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYB0","description":"ICD-CFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","description":"HCPCS-Q4406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow imaging body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78104","description":"Bone marrow imaging body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct orbit/forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21172","description":"Reconstruct orbit/forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse/graft added joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26863","description":"Fuse/graft added joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rufinamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80210","description":"Rufinamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mmrv vaccine sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90710","description":"Mmrv vaccine sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IN GNOTYP CD44 EXONS 2 3 6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0191U","description":"IN GNOTYP CD44 EXONS 2 3 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vehicle Modifications","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0139","description":"Vehicle Modifications","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8B","description":"High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53621","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRA1","description":"ICD-KBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMA1","description":"ICD-CAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLE0","description":"ICD-MJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve palsy fascial graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15840","description":"Nerve palsy fascial graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ophthalmoscopy/dynamometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92260","description":"Ophthalmoscopy/dynamometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray upper gi delay w/kub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74241","description":"X-ray upper gi delay w/kub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Band stabilization - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2976","description":"Band stabilization - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOE1","description":"ICD-KFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of beta-2 protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82232","description":"Assay of beta-2 protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apexification/recalc initial","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3351","description":"Apexification/recalc initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHC0","description":"ICD-FCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVF1","description":"ICD-BGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBB1","description":"ICD-MFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLA1","description":"ICD-ABLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBE1","description":"ICD-OFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLC1","description":"ICD-GHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWD0","description":"ICD-HGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33852","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCB1","description":"ICD-MBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAF0","description":"ICD-CHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colorectal ca screen doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3017F","description":"Colorectal ca screen doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reopening of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49002","description":"Reopening of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Thyroid)_ Mrna_ Gene Expression Analysis Of 10_196 Genes_ Utilizing Fine Needle Aspirate_ Algorithm Reported As A Categorical Result (Eg_ Benign Or Suspicious)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81546","description":"Oncology (Thyroid)_ Mrna_ Gene Expression Analysis Of 10_196 Genes_ Utilizing Fine Needle Aspirate_ Algorithm Reported As A Categorical Result (Eg_ Benign Or Suspicious)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQA1","description":"ICD-PGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC106","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37255","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","description":"CPT-37255","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKE1","description":"ICD-BEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWC0","description":"ICD-DAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPE1","description":"ICD-KIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC120","description":"Special Care Low _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXC0","description":"ICD-FEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXC1","description":"ICD-KCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periph field stimul analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0285T","description":"Periph field stimul analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8X","description":"Very High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJA0","description":"ICD-GEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYD1","description":"ICD-OHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0D","description":"Medium Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43610","description":"Excision of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGC1","description":"ICD-BFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTE0","description":"ICD-MBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thigh length surg stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4495","description":"Thigh length surg stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKA0","description":"ICD-OAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHA0","description":"ICD-NDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAD1","description":"ICD-NBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us exam scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76870","description":"Us exam scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gen use back cush wdth <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2611","description":"Gen use back cush wdth <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUF1","description":"ICD-CDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop app non-wgt bear dsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5450","description":"Postop app non-wgt bear dsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder prosthesis removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23335","description":"Shoulder prosthesis removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNB0","description":"ICD-OGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAE1","description":"ICD-GCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11C","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ex for nonspeech device rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92605","description":"Ex for nonspeech device rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92986","description":"Revision of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17273","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTD1","description":"ICD-NBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC221","description":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C7568","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7568","description":"HCPCS-C7568","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNA1","description":"ICD-FDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEF0","description":"ICD-OEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant hormone pellet(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11980","description":"Implant hormone pellet(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sisi hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92564","description":"Sisi hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOC0","description":"ICD-PLOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc fcn/care plan w/30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8942","description":"Doc fcn/care plan w/30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCA1","description":"ICD-AGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); open_ from living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0665T","description":"Donor hysterectomy (including cold preservation); open_ from living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDC1","description":"ICD-AHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx head/neck t3-4 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9110","description":"Onc dx head/neck t3-4 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9481","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDB1","description":"ICD-EHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dstry eye lesn_fdr vssl tech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0186","description":"Dstry eye lesn_fdr vssl tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0662","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","description":"HCPCS-G0662","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGD0","description":"ICD-GEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEA0","description":"ICD-BFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAD1","description":"ICD-GHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33986","description":"Ecmo/ecls rmvl ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXE1","description":"ICD-GAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISF0","description":"ICD-GISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove shoulder bone part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23130","description":"Remove shoulder bone part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ftl cgen abnor five anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81512","description":"Ftl cgen abnor five anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01772","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","description":"CPT-01772","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTE0","description":"ICD-MKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMC1","description":"ICD-MGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35091","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurovascular pedicle flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15750","description":"Neurovascular pedicle flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plasma protein fract_5%_50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9043","description":"Plasma protein fract_5%_50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXA0","description":"ICD-FGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXC0","description":"ICD-NCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHE0","description":"ICD-IHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultraviolet therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97028","description":"Ultraviolet therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC44","description":"High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brain flow imaging only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78610","description":"Brain flow imaging only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene other bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81208","description":"Bcr/abl1 gene other bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB234","description":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIF0","description":"ICD-JGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQF0","description":"ICD-LFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQD1","description":"ICD-OBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hard protect helmet custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8003","description":"Hard protect helmet custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5946","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5946","description":"CDT-D5946","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXC0","description":"ICD-BBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL14","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ONC MRNA 5 genes alg risk recr urothelial cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013M","description":"ONC MRNA 5 genes alg risk recr urothelial cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICF0","description":"ICD-JICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVC0","description":"ICD-ODVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0120U","description":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arthroscopy biceps tenodesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29828","description":"Arthroscopy biceps tenodesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUC0","description":"ICD-CIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSA0","description":"ICD-CCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLA1","description":"ICD-CHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental saliography","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0310","description":"Dental saliography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETC1","description":"ICD-JETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKD1","description":"ICD-KFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFID0","description":"ICD-AFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrin degrade semiquant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85378","description":"Fibrin degrade semiquant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLD1","description":"ICD-NKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-ss pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0456","description":"Tlso flex trnk sj-ss pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21240","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMD1","description":"ICD-JDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCF0","description":"ICD-JHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJE1","description":"ICD-JGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKF0","description":"ICD-CHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0545","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","description":"HCPCS-G0545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPE1","description":"ICD-BEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA50","description":"Ultra High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTB0","description":"ICD-JFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score knee not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8650","description":"Fun stat score knee not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bld glucose monitor w lance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2101","description":"Bld glucose monitor w lance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLB1","description":"ICD-NJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXF0","description":"ICD-GGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trans-abdominal or trans-vaginal ultrasound not performed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8808","description":"Trans-abdominal or trans-vaginal ultrasound not performed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pm device interrogate remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93294","description":"Pm device interrogate remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjv thxpyrxd/rcvd colon ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4180F","description":"Adjv thxpyrxd/rcvd colon ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ckd meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8495","description":"Ckd meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","description":"HCPCS-J3379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mdd severe w/o psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3090F","description":"Mdd severe w/o psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWA0","description":"ICD-OBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKC1","description":"ICD-FFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOC1","description":"ICD-CIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYA0","description":"ICD-LHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDC0","description":"ICD-BEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBA0","description":"ICD-GIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg <=16 in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6242","description":"Hydrogel drg <=16 in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA52","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHD0","description":"ICD-CFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain bag/bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4911","description":"Drain bag/bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQC1","description":"ICD-DEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJC0","description":"ICD-KEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replantation foot complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20838","description":"Replantation foot complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEB1","description":"ICD-BIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ coagulation factor ix (recombinant)_ ixinity_ 1 i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7213","description":"Injection_ coagulation factor ix (recombinant)_ ixinity_ 1 i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJE0","description":"ICD-KIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLE0","description":"ICD-KCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVD1","description":"ICD-OLVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWD0","description":"ICD-PFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBB1","description":"ICD-IFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEC1","description":"ICD-KDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cellular therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0075","description":"Cellular therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGD0","description":"ICD-FHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBA1","description":"ICD-OEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFB0","description":"ICD-JCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0403","description":"HCPCS-B0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-84394","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","description":"CPT-84394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sensory integration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97533","description":"Sensory integration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28F","description":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX24","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBE0","description":"ICD-FIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAA0","description":"ICD-NIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37605","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICA0","description":"ICD-NICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cran surg hemotoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21151","description":"Anesth cran surg hemotoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debride skin musc at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11011","description":"Debride skin musc at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4046","description":"Cast sup sht leg splnt fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj filgrastim excl biosimil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1442","description":"Inj filgrastim excl biosimil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXF0","description":"ICD-BCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exome (ie_ somatic mutations)_ paired formalin-fixed paraffin-embedded tumor tissue and normal specimen_ sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0036U","description":"Exome (ie_ somatic mutations)_ paired formalin-fixed paraffin-embedded tumor tissue and normal specimen_ sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEF1","description":"ICD-CGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFD0","description":"ICD-KCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHB0","description":"ICD-JAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXD0","description":"ICD-OFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKB0","description":"ICD-KFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0511U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","description":"CPT-0511U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tablo Hemodialysis System For The Billable Dialysis Service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1629","description":"Tablo Hemodialysis System For The Billable Dialysis Service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGA0","description":"ICD-KBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ustekinumab_ for intravenous injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9487","description":"Ustekinumab_ for intravenous injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-93898","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","description":"CPT-93898","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYC0","description":"ICD-OAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Telemonitoring/home per mnth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9110","description":"Telemonitoring/home per mnth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61321","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Visualization of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31615","description":"Visualization of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59841","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDF0","description":"ICD-IGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHC0","description":"ICD-NEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of finger lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26210","description":"Removal of finger lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELE0","description":"ICD-NELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Corneal topography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92025","description":"Corneal topography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTA1","description":"ICD-JGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQC1","description":"ICD-HDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGB1","description":"ICD-FAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (heparin-induced thrombocytopenia)_ platelet antibody reactivity by flow cytometry_ serum (Versiti™ Heparin-Induced Thrombocytopenia Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0275U","description":"Hematology (heparin-induced thrombocytopenia)_ platelet antibody reactivity by flow cytometry_ serum (Versiti™ Heparin-Induced Thrombocytopenia Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCB0","description":"ICD-CBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHA0","description":"ICD-FFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRC1","description":"ICD-HCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIA1","description":"ICD-MDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHD1","description":"ICD-NDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remv/replc penis pros compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54417","description":"Remv/replc penis pros compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Estradiol; Free_ Direct Measurement (Eg_ Equilibrium Dialysis)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82681","description":"Estradiol; Free_ Direct Measurement (Eg_ Equilibrium Dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair head rest extensi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0966","description":"Wheelchair head rest extensi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYF1","description":"ICD-PLYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prefab stainless steel crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2933","description":"Prefab stainless steel crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACA0","description":"ICD-NACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-87627","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","description":"CPT-87627","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ vedolizumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3380","description":"Injection_ vedolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYA1","description":"ICD-LCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pessary_ non rubber_any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4562","description":"Pessary_ non rubber_any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKB1","description":"ICD-GIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin barrier liquid per oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4369","description":"Skin barrier liquid per oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWB1","description":"ICD-DCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB117","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB50","description":"Medium Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIF1","description":"ICD-ECIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDE1","description":"ICD-GCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1472","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","description":"HCPCS-M1472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21450","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bcg vaccine percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90585","description":"Bcg vaccine percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDE1","description":"ICD-IHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy ureterolithotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50945","description":"Laparoscopy ureterolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUB0","description":"ICD-MEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aortic suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33800","description":"Aortic suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine nrv half segmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63185","description":"Incise spine nrv half segmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo dbl solid stirrup w/o j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2030","description":"Kafo dbl solid stirrup w/o j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0798T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEA1","description":"ICD-GEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng anti r-viral thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4270F","description":"Pt rcvng anti r-viral thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPE1","description":"ICD-FHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYD0","description":"ICD-PHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen dsg wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6024","description":"Collagen dsg wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAD1","description":"ICD-KEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Naltrexone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Tes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2073","description":"Medication Assisted Treatment_ Naltrexone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Tes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9306","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9306","description":"HCPCS-C9306","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELB1","description":"ICD-EELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pouch drain high output","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4412","description":"Ost pouch drain high output","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26843","description":"Fusion of hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFC1","description":"ICD-FBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWE0","description":"ICD-PHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24C","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUF0","description":"ICD-OKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 10 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP10","description":"Auto.test pane pricing code_ 10 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHF0","description":"ICD-EAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGB1","description":"ICD-KDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUD0","description":"ICD-NIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interferon gamma 1-b inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9216","description":"Interferon gamma 1-b inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54050","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMF1","description":"ICD-BEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJD1","description":"ICD-KGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAA0","description":"ICD-EDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim_ excludes biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2506","description":"Injection_ pegfilgrastim_ excludes biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCE0","description":"ICD-NCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung function test (mbc/mvv)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94200","description":"Lung function test (mbc/mvv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFA1","description":"ICD-NKFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Romidepsin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9315","description":"Romidepsin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional_ 30 m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99452","description":"Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional_ 30 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal and reinsertion of sinus tarsi implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0511T","description":"Removal and reinsertion of sinus tarsi implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCC1","description":"ICD-CHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYE1","description":"ICD-GBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preparation of report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90889","description":"Preparation of report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNB0","description":"ICD-OCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLD0","description":"ICD-MFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAB0","description":"ICD-KBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01380","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","description":"CPT-01380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWA1","description":"ICD-DAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVB1","description":"ICD-KDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAME1","description":"ICD-MAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp subclav-vertebrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35645","description":"Art byp subclav-vertebrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIE0","description":"ICD-CAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWE1","description":"ICD-GEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQA0","description":"ICD-LBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4355","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","description":"HCPCS-Q4355","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rabies vaccine id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90676","description":"Rabies vaccine id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prost cncr rsk not lw/md/hgh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3274F","description":"Prost cncr rsk not lw/md/hgh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGD0","description":"ICD-CHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allogen_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4212","description":"Allogen_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Substernal Implantable Defibrillator Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0573T","description":"Removal Of Substernal Implantable Defibrillator Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIA1","description":"ICD-BCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETE0","description":"ICD-IETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mitoxantrone hydrochl / 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9293","description":"Mitoxantrone hydrochl / 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aed garment w elec analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0606","description":"Aed garment w elec analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ciliary endoscopic ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66711","description":"Ciliary endoscopic ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virus inoculation tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87252","description":"Virus inoculation tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove elbow lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24120","description":"Remove elbow lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAA1","description":"ICD-CFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amphetamines 5 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80326","description":"Amphetamines 5 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73600","description":"X-ray exam of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC215","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBD1","description":"ICD-EDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECD1","description":"ICD-CECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTF1","description":"ICD-IBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXA0","description":"ICD-OGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70260","description":"X-ray exam of skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj reconstruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7858","description":"Tmj reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIB1","description":"ICD-OEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETF1","description":"ICD-FETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy/lung bx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31632","description":"Bronchoscopy/lung bx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKE1","description":"ICD-JGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27814","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28505","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of uvula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42140","description":"Excision of uvula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sewhfo cap design w/o jnt cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3975","description":"Sewhfo cap design w/o jnt cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMA0","description":"ICD-ODMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILD0","description":"ICD-BILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAA0","description":"ICD-BGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGE0","description":"ICD-CBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXB0","description":"ICD-KCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoscopy w/fb & op scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31531","description":"Laryngoscopy w/fb & op scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQC0","description":"ICD-KIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Npm1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81310","description":"Npm1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semen analysis w/count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89310","description":"Semen analysis w/count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCD1","description":"ICD-NLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cataract surgery complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66982","description":"Cataract surgery complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMA1","description":"ICD-MAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5246","description":"Hearing aid_ prog_ mon_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYE1","description":"ICD-PDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFA1","description":"ICD-CCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC112","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOA1","description":"ICD-DEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITD0","description":"ICD-KITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc hip/pelvis les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27047","description":"Exc hip/pelvis les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWD1","description":"ICD-LHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sacral nerve stim test lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4290","description":"Sacral nerve stim test lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle-skin graft leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15738","description":"Muscle-skin graft leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg monitoring/videorecord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95951","description":"Eeg monitoring/videorecord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML60","description":"Medium Rehab plus Extensive_ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bupren/nal up to 3mg bupreno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0572","description":"Bupren/nal up to 3mg bupreno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRA0","description":"ICD-KDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKB1","description":"ICD-GBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1112","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures adjust part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5421","description":"Dentures adjust part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0805","description":"HCPCS-C0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech volume modulation system_ any type_ including all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1009","description":"Speech volume modulation system_ any type_ including all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLE0","description":"ICD-ADLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWE0","description":"ICD-HDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8918","description":"Mra w/cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEME0","description":"ICD-JEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove epididymis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54840","description":"Remove epididymis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMF1","description":"ICD-GAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMA1","description":"ICD-KDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCC0","description":"ICD-CBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUB0","description":"ICD-BCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise bladder/drain ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51045","description":"Incise bladder/drain ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental recement bridge","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6930","description":"Dental recement bridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNF1","description":"ICD-FHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJF0","description":"ICD-OAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLE0","description":"ICD-NKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Delayed breast prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19342","description":"Delayed breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wrist disarticul switch ctrl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6920","description":"Wrist disarticul switch ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ patisiran_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9036","description":"Injection_ patisiran_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAB0","description":"ICD-EAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B2001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2001","description":"HCPCS-B2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERF1","description":"ICD-HERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXB1","description":"ICD-BDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye service or procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92499","description":"Eye service or procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69646","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABB0","description":"ICD-FABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXC0","description":"ICD-CAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open/perq place stent ea add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37237","description":"Open/perq place stent ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gemcitabine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9201","description":"Gemcitabine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0905T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","description":"CPT-0905T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIF1","description":"ICD-EAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee joint cam lock each joi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2415","description":"Knee joint cam lock each joi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYF1","description":"ICD-OAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKB0","description":"ICD-NIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hgb lvl <11 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3281F","description":"Hgb lvl <11 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHC0","description":"ICD-ADHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOC0","description":"ICD-KEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOD0","description":"ICD-OJOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMF1","description":"ICD-MKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACA0","description":"ICD-AACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2008","description":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATE1","description":"ICD-MATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onlay repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2982","description":"Onlay repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTB0","description":"ICD-IGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXE1","description":"ICD-KEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUC1","description":"ICD-NEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test rbc protoporphyrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84203","description":"Test rbc protoporphyrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETB1","description":"ICD-BETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8E","description":"Very High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGA1","description":"ICD-BIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental case management - care coordination","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9992","description":"Dental case management - care coordination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27254","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEC0","description":"ICD-CHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath indw foley 2 way silicn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4344","description":"Cath indw foley 2 way silicn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37780","description":"Revision of leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00537","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","description":"CPT-00537","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystouretero w/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52354","description":"Cystouretero w/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse pancreas cyst and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48520","description":"Fuse pancreas cyst and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ infliximab-dyyb_ biosimilar_ (Inflectra)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5103","description":"Injection_ infliximab-dyyb_ biosimilar_ (Inflectra)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy/needle bx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31633","description":"Bronchoscopy/needle bx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ is referred within 1 month of the reactive hcv antibody test to a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1229","description":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ is referred within 1 month of the reactive hcv antibody test to a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKB0","description":"ICD-NEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTC1","description":"ICD-BHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLA1","description":"ICD-ODLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4358","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","description":"HCPCS-Q4358","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVA0","description":"ICD-NFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESE1","description":"ICD-KESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay galactose transferase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82775","description":"Assay galactose transferase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25A","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUF0","description":"ICD-NHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJE1","description":"ICD-BAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMC0","description":"ICD-BAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"teledentistry synchronous real time encounter","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9995","description":"teledentistry synchronous real time encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTC0","description":"ICD-KCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Create eardrum opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69436","description":"Create eardrum opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIB1","description":"ICD-CCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB11","description":"ICD-4GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Testosterone response","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80414","description":"Testosterone response","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENF1","description":"ICD-FENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSF1","description":"ICD-HFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEC0","description":"ICD-ECEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g._ inadequate prep_ familial or personal history of colonic polyps_ patient h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9862","description":"Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g._ inadequate prep_ familial or personal history of colonic polyps_ patient h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQA0","description":"ICD-HFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYF1","description":"ICD-KCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2206","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB35","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth pelvis surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84451","description":"Anesth pelvis surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYD0","description":"ICD-DGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27880","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWC0","description":"ICD-LHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUE1","description":"ICD-OBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBA0","description":"ICD-IIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJF0","description":"ICD-BGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ex hd hosp bed > 600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0302","description":"Ex hd hosp bed > 600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMA1","description":"ICD-IHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIC1","description":"ICD-AAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (genetic bleeding disorders)_ genomic sequence analysis of 51 genes_ blood_ buccal swab_ or amniotic fluid_ comprehensive (Versiti™ Comprehensive Bleeding Disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0272U","description":"Hematology (genetic bleeding disorders)_ genomic sequence analysis of 51 genes_ blood_ buccal swab_ or amniotic fluid_ comprehensive (Versiti™ Comprehensive Bleeding Disorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBA1","description":"ICD-JGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXE1","description":"ICD-JCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAA1","description":"ICD-KHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23C","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJE1","description":"ICD-BDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOD0","description":"ICD-GFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cptr-asst dir ms px","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20985","description":"Cptr-asst dir ms px","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1090T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1090T","description":"CPT-1090T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26410","description":"Repair hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHD1","description":"ICD-OCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01961","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","description":"CPT-01961","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy speaking valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8501","description":"Tracheostomy speaking valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUD1","description":"ICD-OBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFE1","description":"ICD-GEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBF0","description":"ICD-GCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDE0","description":"ICD-NHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA136","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYA0","description":"ICD-OBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81404","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDC0","description":"ICD-NCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96933","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAF1","description":"ICD-JIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKF1","description":"ICD-FBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert semi-rigid prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54400","description":"Insert semi-rigid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinsert spinal fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22849","description":"Reinsert spinal fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13B","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuromuscular stim for shock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0745","description":"Neuromuscular stim for shock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0044A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTA0","description":"ICD-JDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29901","description":"Mcp joint arthroscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALD1","description":"ICD-OALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWC0","description":"ICD-CDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANC0","description":"ICD-JANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stationary liquid 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0439","description":"Stationary liquid 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXC1","description":"ICD-NBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef incomplete/modular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4155","description":"Ef incomplete/modular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQC1","description":"ICD-LDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTC1","description":"ICD-MHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous exchange of biliary drainage catheter (eg_ external_ internal-external_ or conversion of internal-external to external only)_ with removal of calculi/debris from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7545","description":"Percutaneous exchange of biliary drainage catheter (eg_ external_ internal-external_ or conversion of internal-external to external only)_ with removal of calculi/debris from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQB1","description":"ICD-KDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfusion procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86999","description":"Transfusion procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNE1","description":"ICD-BFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOA0","description":"ICD-PCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEF0","description":"ICD-AIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGE0","description":"ICD-NAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transapical mitral valve repair_ including transthoracic echocardiography_ when performed_ with placement of artificial chordae tendineae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0543T","description":"Transapical mitral valve repair_ including transthoracic echocardiography_ when performed_ with placement of artificial chordae tendineae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ Response To Radiation_ Cell-Free Dna_ Quantitative Branched Chain Dna Amplification_ Plasma_ Reported As A Radiation Toxicity Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0285U","description":"Oncology_ Response To Radiation_ Cell-Free Dna_ Quantitative Branched Chain Dna Amplification_ Plasma_ Reported As A Radiation Toxicity Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft head/neck </4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64885","description":"Nerve graft head/neck </4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLA0","description":"ICD-CCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1159","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHB0","description":"ICD-MCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cntct gas permeable sphericl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2510","description":"Cntct gas permeable sphericl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mwc acc_ wheelchair brake","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2228","description":"Mwc acc_ wheelchair brake","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB225","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLD1","description":"ICD-JDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISE1","description":"ICD-PISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRC1","description":"ICD-CIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCE1","description":"ICD-NGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Naltrexone_ depot form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2315","description":"Naltrexone_ depot form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC251","description":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (Lung)_ Mrna_ Quantitative Pcr Analysis Of 11 Genes (Bag1_ Brca1_ Cdc6_ Cdk2Ap1_ Erbb3_ Fut3_ Il11_ Lck_ Rnd3_ Sh3Bgr_ Wnt3A) And 3 Reference Genes (Esd_ Tbp_ Yap1)_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0288U","description":"Oncology (Lung)_ Mrna_ Quantitative Pcr Analysis Of 11 Genes (Bag1_ Brca1_ Cdc6_ Cdk2Ap1_ Erbb3_ Fut3_ Il11_ Lck_ Rnd3_ Sh3Bgr_ Wnt3A) And 3 Reference Genes (Esd_ Tbp_ Yap1)_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Salicylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6038","description":"Salicylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLB0","description":"ICD-FBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2101","description":"HCPCS-A2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWF0","description":"ICD-CHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Healthcare Professional Online Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 11-20 Minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2062","description":"Qualified Nonphysician Healthcare Professional Online Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 11-20 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78201","description":"Liver imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLE1","description":"ICD-MLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for non ESRD use)_ 1000 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5106","description":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for non ESRD use)_ 1000 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGC0","description":"ICD-BDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc medrsn no histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9282","description":"Doc medrsn no histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICF1","description":"ICD-KICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00844","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","description":"CPT-00844","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGA1","description":"ICD-NDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ATN1 (atrophin 1) (eg_ dentatorubral-pallidoluysian atrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81177","description":"ATN1 (atrophin 1) (eg_ dentatorubral-pallidoluysian atrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGC0","description":"ICD-GEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMB1","description":"ICD-JCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB23","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home Adaptations (>$6_000)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0141","description":"Home Adaptations (>$6_000)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit >30.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12047","description":"Intmd rpr n-hf/genit >30.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31240","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIE0","description":"ICD-EIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIB0","description":"ICD-MEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHD1","description":"ICD-FHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRD1","description":"ICD-KHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXF0","description":"ICD-JGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96203","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRF1","description":"ICD-PIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJC1","description":"ICD-NGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22B","description":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gross pulpal debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3221","description":"Gross pulpal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m succimer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9551","description":"Tc99m succimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATD0","description":"ICD-IATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11B","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart/lung resuscitation cpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92950","description":"Heart/lung resuscitation cpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove & graft wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25136","description":"Remove & graft wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWD1","description":"ICD-LBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJF1","description":"ICD-FGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVB1","description":"ICD-NBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJE0","description":"ICD-GIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair throat wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42900","description":"Repair throat wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0264U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I125 serum albumin_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9532","description":"I125 serum albumin_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKED1","description":"ICD-NKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASF1","description":"ICD-DASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABB1","description":"ICD-FABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27193","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressant tricyclic 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80336","description":"Antidepressant tricyclic 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFB1","description":"ICD-FIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMD1","description":"ICD-KCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Av fusion/forearm vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36820","description":"Av fusion/forearm vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJB1","description":"ICD-GGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDF1","description":"ICD-EIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg ak ea add cast ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5430","description":"Postop dsg ak ea add cast ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGD1","description":"ICD-NJGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test socket shldr disart/tho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6684","description":"Test socket shldr disart/tho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECA0","description":"ICD-KECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Molecular Fluorescent Imaging Of Suspicious Nevus; First Lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0700T","description":"Molecular Fluorescent Imaging Of Suspicious Nevus; First Lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15A","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOF1","description":"ICD-KIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUB1","description":"ICD-KAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIA0","description":"ICD-KHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87426","description":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWD1","description":"ICD-PGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB224","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUB0","description":"ICD-EFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBA0","description":"ICD-BFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27882","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; paper_ 2-dimensional_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82488","description":"Chromatography_ qualitative; paper_ 2-dimensional_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWE0","description":"ICD-KCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBE1","description":"ICD-GIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47556","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt=d(rh)- and unsensitized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3290F","description":"Pt=d(rh)- and unsensitized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Finger tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26497","description":"Finger tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27175","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Air ambulan nonemerg rotary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9961","description":"Air ambulan nonemerg rotary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of zinc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84630","description":"Assay of zinc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ golodirsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1429","description":"Injection_ golodirsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1321","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31588","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ep & ablate ventric tachy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93654","description":"Ep & ablate ventric tachy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29700","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autoimmune rheumatoid arthr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81490","description":"Autoimmune rheumatoid arthr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSD0","description":"ICD-LHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRF1","description":"ICD-PKRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBC0","description":"ICD-BHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUE1","description":"ICD-EIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQC0","description":"ICD-OBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQB0","description":"ICD-PLQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infrared therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97026","description":"Infrared therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECC0","description":"ICD-NECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy w/biopsy(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52204","description":"Cystoscopy w/biopsy(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estrone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82679","description":"Assay of estrone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKC1","description":"ICD-BIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped crit care age 2-5 subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99476","description":"Ped crit care age 2-5 subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOC1","description":"ICD-CDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTD0","description":"ICD-FBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61150","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJF1","description":"ICD-GEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQD0","description":"ICD-OIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c wdth 24-27 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2341","description":"W/c wdth 24-27 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTE1","description":"ICD-OFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJE1","description":"ICD-BFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYC1","description":"ICD-LHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACE1","description":"ICD-EACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKE1","description":"ICD-NCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUC1","description":"ICD-KAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWF1","description":"ICD-CGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Daunorubicin citrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9151","description":"Daunorubicin citrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx cesium-131 chloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2644","description":"Brachytx cesium-131 chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPB0","description":"ICD-JAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGE1","description":"ICD-ODGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kanamycin sulfate 75 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1850","description":"Kanamycin sulfate 75 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDB1","description":"ICD-CDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/fast/dir lab ldl-c >190","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9675","description":"Pt w/fast/dir lab ldl-c >190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who utilize hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9768","description":"Patients who utilize hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tis trnfr f/c/c/m/n/a/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14041","description":"Tis trnfr f/c/c/m/n/a/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef ped specmetabolic inherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4162","description":"Ef ped specmetabolic inherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam filled drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2386","description":"Foam filled drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCC0","description":"ICD-MKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFF0","description":"ICD-FBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEE0","description":"ICD-OAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj testosterone cypionate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1071","description":"Inj testosterone cypionate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRC0","description":"ICD-HCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPA1","description":"ICD-CAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE112","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIF1","description":"ICD-CDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHD1","description":"ICD-AAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHC0","description":"ICD-FAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUD1","description":"ICD-IAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC21","description":"ICD-1LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9838","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of skull arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61711","description":"Fusion of skull arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIC0","description":"ICD-EBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Normal Native Connection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93593","description":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Normal Native Connection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8911","description":"Mra w/o fol w/cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7207","description":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXE0","description":"ICD-NEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar or lumbar rib pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1040","description":"Lumbar or lumbar rib pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy supply misc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4421","description":"Ostomy supply misc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast supplies unlisted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4050","description":"Cast supplies unlisted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYB0","description":"ICD-PHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Io rad tx delivery by x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77424","description":"Io rad tx delivery by x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC21","description":"ICD-4KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSF1","description":"ICD-OLSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBF1","description":"ICD-BIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bridge porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6245","description":"Bridge porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00810","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00810","description":"CPT-00810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87336","description":"IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWD1","description":"ICD-CDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOA0","description":"ICD-OBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diabetic custom molded shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5501","description":"Diabetic custom molded shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with strain im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9762","description":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with strain im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBF1","description":"ICD-EEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1326","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","description":"HCPCS-J1326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","description":"CPT-00472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSA1","description":"ICD-LHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVF0","description":"ICD-OAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cord blood harvesting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2140","description":"Cord blood harvesting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMF1","description":"ICD-KAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKE1","description":"ICD-CEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHA1","description":"ICD-NEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYE0","description":"ICD-LHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24A","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKC0","description":"ICD-FHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3310","description":"Anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDA1","description":"ICD-MCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","description":"CPT-64474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALF0","description":"ICD-EALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCB1","description":"ICD-ABCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIID0","description":"ICD-NIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJB1","description":"ICD-OKJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27517","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWC0","description":"ICD-DFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Red cell survival study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78130","description":"Red cell survival study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen quan lamotrigine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80175","description":"Drug screen quan lamotrigine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9378","description":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Core Needle Biopsy_ Lung Or Mediastinum_ Percutaneous_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32408","description":"Core Needle Biopsy_ Lung Or Mediastinum_ Percutaneous_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of finger abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26010","description":"Drainage of finger abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation wi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7522","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoabdominal graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33877","description":"Thoracoabdominal graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBF1","description":"ICD-JHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNA0","description":"ICD-JFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDD0","description":"ICD-AIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCC0","description":"ICD-EGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart infarct image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78466","description":"Heart infarct image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body-worn binaur hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5120","description":"Body-worn binaur hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGE1","description":"ICD-NFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD104","description":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acoustic immitance testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92570","description":"Acoustic immitance testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDD0","description":"ICD-MDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endomysial Antibody (Ema)_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86231","description":"Endomysial Antibody (Ema)_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Persistent asthma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1038F","description":"Persistent asthma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Penis plastic surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54360","description":"Penis plastic surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGC1","description":"ICD-OCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Color cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0514","description":"Color cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB245","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMC1","description":"ICD-KAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWC1","description":"ICD-CDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCC1","description":"ICD-BDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay ph body fluid nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83986","description":"Assay ph body fluid nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGC1","description":"ICD-CEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"EpiFix or Epicord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4131","description":"EpiFix or Epicord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVD0","description":"ICD-BDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCND0","description":"ICD-OCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUF0","description":"ICD-BEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Simple cystometrogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51725","description":"Simple cystometrogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKC1","description":"ICD-JIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB45","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTC1","description":"ICD-JDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag ctr rigi pos pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0643","description":"Lso sag ctr rigi pos pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFC0","description":"ICD-NIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBF0","description":"ICD-KIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNB0","description":"ICD-FGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sc ther infusion addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96370","description":"Sc ther infusion addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDE1","description":"ICD-FCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMC1","description":"ICD-IIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible; with ablation of tumor(s)_ polyp(s)_ or other lesions(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6022","description":"Sigmoidoscopy_ flexible; with ablation of tumor(s)_ polyp(s)_ or other lesions(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQA0","description":"ICD-OKQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB07","description":"Very High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whfo electric custom fitted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3904","description":"Whfo electric custom fitted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABE1","description":"ICD-IABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx laryngoscopy newborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31520","description":"Dx laryngoscopy newborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem nonodonto cyst > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7461","description":"Rem nonodonto cyst > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAA1","description":"ICD-EHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKD1","description":"ICD-BFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Unilateral Study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93986","description":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Unilateral Study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXE1","description":"ICD-KIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPC0","description":"ICD-GCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB31","description":"ICD-2CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDA0","description":"ICD-ADDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virtual reality cognitive behavioral therapy device (cbt)_ including pre-programmed therapy software","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1905","description":"Virtual reality cognitive behavioral therapy device (cbt)_ including pre-programmed therapy software","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home phototherapy visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9098","description":"Home phototherapy visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1444","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","description":"HCPCS-M1444","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHB0","description":"ICD-IFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMF0","description":"ICD-AFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation Supply; Sleeve_ Reusable_ Per Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4436","description":"Irrigation Supply; Sleeve_ Reusable_ Per Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXB1","description":"ICD-GGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOE1","description":"ICD-PJOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immntx 3 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95132","description":"Immntx 3 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cushioned headrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0955","description":"Cushioned headrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1B","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37257","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","description":"CPT-37257","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMD1","description":"ICD-EBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aflibercept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0178","description":"Aflibercept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lev 4 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0383","description":"Lev 4 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4367","description":"Ostomy belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0493U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","description":"CPT-0493U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE117","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKD0","description":"ICD-BFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ coagulation Factor Xa (recombinant)_ inactivated (Andexxa)_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9041","description":"Injection_ coagulation Factor Xa (recombinant)_ inactivated (Andexxa)_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5D","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery transpose/endovas taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33889","description":"Artery transpose/endovas taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46746","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACD0","description":"ICD-JACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"2+ anti-hyprtnsv agents tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4145F","description":"2+ anti-hyprtnsv agents tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGE1","description":"ICD-JGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQA1","description":"ICD-GCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBE1","description":"ICD-EFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transposition ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58825","description":"Transposition ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIA0","description":"ICD-CGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27307","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection for myelogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62284","description":"Injection for myelogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADD0","description":"ICD-MADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cftr gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81221","description":"Cftr gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15D","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBB0","description":"ICD-GEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGB1","description":"ICD-GGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAB0","description":"ICD-OFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKA1","description":"ICD-OCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLF0","description":"ICD-KGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ piperacillin sodi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0081","description":"Injection_ piperacillin sodi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCC0","description":"ICD-OGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMC0","description":"ICD-CDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFD0","description":"ICD-FHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0702","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0702","description":"CDT-D0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPE0","description":"ICD-FBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJB1","description":"ICD-FAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSB0","description":"ICD-HFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPB1","description":"ICD-KAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33468","description":"Revision of tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin for insulin pump use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1817","description":"Insulin for insulin pump use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGD0","description":"ICD-CEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJB0","description":"ICD-GEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYB1","description":"ICD-KEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47141","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test cran nerve bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95868","description":"Muscle test cran nerve bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise excessive skin hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15834","description":"Excise excessive skin hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso s/c shell/panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0640","description":"Lso s/c shell/panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28705","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIC0","description":"ICD-IEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNF0","description":"ICD-OLNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRD0","description":"ICD-OKRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMD1","description":"ICD-CAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLB0","description":"ICD-OKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB23","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLA0","description":"ICD-BFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Macroscopic exam arthropod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87168","description":"Macroscopic exam arthropod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEA1","description":"ICD-GAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-explore parathyroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60502","description":"Re-explore parathyroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAF0","description":"ICD-CBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lefort i-1 piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21141","description":"Lefort i-1 piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGA0","description":"ICD-JGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEF1","description":"ICD-JFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXB1","description":"ICD-BCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDF1","description":"ICD-IHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUF1","description":"ICD-MHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ Asparaginase_ Recombinant_ (Rylaze)_ 0.1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9021","description":"Injection_ Asparaginase_ Recombinant_ (Rylaze)_ 0.1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCE1","description":"ICD-JBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove tunneled ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49422","description":"Remove tunneled ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTE0","description":"ICD-OGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAE1","description":"ICD-KHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0532","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","description":"HCPCS-G0532","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIED0","description":"ICD-CIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention On The Date Of The Encounter Or Within The Previous 12 Months (Counseling_ Pharmacotherapy_ Or Bot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0030","description":"Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention On The Date Of The Encounter Or Within The Previous 12 Months (Counseling_ Pharmacotherapy_ Or Bot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of spleen total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38102","description":"Removal of spleen total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSF1","description":"ICD-LDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHD0","description":"ICD-OJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95705","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sex offend tx svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2029","description":"Sex offend tx svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWE1","description":"ICD-CAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone_ Normal Or Abnormal Native","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93595","description":"Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone_ Normal Or Abnormal Native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-70472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","description":"CPT-70472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCA0","description":"ICD-ICCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADD1","description":"ICD-OADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53010","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wound pouch each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6154","description":"Wound pouch each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Misc sup/acc ext vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0507","description":"Misc sup/acc ext vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAA1","description":"ICD-JGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHA1","description":"ICD-FAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Battery charger_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1357","description":"Battery charger_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHE1","description":"ICD-MDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (colorectal)_ quantitative assessment of three urine metabolites","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0107U","description":"Oncology (colorectal)_ quantitative assessment of three urine metabolites","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11107","description":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen dressing <=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6021","description":"Collagen dressing <=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBE0","description":"ICD-AHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYB0","description":"ICD-PKYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct angio abd&pelv w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74174","description":"Ct angio abd&pelv w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/balloon dilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45386","description":"Colonoscopy w/balloon dilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair ruptd popliteal art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35152","description":"Repair ruptd popliteal art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA HPYLORI","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87339","description":"IAAD IA HPYLORI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC236","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHED1","description":"ICD-IHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37287","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","description":"CPT-37287","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIB1","description":"ICD-CEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFB0","description":"ICD-JGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assess anginal symptom/level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1002F","description":"Assess anginal symptom/level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc exten prosth addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34826","description":"Endovasc exten prosth addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUD1","description":"ICD-FDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBF1","description":"ICD-BCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90476","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee-shin exo mnl lock ultra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5711","description":"Knee-shin exo mnl lock ultra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocortisone sodium ph inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1710","description":"Hydrocortisone sodium ph inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; first target lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76982","description":"Ultrasound_ elastography; first target lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIC1","description":"ICD-EHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEA1","description":"ICD-FAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFA1","description":"ICD-BHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFB0","description":"ICD-GBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply srs headframe add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61800","description":"Apply srs headframe add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUF0","description":"ICD-EEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRA1","description":"ICD-GBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic seal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0456T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic seal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Virus inoculate tissue addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87253","description":"Virus inoculate tissue addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepagam b im injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1571","description":"Hepagam b im injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8E","description":"High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB246","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHD0","description":"ICD-BGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCB1","description":"ICD-EBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone graft time of implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6104","description":"Bone graft time of implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXC1","description":"ICD-CIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18H","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHC1","description":"ICD-EEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICC1","description":"ICD-GICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFE1","description":"ICD-CIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUB0","description":"ICD-CDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory surgical boot eac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3260","description":"Ambulatory surgical boot eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMF1","description":"ICD-FCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSF1","description":"ICD-HGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing loss sequence analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81430","description":"Hearing loss sequence analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKB0","description":"ICD-BAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Detect agnt mult dna ampli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87801","description":"Detect agnt mult dna ampli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of stomach nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64755","description":"Incision of stomach nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL20","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cefiderocol_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0693","description":"Injection_ cefiderocol_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPF0","description":"ICD-GCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumoc vac/admin/rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4040F","description":"Pneumoc vac/admin/rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUF0","description":"ICD-OAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosphate (baxter)_ not therapeutically equivalent to j0736_ 300 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0737","description":"Injection_ clindamycin phosphate (baxter)_ not therapeutically equivalent to j0736_ 300 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDB1","description":"ICD-KHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJB0","description":"ICD-OKJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of tibiofibular joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27871","description":"Fusion of tibiofibular joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Image cath fluid colxn visc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49405","description":"Image cath fluid colxn visc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNF1","description":"ICD-NKNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of estrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84233","description":"Assay of estrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic/Device/Drug Matrix For Opposing Bone-To-Bone Or Soft Tissue-To Bone (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1734","description":"Orthopedic/Device/Drug Matrix For Opposing Bone-To-Bone Or Soft Tissue-To Bone (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0473U","description":"Oncology (solid tumor)_ next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAD1","description":"ICD-IHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlordiazepoxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1990","description":"Chlordiazepoxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDE0","description":"ICD-NIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1331","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHF0","description":"ICD-FCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cltx medial ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27760","description":"Cltx medial ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVD0","description":"ICD-CGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLD1","description":"ICD-NDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC114","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDE0","description":"ICD-EBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUA0","description":"ICD-GEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQE1","description":"ICD-PLQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial vaginosis and vaginitis)_ multiplex amplified probe technique_ for detection of bacterial vaginosis-associated bacteria (BVAB-2_ Atopobium vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0352U","description":"Infectious disease (bacterial vaginosis and vaginitis)_ multiplex amplified probe technique_ for detection of bacterial vaginosis-associated bacteria (BVAB-2_ Atopobium vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHD1","description":"ICD-JEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPA1","description":"ICD-CEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Female condom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4268","description":"Female condom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"5% dextrose in lac ringers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7121","description":"5% dextrose in lac ringers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECC1","description":"ICD-NECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHA1","description":"ICD-CAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWA1","description":"ICD-OFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASB1","description":"ICD-PASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWA1","description":"ICD-PHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21C","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALB0","description":"ICD-BALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary artery correction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33502","description":"Coronary artery correction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99335","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert multi-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54405","description":"Insert multi-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLC0","description":"ICD-MJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVB0","description":"ICD-GCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC11","description":"ICD-2AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAE1","description":"ICD-GGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOD0","description":"ICD-CAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ventral hern init block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49561","description":"Rpr ventral hern init block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sbrt management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77435","description":"Sbrt management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDA1","description":"ICD-ECDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Silicone gel sheet_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6025","description":"Silicone gel sheet_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22841","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLA0","description":"ICD-JCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Statin therapy/currently tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4013F","description":"Statin therapy/currently tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0604","description":"HCPCS-B0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sternal pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1050","description":"Sternal pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX24","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBF0","description":"ICD-BCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE254","description":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVD1","description":"ICD-FCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOA1","description":"ICD-HFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine & cord thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63195","description":"Incise spine & cord thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Req ret or w/in 90d of surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9514","description":"Req ret or w/in 90d of surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBND1","description":"ICD-OBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body mass index docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3008F","description":"Body mass index docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHA0","description":"ICD-IFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEB1","description":"ICD-GBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXB1","description":"ICD-NDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHC0","description":"ICD-OLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXF0","description":"ICD-FIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD121","description":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKB0","description":"ICD-JEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of osteocalcin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83937","description":"Assay of osteocalcin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAC1","description":"ICD-MEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAC0","description":"ICD-OGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAB1","description":"ICD-NHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKME1","description":"ICD-MKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDB1","description":"ICD-OGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18G","description":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRF1","description":"ICD-LGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c seat lift mechanism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0985","description":"W/c seat lift mechanism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNE0","description":"ICD-NCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCE1","description":"ICD-BDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Debride genit/per/abdom wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11006","description":"Debride genit/per/abdom wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBD0","description":"ICD-NCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient Did Not Receive An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period; Or Did Not Have A Prior In","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2165","description":"Patient Did Not Receive An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period; Or Did Not Have A Prior In","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHC1","description":"ICD-NLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Catheter_ ureteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1758","description":"Catheter_ ureteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCF0","description":"ICD-NHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nursing assessment/evaluatn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1001","description":"Nursing assessment/evaluatn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQF1","description":"ICD-CDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWA1","description":"ICD-DIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGED0","description":"ICD-AGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMD1","description":"ICD-BAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0924T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","description":"CPT-0924T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Not >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9352","description":"Not >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit picc insert no supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5522","description":"Hit picc insert no supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg myelomeningo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2404","description":"Fetal surg myelomeningo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thawing cryopresrved sperm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89353","description":"Thawing cryopresrved sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEF1","description":"ICD-EFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAB0","description":"ICD-MLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYB0","description":"ICD-GGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXE1","description":"ICD-KAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIB0","description":"ICD-MHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of clot in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35875","description":"Removal of clot in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57522","description":"Conization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL12","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFD1","description":"ICD-NCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAD0","description":"ICD-MDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Charger elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0495","description":"Charger elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMC0","description":"ICD-EBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAD1","description":"ICD-GAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eval for deep sed/gen anesth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9219","description":"Eval for deep sed/gen anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSD0","description":"ICD-DGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay aminolevulinic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82135","description":"Assay aminolevulinic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Copd symptoms assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1015F","description":"Copd symptoms assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBC1","description":"ICD-KFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5D","description":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1151","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trabeculoplasty laser surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65855","description":"Trabeculoplasty laser surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMA0","description":"ICD-IGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEE1","description":"ICD-OBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Participant-Directed Goods and Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1901","description":"Participant-Directed Goods and Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone mineral single photon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78350","description":"Bone mineral single photon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ dostarlimab-gxly_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9082","description":"Injection_ dostarlimab-gxly_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGF0","description":"ICD-CDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ melphalan flufenamide_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9247","description":"Injection_ melphalan flufenamide_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0904","description":"HCPCS-C0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJB0","description":"ICD-FIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELD0","description":"ICD-OELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQF1","description":"ICD-PBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOF0","description":"ICD-HEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGD0","description":"ICD-KCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Above elbow switch control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6950","description":"Above elbow switch control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAC1","description":"ICD-BBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEA1","description":"ICD-MKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMF1","description":"ICD-KGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4409","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","description":"HCPCS-Q4409","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAD1","description":"ICD-OGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt post facet implt cerv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0219T","description":"Plmt post facet implt cerv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEA0","description":"ICD-OGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28250","description":"Revision of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQA1","description":"ICD-GAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD235","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen one/mult class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80304","description":"Drug screen one/mult class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDF0","description":"ICD-JCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/graft of thigh muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27386","description":"Repair/graft of thigh muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERB0","description":"ICD-PERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insulin dispos pen 3 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5571","description":"Insulin dispos pen 3 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUE0","description":"ICD-IDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB41","description":"Very High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHE0","description":"ICD-EFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pure tone audiometry air","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92552","description":"Pure tone audiometry air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUB0","description":"ICD-OKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self-adher band >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6455","description":"Self-adher band >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo ak/hip knee extens assi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5850","description":"Endo ak/hip knee extens assi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumat walking boot pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4360","description":"Pneumat walking boot pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBE1","description":"ICD-NGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOB0","description":"ICD-OAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0871","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0871","description":"HCPCS-J0871","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 4 or more views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71048","description":"Radiologic examination_ chest; 4 or more views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDE1","description":"ICD-GGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0861","description":"Pwc gp3 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTC0","description":"ICD-OGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEF1","description":"ICD-ADEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKB0","description":"ICD-CBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; not otherwise specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0129U","description":"Anesthesia for intracranial procedures; not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWC1","description":"ICD-KFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w iv ab given on time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8916","description":"Pt w iv ab given on time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBB0","description":"ICD-IGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYE0","description":"ICD-DBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNE0","description":"ICD-KBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23A","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBC0","description":"ICD-FIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAB1","description":"ICD-AHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLE0","description":"ICD-ABLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"PEANUT ALLG ASMT EPI CLIN RX","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0178U","description":"PEANUT ALLG ASMT EPI CLIN RX","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reloc skin pocket pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0416T","description":"Reloc skin pocket pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA46","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analyze pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93724","description":"Analyze pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair solid seat insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0992","description":"Wheelchair solid seat insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHE0","description":"ICD-OEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Above knee surgical stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4490","description":"Above knee surgical stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11B","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCA0","description":"ICD-GFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXD1","description":"ICD-JBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSE0","description":"ICD-KBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINA0","description":"ICD-JINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYF1","description":"ICD-HCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAB0","description":"ICD-AHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AJCC stage at breast cancer diagnosis = II or III","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9831","description":"AJCC stage at breast cancer diagnosis = II or III","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19330","description":"Removal of implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXB0","description":"ICD-KBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Umbilical artery echo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76820","description":"Umbilical artery echo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMB1","description":"ICD-IEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGB0","description":"ICD-JGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopic cholecystectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47562","description":"Laparoscopic cholecystectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMB0","description":"ICD-ADMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1306","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCC1","description":"ICD-NGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSB0","description":"ICD-CHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBID1","description":"ICD-MBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRE0","description":"ICD-LFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dysphag test done b/4 eating","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6015F","description":"Dysphag test done b/4 eating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRA1","description":"ICD-LFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast prosthesis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8039","description":"Breast prosthesis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cor artery disease mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81493","description":"Cor artery disease mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCC0","description":"ICD-MFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0513U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","description":"CPT-0513U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26123","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERB1","description":"ICD-GERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vestibuloplasty exten graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7350","description":"Vestibuloplasty exten graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ven blood coll snf/hha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0471","description":"Ven blood coll snf/hha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBD0","description":"ICD-EGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unskilled respite care /15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5150","description":"Unskilled respite care /15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Florbetaben f18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9458","description":"Florbetaben f18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluorine-18 fluorodeoxygluco","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8085","description":"Fluorine-18 fluorodeoxygluco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABD1","description":"ICD-FABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWB0","description":"ICD-CGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCE0","description":"ICD-ABCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC56","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-38228","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","description":"CPT-38228","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHF0","description":"ICD-JCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJC0","description":"ICD-CGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC214","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJE0","description":"ICD-BGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDE0","description":"ICD-FFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67911","description":"Revise eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEE1","description":"ICD-IEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6548","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","description":"HCPCS-A6548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGED1","description":"ICD-NGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRB1","description":"ICD-KHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFE1","description":"ICD-NBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Humidifier supplemental w/ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0560","description":"Humidifier supplemental w/ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6060","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHC0","description":"ICD-OJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transection or ligation_ carotid artery in cavernous sinus_ with repair by anastomosis or graft (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61610","description":"Transection or ligation_ carotid artery in cavernous sinus_ with repair by anastomosis or graft (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tb ag response t-cell susp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86481","description":"Tb ag response t-cell susp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00532","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","description":"CPT-00532","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore parathyroid glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60500","description":"Explore parathyroid glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLC1","description":"ICD-EBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUF0","description":"ICD-BCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52332","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB111","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Meckels divert exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78290","description":"Meckels divert exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAC1","description":"ICD-NJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCF1","description":"ICD-BCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWC1","description":"ICD-PAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thera&Couns Svcs (Counseling Svcs)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0093","description":"Thera&Couns Svcs (Counseling Svcs)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUE1","description":"ICD-BBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAF0","description":"ICD-NJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cetirizine hydrochloride_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9057","description":"Injection_ cetirizine hydrochloride_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELA0","description":"ICD-AELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQA1","description":"ICD-KGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown full base metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6791","description":"Crown full base metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7354","description":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc cardiac modulj pls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0409T","description":"Insj/rplc cardiac modulj pls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20705","description":"Removal Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54500","description":"Biopsy of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWF0","description":"ICD-GBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apply interstit radiat compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77778","description":"Apply interstit radiat compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dicom format doc on rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9340","description":"Dicom format doc on rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJD0","description":"ICD-JAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5940","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5940","description":"CDT-D5940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSF1","description":"ICD-OFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33775","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMB1","description":"ICD-JAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVF0","description":"ICD-CCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36904","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore parathyroid glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60505","description":"Explore parathyroid glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOF1","description":"ICD-OHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGF0","description":"ICD-FFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHB1","description":"ICD-GHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67921","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTA0","description":"ICD-FBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMF0","description":"ICD-JIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMF0","description":"ICD-IBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19357","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACD1","description":"ICD-NACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28360","description":"Reconstruct cleft foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHF0","description":"ICD-GBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLE0","description":"ICD-IBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUC0","description":"ICD-IEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKC1","description":"ICD-CIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis_ 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0380U","description":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis_ 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWD0","description":"ICD-LEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHC0","description":"ICD-FIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHF0","description":"ICD-BDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHA1","description":"ICD-KIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADE1","description":"ICD-EADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1086","description":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWE0","description":"ICD-ODWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diskectomy_ anterior_ with d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2350","description":"Diskectomy_ anterior_ with d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPB0","description":"ICD-NDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSB0","description":"ICD-HDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGA1","description":"ICD-NBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHA0","description":"ICD-MJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOD0","description":"ICD-LFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUF0","description":"ICD-FIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMD0","description":"ICD-ECMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEB0","description":"ICD-IGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWD0","description":"ICD-DEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93585","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92972","description":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE141","description":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11A","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Enterectomy cong add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44128","description":"Enterectomy cong add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18F","description":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATE1","description":"ICD-CATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBE0","description":"ICD-GBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBB1","description":"ICD-BIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0645U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0645U","description":"CPT-0645U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFB0","description":"ICD-GCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVC0","description":"ICD-FCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCB0","description":"ICD-OLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQA1","description":"ICD-DEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53660","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBC1","description":"ICD-KGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5255","description":"Hearing aid_ digit_ mon_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00176","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","description":"CPT-00176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHE1","description":"ICD-AFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRC0","description":"ICD-PGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDB0","description":"ICD-EFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACD1","description":"ICD-OACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0585U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","description":"CPT-0585U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extraction coronal remnants","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7111","description":"Extraction coronal remnants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ustekinumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3357","description":"Ustekinumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50722","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open tx iliac spine uni/bil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0412","description":"Open tx iliac spine uni/bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rec antivir treat hep c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8461","description":"Pt rec antivir treat hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO shoulder intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9735","description":"Patient unable to complete the FOTO shoulder intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAC1","description":"ICD-JBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ item that has been trimmed_ bent_ molded_ assembled_ or otherwise customized to fit a specific p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3760","description":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ item that has been trimmed_ bent_ molded_ assembled_ or otherwise customized to fit a specific p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise/replace knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27487","description":"Revise/replace knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBF0","description":"ICD-KCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHF1","description":"ICD-MDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFC0","description":"ICD-BDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Didanosine_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0137","description":"Didanosine_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGF0","description":"ICD-BGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1038T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1038T","description":"CPT-1038T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUF1","description":"ICD-GHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTA0","description":"ICD-JGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLF1","description":"ICD-OKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRF0","description":"ICD-OBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exhaled nitric oxide meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95012","description":"Exhaled nitric oxide meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMC1","description":"ICD-MDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUD1","description":"ICD-CEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport meals recip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0190","description":"Noner transport meals recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Triflupromazine hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3400","description":"Triflupromazine hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug Screen_ Other Than Chromatographic; Any Number Of Drug Classes_ By Clia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0434","description":"Drug Screen_ Other Than Chromatographic; Any Number Of Drug Classes_ By Clia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHE1","description":"ICD-MJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surfactant admin thru tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94610","description":"Surfactant admin thru tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ limited_ joint or other nonvascular extremity structure(s) (eg_ joint space_ peri-articular tendon[s]_ muscle[s]_ nerve[s]_ other soft tissue structure[s]_ or soft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76882","description":"Ultrasound_ limited_ joint or other nonvascular extremity structure(s) (eg_ joint space_ peri-articular tendon[s]_ muscle[s]_ nerve[s]_ other soft tissue structure[s]_ or soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chlamydia igm antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86632","description":"Chlamydia igm antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1117","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (lung cancer)_ four-probe FISH (3q29_ 3p22.1_ 10q22.3_ 10cen) assay_ whole blood_ predictive algorithm-generated evaluation reported as decreased or increased risk fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0317U","description":"Oncology (lung cancer)_ four-probe FISH (3q29_ 3p22.1_ 10q22.3_ 10cen) assay_ whole blood_ predictive algorithm-generated evaluation reported as decreased or increased risk fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFA1","description":"ICD-BFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUE0","description":"ICD-ODUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB11","description":"ICD-2CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Services outside us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9989","description":"Services outside us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2100","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABA1","description":"ICD-EABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPD0","description":"ICD-JFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33786","description":"Repair arterial trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11308","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSB0","description":"ICD-OBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g._ general_ intravenous sedation (monitored anesthesia ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0330","description":"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g._ general_ intravenous sedation (monitored anesthesia ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB11","description":"ICD-2DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAED0","description":"ICD-AAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery x-ray each vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75774","description":"Artery x-ray each vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Z7610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Z7610","description":"HCPCS-Z7610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYB1","description":"ICD-GIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLE1","description":"ICD-BDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clin symp vol ovrld assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1004F","description":"Clin symp vol ovrld assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKC1","description":"ICD-FEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup gauntlet ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4016","description":"Cast sup gauntlet ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81190","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient screened for future fall risk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1069","description":"Patient screened for future fall risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99281","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNB1","description":"ICD-KCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEA0","description":"ICD-NBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1339","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrode stimulation brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95961","description":"Electrode stimulation brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMD1","description":"ICD-EHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUC1","description":"ICD-JIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ unilateral (List se","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93569","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ unilateral (List se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLE1","description":"ICD-CGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRA0","description":"ICD-ODRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISF0","description":"ICD-CISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGD1","description":"ICD-KIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frozen cell preparation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88241","description":"Frozen cell preparation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPB0","description":"ICD-JCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXD0","description":"ICD-FBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPC0","description":"ICD-BFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Initial Set-Up And Patient Education On Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98975","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Initial Set-Up And Patient Education On Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCC1","description":"ICD-IDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anl sp inf pmp w/mdreprg&fil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62370","description":"Anl sp inf pmp w/mdreprg&fil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elbow disart myoelectronic c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6945","description":"Elbow disart myoelectronic c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADF1","description":"ICD-MADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMA0","description":"ICD-EAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFC0","description":"ICD-BFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1099T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1099T","description":"CPT-1099T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAC0","description":"ICD-AIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower leg joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27829","description":"Treat lower leg joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAB0","description":"ICD-KFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCB1","description":"ICD-ECCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCB1","description":"ICD-OJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser surgery anal lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46917","description":"Laser surgery anal lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMC0","description":"ICD-AIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPB0","description":"ICD-NGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSC1","description":"ICD-PKSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01742","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","description":"CPT-01742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assess cyst contrast inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49424","description":"Assess cyst contrast inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ risperidone (Perseris)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9037","description":"Injection_ risperidone (Perseris)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYA0","description":"ICD-PBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHD1","description":"ICD-MIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open red comp malar/zygma fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7750","description":"Open red comp malar/zygma fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDA1","description":"ICD-JCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB11","description":"ICD-1HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trnscth renal symp denrv unl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0338T","description":"Trnscth renal symp denrv unl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/bone grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21408","description":"Opn tx orbit fx w/bone grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise palsy hand tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25315","description":"Revise palsy hand tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIF0","description":"ICD-IDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; Prolonged Service_ Each Additional 30 Minutes (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80506","description":"Pathology Clinical Consultation; Prolonged Service_ Each Additional 30 Minutes (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos airway press headgear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7035","description":"Pos airway press headgear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPE0","description":"ICD-JBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome karyotype study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88280","description":"Chromosome karyotype study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4342","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","description":"HCPCS-Q4342","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAF0","description":"ICD-EFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJD0","description":"ICD-KIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWA1","description":"ICD-GDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVE0","description":"ICD-JEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGA1","description":"ICD-CBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAA1","description":"ICD-CAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALB0","description":"ICD-NALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKB1","description":"ICD-JEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0465T","description":"Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFA1","description":"ICD-BCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo tib fx cast molded to pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2108","description":"Afo tib fx cast molded to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKB0","description":"ICD-BHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB31","description":"ICD-4FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJA0","description":"ICD-OLJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL06","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21081","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB251","description":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB121","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAE1","description":"ICD-KEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resin-based composite - four or more surfaces (anterior)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2335","description":"Resin-based composite - four or more surfaces (anterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUD1","description":"ICD-OCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEE1","description":"ICD-NCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEME1","description":"ICD-JEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKF0","description":"ICD-CAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHE0","description":"ICD-CFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB31","description":"ICD-2KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I131 serum albumin_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9524","description":"I131 serum albumin_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATE0","description":"ICD-GATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-81524","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","description":"CPT-81524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKB0","description":"ICD-CDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Legion pneumo dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87541","description":"Legion pneumo dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ft insert ucb berkeley shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3000","description":"Ft insert ucb berkeley shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27198","description":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1189","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQF0","description":"ICD-HIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRC0","description":"ICD-CBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQB0","description":"ICD-OGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of midfoot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28264","description":"Release of midfoot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect shoulder tumor < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23077","description":"Resect shoulder tumor < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALB1","description":"ICD-BALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBID1","description":"ICD-IBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEF0","description":"ICD-JEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEB1","description":"ICD-AEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPD1","description":"ICD-NGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15C","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJC0","description":"ICD-CBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKB0","description":"ICD-OGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPB1","description":"ICD-JDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Postop dsg & 1 cast chg ak/d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5420","description":"Postop dsg & 1 cast chg ak/d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01829","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","description":"CPT-01829","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq sacral augmt unilat inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0200T","description":"Perq sacral augmt unilat inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAB0","description":"ICD-MAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQF0","description":"ICD-KAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24500","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB131","description":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart infarct image (ef)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78468","description":"Heart infarct image (ef)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ CROS_ behind the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5180","description":"Hearing aid_ CROS_ behind the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB160","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKF1","description":"ICD-JDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit device repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5036","description":"Hit device repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acellular derm matrix implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15777","description":"Acellular derm matrix implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFID0","description":"ICD-EFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection Factor V111 FC Fusion Protein (Recombinant) Per IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9975","description":"Injection Factor V111 FC Fusion Protein (Recombinant) Per IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEID0","description":"ICD-AEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSB1","description":"ICD-KGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYA0","description":"ICD-PJYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDA0","description":"ICD-IGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIB0","description":"ICD-NAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81413","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp3 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0860","description":"Pwc gp3 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPB1","description":"ICD-NGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51700","description":"Irrigation of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test urine for porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84119","description":"Test urine for porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGA0","description":"ICD-KFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHC1","description":"ICD-NHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cyp2c19 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81225","description":"Cyp2c19 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMF0","description":"ICD-OJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXB1","description":"ICD-GBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPD1","description":"ICD-KIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUC1","description":"ICD-NFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXC0","description":"ICD-KCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE205","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1081T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1081T","description":"CPT-1081T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDC0","description":"ICD-AHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hsv dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87528","description":"Hsv dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat hyoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21495","description":"Treat hyoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWA1","description":"ICD-OIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40840","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo iv infusion 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96413","description":"Chemo iv infusion 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE111","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHB1","description":"ICD-KCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQA0","description":"ICD-KGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9743","description":"Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTD0","description":"ICD-MBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mediastinoscopy_ with or without biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39400","description":"Mediastinoscopy_ with or without biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXE1","description":"ICD-BCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no pneumococcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8865","description":"Doc med reas no pneumococcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC214","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPA1","description":"ICD-BBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRF0","description":"ICD-LCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAF1","description":"ICD-MJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWC1","description":"ICD-KCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace trilateral socket br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4010","description":"Replace trilateral socket br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26705","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nephrology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4014","description":"Nephrology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJB0","description":"ICD-GGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHC1","description":"ICD-JAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIE1","description":"ICD-MGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYA0","description":"ICD-HAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHB1","description":"ICD-MDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWF1","description":"ICD-GCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALF0","description":"ICD-OALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVD1","description":"ICD-GIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSA1","description":"ICD-PCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21431","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRD1","description":"ICD-CFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMF0","description":"ICD-CIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOC1","description":"ICD-HIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Whfo w/joint(s) custom fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3806","description":"Whfo w/joint(s) custom fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE215","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med reas not incl histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9419","description":"Med reas not incl histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp 5/>yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99149","description":"Mod sed diff phys/qhp 5/>yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEB0","description":"ICD-MJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gravlee jet washer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4470","description":"Gravlee jet washer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respite care service 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1005","description":"Respite care service 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft ipsilat carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35501","description":"Art byp grft ipsilat carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical boot each infant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3208","description":"Surgical boot each infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCA0","description":"ICD-AHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWB1","description":"ICD-HHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged iv inf_ req pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8957","description":"Prolonged iv inf_ req pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq card stent w/angio 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92928","description":"Prq card stent w/angio 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQF0","description":"ICD-PDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","description":"HCPCS-A2033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEME0","description":"ICD-IEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spectinomycn di-hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3320","description":"Spectinomycn di-hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDE0","description":"ICD-BDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEE1","description":"ICD-FGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Docrsn for cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9264","description":"Docrsn for cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDB1","description":"ICD-MCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Care level rationale doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6005F","description":"Care level rationale doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJF0","description":"ICD-NJJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hh aide or cn aide per visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1021","description":"Hh aide or cn aide per visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNA0","description":"ICD-JBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAE1","description":"ICD-OKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPB1","description":"ICD-FAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","description":"HCPCS-Q4379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJA0","description":"ICD-OJJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of eyelid abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67700","description":"Drainage of eyelid abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNB1","description":"ICD-BFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQC0","description":"ICD-OGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound exam follow-up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76970","description":"Ultrasound exam follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12A","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA56","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB113","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBF0","description":"ICD-BFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIB1","description":"ICD-AAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0836","description":"Pwc gp2 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQB1","description":"ICD-DEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42205","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVF0","description":"ICD-GFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUF0","description":"ICD-MLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOC1","description":"ICD-KFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand/finger surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26989","description":"Hand/finger surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRE1","description":"ICD-CBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES345","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intensive outpatient services; weekly bundle_ minimum of 9 services over a 7 contiguous day period_ which can include individual and group therapy with physicians or psycholog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0137","description":"Intensive outpatient services; weekly bundle_ minimum of 9 services over a 7 contiguous day period_ which can include individual and group therapy with physicians or psycholog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15D","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc tb scrng-rslts interpd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3510F","description":"Doc tb scrng-rslts interpd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLB1","description":"ICD-CBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBD1","description":"ICD-CIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1185","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trastuzumab administered within 12 months of diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9835","description":"Trastuzumab administered within 12 months of diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDID1","description":"ICD-FDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip clevis/thrust bearing lo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2610","description":"Hip clevis/thrust bearing lo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp2 hd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0843","description":"Pwc gp2 hd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMF1","description":"ICD-NAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSD1","description":"ICD-LCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit complex cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5501","description":"Hit complex cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQC1","description":"ICD-CFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D8091","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D8091","description":"CDT-D8091","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reinforce clavicle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23490","description":"Reinforce clavicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFE0","description":"ICD-JBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip core decompression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2325","description":"Hip core decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICA1","description":"ICD-OICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer); genomic sequence analysis panel_ must incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81432","description":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer); genomic sequence analysis panel_ must incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2281","description":"Injection_ moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with implantable stimulation lead and external paired stimulation controller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1827","description":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with implantable stimulation lead and external paired stimulation controller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Irrig drug delivery device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96523","description":"Irrig drug delivery device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9702","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth blood vessel repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77051","description":"Anesth blood vessel repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"guided tissue regeneration_ edentulous area - resorbable barrier_ per site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7956","description":"guided tissue regeneration_ edentulous area - resorbable barrier_ per site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at 12 months as demonstrated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1019","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at 12 months as demonstrated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Optx post ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27769","description":"Optx post ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tcranial magn stim tx deli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90868","description":"Tcranial magn stim tx deli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFF1","description":"ICD-OCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEB0","description":"ICD-MEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAA0","description":"ICD-FFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWA0","description":"ICD-LGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection procedure for pyelography (as nephrostogram_ pyelostogram_ antegrade pyeloureterograms) through nephrostomy or pyelostomy tube_ or indwelling ureteral c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50394","description":"Injection procedure for pyelography (as nephrostogram_ pyelostogram_ antegrade pyeloureterograms) through nephrostomy or pyelostomy tube_ or indwelling ureteral c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA24","description":"High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCA1","description":"ICD-ICCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHD1","description":"ICD-CIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJE0","description":"ICD-NBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote dx retinal imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92227","description":"Remote dx retinal imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (hepatic)_ mRNA expression levels of 161 genes_ utilizing fresh he","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0110U","description":"Oncology (hepatic)_ mRNA expression levels of 161 genes_ utilizing fresh he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYA0","description":"ICD-KGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBB0","description":"ICD-JHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNC1","description":"ICD-CGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRA1","description":"ICD-OBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepb vaccine 3 dose adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90746","description":"Hepb vaccine 3 dose adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHB1","description":"ICD-NJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWB0","description":"ICD-PHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34101","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIA0","description":"ICD-MDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAE1","description":"ICD-CCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Forearm or wrist surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25999","description":"Forearm or wrist surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53661","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOC0","description":"ICD-LEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHF1","description":"ICD-MLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQD1","description":"ICD-HAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressant rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4064F","description":"Antidepressant rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFE1","description":"ICD-CFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQE1","description":"ICD-KHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEA0","description":"ICD-MEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBB1","description":"ICD-IHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFA0","description":"ICD-NAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYD0","description":"ICD-OBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOB1","description":"ICD-KAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown full high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6790","description":"Crown full high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMA1","description":"ICD-AFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOE0","description":"ICD-HDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA217","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy intracavitary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96440","description":"Chemotherapy intracavitary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Services provided as part of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9991","description":"Services provided as part of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull & remove clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61154","description":"Pierce skull & remove clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC234","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRE0","description":"ICD-KCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPF1","description":"ICD-BCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHF1","description":"ICD-OIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETA0","description":"ICD-NETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect distal humerus tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24150","description":"Resect distal humerus tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMD0","description":"ICD-OLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBD1","description":"ICD-NEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tee w or w/o fol w/cont_ mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8927","description":"Tee w or w/o fol w/cont_ mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21A","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRA0","description":"ICD-CCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHD1","description":"ICD-AIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45114","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALC0","description":"ICD-IALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22A","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc sinus ct 28d or dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9350","description":"No doc sinus ct 28d or dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFB0","description":"ICD-FIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUA1","description":"ICD-OIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22854","description":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJD1","description":"ICD-BEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aoe comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9466","description":"Aoe comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRE1","description":"ICD-PLRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CT/MRI chest/neck no thy nod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9557","description":"CT/MRI chest/neck no thy nod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27479","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTB0","description":"ICD-BGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRA1","description":"ICD-PFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knuckle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26850","description":"Fusion of knuckle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replantation of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54438","description":"Replantation of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of toes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28280","description":"Fusion of toes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAA1","description":"ICD-NGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEF0","description":"ICD-OFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPF1","description":"ICD-JAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX21","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSA1","description":"ICD-CBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Y set tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4719","description":"Y set tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18C","description":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy thigh soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27324","description":"Biopsy thigh soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPB0","description":"ICD-JGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWE0","description":"ICD-PGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction_ hallux valgus (bunionectomy)_ with sesamoidectomy_ when performed; with proximal metatarsal osteotomy_ any method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28295","description":"Correction_ hallux valgus (bunionectomy)_ with sesamoidectomy_ when performed; with proximal metatarsal osteotomy_ any method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWB1","description":"ICD-GGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRE1","description":"ICD-GDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinician Documented That Patient Recevied Vascular Access Other Than Autogenous AV Fistula_ Reason not Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8532","description":"Clinician Documented That Patient Recevied Vascular Access Other Than Autogenous AV Fistula_ Reason not Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKE1","description":"ICD-CCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUC0","description":"ICD-BHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33927","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX50","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATC1","description":"ICD-EATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lvef greater than 35%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3056F","description":"Lvef greater than 35%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVF0","description":"ICD-OIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIC0","description":"ICD-NGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Daunorubicin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9150","description":"Daunorubicin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary proce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0837T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVB1","description":"ICD-GFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVE0","description":"ICD-FEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXB1","description":"ICD-JFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17272","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXA0","description":"ICD-CHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert cervical dilator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59200","description":"Insert cervical dilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQA0","description":"ICD-KEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHA0","description":"ICD-KFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Isoetharine comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7647","description":"Isoetharine comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comm psy sup tx pgm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0037","description":"Comm psy sup tx pgm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ag detection polyval if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87300","description":"Ag detection polyval if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0681U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681U","description":"CPT-0681U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOE0","description":"ICD-GAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD254","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDB1","description":"ICD-OJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDF1","description":"ICD-OLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1458","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","description":"HCPCS-M1458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMD0","description":"ICD-CGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ 5-50 genes (eg_ ALK_ BRAF_ CDKN2A_ EGFR_ ERBB2_ KIT_ KRAS_ MET_ NRAS_ PDGFRA_ PDGFRB_ PGR_ PIK3CA_ PTEN_ RET)_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81449","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ 5-50 genes (eg_ ALK_ BRAF_ CDKN2A_ EGFR_ ERBB2_ KIT_ KRAS_ MET_ NRAS_ PDGFRA_ PDGFRB_ PGR_ PIK3CA_ PTEN_ RET)_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMF0","description":"ICD-MDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYA1","description":"ICD-LFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJC0","description":"ICD-FEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKB1","description":"ICD-GEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fmr1 gene detection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81243","description":"Fmr1 gene detection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCA1","description":"ICD-FHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCID1","description":"ICD-GCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPF0","description":"ICD-OIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIB1","description":"ICD-KCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMC0","description":"ICD-MCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTA1","description":"ICD-KGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transpetrosal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61598","description":"Transpetrosal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Folding ped wc tilt-in-space","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1232","description":"Folding ped wc tilt-in-space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJC1","description":"ICD-NHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDB1","description":"ICD-FBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cavopulmonary shunting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33768","description":"Cavopulmonary shunting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAF1","description":"ICD-JCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCB0","description":"ICD-AHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIB1","description":"ICD-IIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE224","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUC1","description":"ICD-ECUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAB1","description":"ICD-KDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSA0","description":"ICD-LHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELC1","description":"ICD-JELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art trnsposj vertbrl carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35691","description":"Art trnsposj vertbrl carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUC0","description":"ICD-KHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gene test beta-thalassemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3846","description":"Gene test beta-thalassemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Limited motion knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2184","description":"Limited motion knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB201","description":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUD0","description":"ICD-ABUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITB0","description":"ICD-NITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25695","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI low field","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8042","description":"MRI low field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Smoking cessation gum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4995","description":"Smoking cessation gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1483","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","description":"HCPCS-M1483","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","description":"CPT-92930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAF0","description":"ICD-GDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext antenna phren nerve stim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8696","description":"Ext antenna phren nerve stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD)_ leukocyte enzyme activity_ whole blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0257U","description":"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD)_ leukocyte enzyme activity_ whole blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKE0","description":"ICD-OBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC23","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOF1","description":"ICD-LIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inflamation (eosinophilic esophagitis)_ ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2_ pro eosinophil major","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0095U","description":"Inflamation (eosinophilic esophagitis)_ ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2_ pro eosinophil major","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Toc tool incl elem not used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9658","description":"Toc tool incl elem not used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCF0","description":"ICD-ODCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJC0","description":"ICD-JIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient died at any time during the 24-month measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9751","description":"Patient died at any time during the 24-month measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin sub graft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15271","description":"Skin sub graft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWF1","description":"ICD-HFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBB0","description":"ICD-AIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pierce skull for biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61140","description":"Pierce skull for biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Semi precision attach abut","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6052","description":"Semi precision attach abut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACD0","description":"ICD-IACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRD0","description":"ICD-KIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCD1","description":"ICD-ODCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWF0","description":"ICD-LEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of hemorrhoid clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46320","description":"Removal of hemorrhoid clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC31","description":"ICD-3HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQD1","description":"ICD-CFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXB1","description":"ICD-JGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of CHA2DS2-VASc risk score of 0 or 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9931","description":"Documentation of CHA2DS2-VASc risk score of 0 or 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTB1","description":"ICD-CGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC254","description":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPC1","description":"ICD-GAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27606","description":"Incision of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRF0","description":"ICD-GCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYB0","description":"ICD-OAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunohistochemical stains","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0478","description":"Immunohistochemical stains","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNC1","description":"ICD-KHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2640","description":"Brachytx_ stranded_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj milrinone lactate / 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2260","description":"Inj milrinone lactate / 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEA1","description":"ICD-CHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVB0","description":"ICD-NGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDME0","description":"ICD-FDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLC0","description":"ICD-OGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATF0","description":"ICD-FATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB114","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOC1","description":"ICD-OEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPA0","description":"ICD-OJPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Free/remove chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32320","description":"Free/remove chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of left heart vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33988","description":"Insertion of left heart vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastroenterology_ malabsorption evaluation of alpha-1-antitrypsin_ calprotectin_ pancreatic elastase and reducing substances_ feces_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0430U","description":"Gastroenterology_ malabsorption evaluation of alpha-1-antitrypsin_ calprotectin_ pancreatic elastase and reducing substances_ feces_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth testis suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93051","description":"Anesth testis suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct rpt to reg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9327","description":"Ct rpt to reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMA1","description":"ICD-NJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAB0","description":"ICD-KDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4A","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDF1","description":"ICD-FGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma_ Including Local Exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49013","description":"Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma_ Including Local Exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBB1","description":"ICD-FGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of implanted vestibular device_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0726T","description":"Removal of implanted vestibular device_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle-skin graft arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15736","description":"Muscle-skin graft arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv eccrine glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64653","description":"Chemodenerv eccrine glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBA1","description":"ICD-JEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of glutathione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82978","description":"Assay of glutathione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMB1","description":"ICD-FGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tract frame attach headboard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0840","description":"Tract frame attach headboard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Asthma symptoms evaluate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1005F","description":"Asthma symptoms evaluate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Basic support routine suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0382","description":"Basic support routine suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99235","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXE0","description":"ICD-FGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJD0","description":"ICD-BFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRC0","description":"ICD-LFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"APC (APC regulator of WNT signaling pathway)(EG_familial adenomatosis polyposis [FAP] MRNA sequence analysis (list seperately in addition to code for primary procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0157U","description":"APC (APC regulator of WNT signaling pathway)(EG_familial adenomatosis polyposis [FAP] MRNA sequence analysis (list seperately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65150","description":"Revise ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"At least two orders for the same high-risk medications not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9638","description":"At least two orders for the same high-risk medications not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVB1","description":"ICD-JEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01999","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","description":"CPT-01999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX12","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLD1","description":"ICD-EHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Herpes simplex type 1 test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86695","description":"Herpes simplex type 1 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Puncture/clear windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31612","description":"Puncture/clear windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGD1","description":"ICD-KCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFE0","description":"ICD-KHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDA1","description":"ICD-GGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGB0","description":"ICD-FAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUC0","description":"ICD-KIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRF0","description":"ICD-LHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Therapeutic radiology simulation-aided field setting; complex_ including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy tre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9794","description":"Therapeutic radiology simulation-aided field setting; complex_ including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy tre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB125","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Us transrectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76872","description":"Us transrectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFF0","description":"ICD-OJFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKF1","description":"ICD-BEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of spermatic ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54901","description":"Fusion of spermatic ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPF0","description":"ICD-BEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMD0","description":"ICD-CBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic band & belt thigh fla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2192","description":"Pelvic band & belt thigh fla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/>6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2310","description":"Lens sphc trifocal 4.25-7/>6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photo patch test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95052","description":"Photo patch test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"So acro/clav can web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3670","description":"So acro/clav can web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18B","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-awwb_ biosimilar_ (Mvasi)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5107","description":"Injection_ bevacizumab-awwb_ biosimilar_ (Mvasi)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICC1","description":"ICD-MICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALA0","description":"ICD-MALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGF1","description":"ICD-BGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prostatectomy (turp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52601","description":"Prostatectomy (turp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXB1","description":"ICD-FDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUC0","description":"ICD-AIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Leukocyte phagocytosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86344","description":"Leukocyte phagocytosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHD0","description":"ICD-MLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUE1","description":"ICD-OCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBD0","description":"ICD-NGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQF0","description":"ICD-OCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Riv3 vaccine no preserv im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90673","description":"Riv3 vaccine no preserv im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66930","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFA0","description":"ICD-GCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOF0","description":"ICD-PGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vbac care after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59614","description":"Vbac care after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change ureter stent percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50382","description":"Change ureter stent percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovasc repair abdom aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75952","description":"Endovasc repair abdom aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFID1","description":"ICD-MFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDE0","description":"ICD-BGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53200","description":"Biopsy of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOB0","description":"ICD-DCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFD0","description":"ICD-NAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of bradykinin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82286","description":"Assay of bradykinin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29450","description":"Application of leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixation of shoulder blade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23400","description":"Fixation of shoulder blade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDA0","description":"ICD-BBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L1653","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","description":"HCPCS-L1653","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESA0","description":"ICD-PESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17270","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOE0","description":"ICD-OGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver & spleen image/flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78216","description":"Liver & spleen image/flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","description":"CPT-00190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing 1 locus hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81380","description":"Hla i typing 1 locus hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open bowel to skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44300","description":"Open bowel to skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKA1","description":"ICD-GFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1102T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1102T","description":"CPT-1102T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUB1","description":"ICD-IIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCA0","description":"ICD-KGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB221","description":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB15","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVE1","description":"ICD-CIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rapid desensitization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95180","description":"Rapid desensitization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJC0","description":"ICD-BGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29040","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMF1","description":"ICD-CFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0495T","description":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43762","description":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACC0","description":"ICD-OACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYD1","description":"ICD-KEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8H","description":"High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEB1","description":"ICD-NIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bed board","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0273","description":"Bed board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62303","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXF0","description":"ICD-KIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecg/signal-averaged","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93278","description":"Ecg/signal-averaged","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antineutrophil Cytoplasmic Antibody (Anca); Screen_ Each Antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86036","description":"Antineutrophil Cytoplasmic Antibody (Anca); Screen_ Each Antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIB0","description":"ICD-CGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Detect agent nos dna dir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87797","description":"Detect agent nos dna dir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65272","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBF0","description":"ICD-KDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC33","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEC1","description":"ICD-EDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse pancreas and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48548","description":"Fuse pancreas and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTF0","description":"ICD-MDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVC1","description":"ICD-CCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJC1","description":"ICD-OBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABE1","description":"ICD-FABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Teriparatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3110","description":"Teriparatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVE0","description":"ICD-FBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0501","description":"HCPCS-A0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of sciatic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64712","description":"Revision of sciatic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng arm splint plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4017","description":"Cast sup lng arm splint plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX30","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49428","description":"Ligation of shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6614","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6614","description":"HCPCS-A6614","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLC0","description":"ICD-ECLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0518U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","description":"CPT-0518U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1057T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1057T","description":"CPT-1057T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla ii typing 1 loc hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81382","description":"Hla ii typing 1 loc hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCA0","description":"ICD-MFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCB1","description":"ICD-CBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA52","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAE1","description":"ICD-JCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBD0","description":"ICD-GFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47741","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYA0","description":"ICD-LFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLA0","description":"ICD-NGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC21","description":"ICD-3GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt offered tx for pseudobulb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4541F","description":"Pt offered tx for pseudobulb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVA0","description":"ICD-KCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpt pt cat and pt1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9428","description":"Rpt pt cat and pt1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2192","description":"Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRC0","description":"ICD-HGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIB1","description":"ICD-MAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILC0","description":"ICD-EILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTB0","description":"ICD-NLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56810","description":"Repair of perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB234","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjust wrist ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1805","description":"Adjust wrist ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21490","description":"Repair dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Syringe w/needle insulin 3cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4232","description":"Syringe w/needle insulin 3cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQA1","description":"ICD-LCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADA1","description":"ICD-FADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKC0","description":"ICD-CHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem oct rta techl sprt min 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0605T","description":"Rem oct rta techl sprt min 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAB1","description":"ICD-IEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; With Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0637T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; With Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Long qt syn gene dup/dlt var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81282","description":"Long qt syn gene dup/dlt var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSD0","description":"ICD-HGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33955","description":"Ecmo/ecls insj ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQB0","description":"ICD-GFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBA0","description":"ICD-MDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9885","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUA1","description":"ICD-FCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00560","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","description":"CPT-00560","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E0469","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","description":"HCPCS-E0469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17263","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22C","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGE1","description":"ICD-OKGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYB1","description":"ICD-HAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1603","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1603","description":"CDT-D1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair special seat dept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1297","description":"Wheelchair special seat dept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat recline pwr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1005","description":"Pwr seat recline pwr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSA1","description":"ICD-GDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup lng leg ped plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4031","description":"Cast sup lng leg ped plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35188","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCF0","description":"ICD-MLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M0236","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","description":"HCPCS-M0236","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBE0","description":"ICD-IDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1270","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXA0","description":"ICD-FDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIC1","description":"ICD-OGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92636","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","description":"CPT-92636","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUD1","description":"ICD-KCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLE1","description":"ICD-MGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rickettsia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86757","description":"Rickettsia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITD1","description":"ICD-NITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYE1","description":"ICD-OCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBA1","description":"ICD-OFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fracture frame attachmnts pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0947","description":"Fracture frame attachmnts pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84075","description":"Assay alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0570U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","description":"CPT-0570U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exoskeletal axial rotation u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5982","description":"Exoskeletal axial rotation u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth procedures on eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14051","description":"Anesth procedures on eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Team conf w/o pat by phys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99367","description":"Team conf w/o pat by phys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIB1","description":"ICD-MFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCF1","description":"ICD-OJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hand bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26200","description":"Remove hand bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKD0","description":"ICD-OJKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPE1","description":"ICD-CHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKB0","description":"ICD-OHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHF0","description":"ICD-MJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain hand tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26020","description":"Drain hand tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWA0","description":"ICD-LDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1489","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","description":"HCPCS-M1489","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other drugs/medicaments","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9630","description":"Other drugs/medicaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDD0","description":"ICD-ABDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUF0","description":"ICD-BGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLF1","description":"ICD-JHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVB0","description":"ICD-GIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMC0","description":"ICD-KCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB11","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUC1","description":"ICD-JEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMB0","description":"ICD-IHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGF1","description":"ICD-KCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNB0","description":"ICD-BHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13C","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67909","description":"Revise eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRF1","description":"ICD-HBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPC1","description":"ICD-KAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFD1","description":"ICD-GIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYC1","description":"ICD-LBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB11","description":"ICD-1EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xe133 xenon 10mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9558","description":"Xe133 xenon 10mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coagulation time lee & white","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85345","description":"Coagulation time lee & white","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGA1","description":"ICD-GFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCE1","description":"ICD-NCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neostim membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4266","description":"Neostim membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJF0","description":"ICD-KCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronary artery bypass/reop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33530","description":"Coronary artery bypass/reop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo examination procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76999","description":"Echo examination procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00410","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","description":"CPT-00410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTE0","description":"ICD-JGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB110","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72190","description":"X-ray exam of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of calcium deposits","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23000","description":"Removal of calcium deposits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCB0","description":"ICD-ECCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft hip bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27067","description":"Remove/graft hip bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prevocational services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6107","description":"Prevocational services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64728","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","description":"CPT-64728","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHD1","description":"ICD-ICHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0627U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","description":"CPT-0627U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRB0","description":"ICD-OBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of fibula epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27732","description":"Repair of fibula epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0014","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0014","description":"HCPCS-J0014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETA0","description":"ICD-KETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD106","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUC0","description":"ICD-EGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCC0","description":"ICD-NJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone replce graft first site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4263","description":"Bone replce graft first site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10B","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBC1","description":"ICD-IBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51720","description":"Treatment of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVB1","description":"ICD-GGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth intrcrn nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22051","description":"Anesth intrcrn nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap ing hernia repair init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49650","description":"Lap ing hernia repair init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXB1","description":"ICD-BIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ext hem groups 2+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46250","description":"Remove ext hem groups 2+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBB0","description":"ICD-JCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastro/jejuno tube_ std","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4087","description":"Gastro/jejuno tube_ std","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4420","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","description":"HCPCS-Q4420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLD0","description":"ICD-OJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1233","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATE0","description":"ICD-OATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of subcutaneous peritoneal ascites pump system_ percutaneous_ including pump-pocket creation_ insertion of tunneled indwelling bladder and peritoneal catheters wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0870T","description":"Implantation of subcutaneous peritoneal ascites pump system_ percutaneous_ including pump-pocket creation_ insertion of tunneled indwelling bladder and peritoneal catheters wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXC1","description":"ICD-FFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTE0","description":"ICD-CGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49610","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISB0","description":"ICD-LISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (congenital coagulation disorders)_ genomic sequence analysis of 20 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Coagulation Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0270U","description":"Hematology (congenital coagulation disorders)_ genomic sequence analysis of 20 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Coagulation Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prev visit new age 12-17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99384","description":"Prev visit new age 12-17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSE1","description":"ICD-PFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDE1","description":"ICD-MBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOB1","description":"ICD-PIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq abltj lvr cryoablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47383","description":"Perq abltj lvr cryoablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemodenerv trunk musc 6/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64647","description":"Chemodenerv trunk musc 6/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOA0","description":"ICD-OLOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim 6mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2505","description":"Injection_ pegfilgrastim 6mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special supply_ nos waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2028","description":"Special supply_ nos waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient recorded spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94015","description":"Patient recorded spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVE0","description":"ICD-KEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVE1","description":"ICD-GEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNF1","description":"ICD-JDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXE0","description":"ICD-GDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g._ cystic duct_ common bile duct and common hepatic duct) with intravenous administra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9776","description":"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g._ cystic duct_ common bile duct and common hepatic duct) with intravenous administra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace foot drop spint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4394","description":"Replace foot drop spint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAC1","description":"ICD-IDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWC1","description":"ICD-HAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immed max part denture resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5221","description":"Immed max part denture resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGA1","description":"ICD-KFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inlay porcelain/ceramic 2 su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2620","description":"Inlay porcelain/ceramic 2 su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILD0","description":"ICD-GILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD250","description":"Reduced Physical Function _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBE0","description":"ICD-BCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemotherapy drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9999","description":"Chemotherapy drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRC0","description":"ICD-OFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLF1","description":"ICD-GHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKD1","description":"ICD-NDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAA0","description":"ICD-KIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWB1","description":"ICD-CIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAED1","description":"ICD-AAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBC1","description":"ICD-NKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPA1","description":"ICD-JDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87451","description":"IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric motility studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91020","description":"Gastric motility studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art pancreas ext transmitter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1036","description":"Art pancreas ext transmitter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14C","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diphenhydramine hcl 50mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0163","description":"Diphenhydramine hcl 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEB0","description":"ICD-IDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28C","description":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Formoterol fumarate_ inh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7606","description":"Formoterol fumarate_ inh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXE1","description":"ICD-CIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIA0","description":"ICD-JDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTA1","description":"ICD-IHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBB0","description":"ICD-OCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEB1","description":"ICD-BEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18H","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"von Willebrand factor (VWF)_ type 2B_ platelet-binding evaluation_ radioimmunoassay_ plasma (Versiti™ VWD Type 2B Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0283U","description":"von Willebrand factor (VWF)_ type 2B_ platelet-binding evaluation_ radioimmunoassay_ plasma (Versiti™ VWD Type 2B Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEC1","description":"ICD-OGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System With Interim Analysis_ Review(S) And Report(S) By A P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0578T","description":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System With Interim Analysis_ Review(S) And Report(S) By A P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYF1","description":"ICD-KDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBD1","description":"ICD-BGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYB1","description":"ICD-PIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9370","description":"Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSA1","description":"ICD-KHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLC1","description":"ICD-NJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37200","description":"Transcatheter biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Not Been Ordered Or Performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2120","description":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Not Been Ordered Or Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr seat tilt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1002","description":"Pwr seat tilt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHB0","description":"ICD-NAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPC1","description":"ICD-NCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPC0","description":"ICD-ODPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1078","description":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPB0","description":"ICD-OIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES155","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ergonovine maleate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1330","description":"Ergonovine maleate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Veneer repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2983","description":"Veneer repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Protein western blot tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88371","description":"Protein western blot tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove cartilage for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20910","description":"Remove cartilage for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0463","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","description":"HCPCS-J0463","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLD0","description":"ICD-NLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28455","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay infectious agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86317","description":"Immunoassay infectious agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp5 ped mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0891","description":"Pwc gp5 ped mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAC0","description":"ICD-KAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 100","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88249","description":"Chromosome analysis 100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCC1","description":"ICD-NJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct lip with flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40525","description":"Reconstruct lip with flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEC1","description":"ICD-MDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ ep_ othr than cool-tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1733","description":"Cath_ ep_ othr than cool-tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLE1","description":"ICD-JBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-64655","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","description":"CPT-64655","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXD1","description":"ICD-GBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSD1","description":"ICD-CGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Darbepoetin alfa_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0881","description":"Darbepoetin alfa_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1720","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1720","description":"CDT-D1720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total kt/v less than 1. 7 per week (total clearance of urea [kt] / volume [v])_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8720","description":"Total kt/v less than 1. 7 per week (total clearance of urea [kt] / volume [v])_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0591U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","description":"CPT-0591U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLC0","description":"ICD-EGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21249","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRA0","description":"ICD-LCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUB0","description":"ICD-GEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFA1","description":"ICD-JBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraoral - periapical radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0707","description":"Intraoral - periapical radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHA0","description":"ICD-CDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXE1","description":"ICD-OGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-adcd (vegzelma)_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5129","description":"Injection_ bevacizumab-adcd (vegzelma)_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"3 comp foot exam completed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9226","description":"3 comp foot exam completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEC1","description":"ICD-JIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Focusing on women_s health mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1366","description":"Focusing on women_s health mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5C","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEE1","description":"ICD-GCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL36","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc no comp or mort w in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9270","description":"Doc no comp or mort w in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYC0","description":"ICD-HCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1210","description":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20C","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUC1","description":"ICD-ODUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of indwelling bladder and peritoneal catheters_ including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump_ including imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0872T","description":"Replacement of indwelling bladder and peritoneal catheters_ including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump_ including imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDF1","description":"ICD-OFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ copy number variants and microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81458","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ copy number variants and microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suicide risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3085F","description":"Suicide risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDA1","description":"ICD-JHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQC0","description":"ICD-LDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGID0","description":"ICD-BGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLF0","description":"ICD-MJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAB1","description":"ICD-CAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBB1","description":"ICD-NIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Simult panc kidn trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2065","description":"Simult panc kidn trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDB1","description":"ICD-OFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHA0","description":"ICD-ACHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1399","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","description":"HCPCS-M1399","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDD1","description":"ICD-AFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEF0","description":"ICD-KEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBB1","description":"ICD-NKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJC0","description":"ICD-NBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIF0","description":"ICD-AAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human ig sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90284","description":"Human ig sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEF1","description":"ICD-NCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL60","description":"Very High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0678U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678U","description":"CPT-0678U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB31","description":"ICD-2HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQF1","description":"ICD-LAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILA0","description":"ICD-AILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00906","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","description":"CPT-00906","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group audiometric testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92559","description":"Group audiometric testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDF1","description":"ICD-EBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1001","description":"HCPCS-B1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPC0","description":"ICD-FBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAD0","description":"ICD-IHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJA0","description":"ICD-JHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMD1","description":"ICD-IHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Norsn pt cath >=90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9266","description":"Norsn pt cath >=90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDF1","description":"ICD-MLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMC1","description":"ICD-KDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICA1","description":"ICD-EICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTB0","description":"ICD-NGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55700","description":"Biopsy of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Overdenture complete max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5863","description":"Overdenture complete max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFC1","description":"ICD-CBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAA0","description":"ICD-KCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKC0","description":"ICD-KCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADB1","description":"ICD-CADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixed patient lift system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0640","description":"Fixed patient lift system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid dispensing fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5110","description":"Hearing aid dispensing fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANB1","description":"ICD-FANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXC0","description":"ICD-BDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUA1","description":"ICD-KFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCD1","description":"ICD-BFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGA0","description":"ICD-BDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64896","description":"Nerve graft hand/foot >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXF1","description":"ICD-GGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of finger/thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26952","description":"Amputation of finger/thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPB1","description":"ICD-OAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1101","description":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB44","description":"Very High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENA0","description":"ICD-CENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reteplase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2993","description":"Reteplase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA121","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBF0","description":"ICD-FCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin sub graft face/nk/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15275","description":"Skin sub graft face/nk/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","description":"HCPCS-L6034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34490","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSA0","description":"ICD-OCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assistive Technology","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0138","description":"Assistive Technology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anes medscpy&thorscpy 1 lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52951","description":"Anes medscpy&thorscpy 1 lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPD1","description":"ICD-CEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIC1","description":"ICD-ODIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Docrsn for catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9239","description":"Docrsn for catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of bile ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47800","description":"Reconstruction of bile ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGF0","description":"ICD-OIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ linezolid (hospira) not therapeutically equivalent to j2020_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2021","description":"Injection_ linezolid (hospira) not therapeutically equivalent to j2020_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph fundoplasty lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43327","description":"Esoph fundoplasty lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11B","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB126","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQF1","description":"ICD-HBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69745","description":"Repair facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSD0","description":"ICD-ODSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj desmopressin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2597","description":"Inj desmopressin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantation_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69716","description":"Implantation_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9310","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9310","description":"HCPCS-C9310","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA32","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVC0","description":"ICD-KBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; with biopsy_ single or multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0653T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; with biopsy_ single or multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAA1","description":"ICD-BFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJA0","description":"ICD-NIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOA0","description":"ICD-CIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD213","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPD0","description":"ICD-OFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0688U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688U","description":"CPT-0688U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction maxilla total","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7946","description":"Reconstruction maxilla total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3A","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMC0","description":"ICD-OJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2116","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIA1","description":"ICD-BBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIE1","description":"ICD-OJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFD0","description":"ICD-OKFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMD1","description":"ICD-BIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGME1","description":"ICD-FGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAA0","description":"ICD-AHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWC1","description":"ICD-DGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDD1","description":"ICD-CCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac Tx Nsg Fac Res Fl/Elct Do/Deh Bill Sid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9683","description":"Onsite Ac Tx Nsg Fac Res Fl/Elct Do/Deh Bill Sid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUD1","description":"ICD-MHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7023","description":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tint photochromatic lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2744","description":"Tint photochromatic lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous laser vein addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36479","description":"Endovenous laser vein addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0266T","description":"Implt/rpl crtd sns dev total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPB1","description":"ICD-NCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANC1","description":"ICD-BANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo ia infusion up to 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96422","description":"Chemo ia infusion up to 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95147","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDC0","description":"ICD-CFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSF0","description":"ICD-HGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1C","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECF0","description":"ICD-GECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEB0","description":"ICD-JAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWC1","description":"ICD-OHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28I","description":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSF0","description":"ICD-OGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGA0","description":"ICD-NBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLC0","description":"ICD-JGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj fem single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64447","description":"N block inj fem single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIB1","description":"ICD-MKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ factor VIII (antihemophilic factor_ recombinant) (Afstyla)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9140","description":"Injection_ factor VIII (antihemophilic factor_ recombinant) (Afstyla)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99174","description":"Ocular instrumnt screen bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot plas heel stabi pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3170","description":"Foot plas heel stabi pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ortho shoe add half sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3530","description":"Ortho shoe add half sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eculizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1300","description":"Eculizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC104","description":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/w resect diag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32668","description":"Thoracoscopy w/w resect diag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIME0","description":"ICD-GIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGE1","description":"ICD-OEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQC1","description":"ICD-LIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTA0","description":"ICD-FDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGF0","description":"ICD-BAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluorescent antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86255","description":"Fluorescent antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWA1","description":"ICD-CCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRA1","description":"ICD-DFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITB1","description":"ICD-AITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0202","description":"HCPCS-A0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTA1","description":"ICD-MBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE145","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Renal biopsy open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50205","description":"Renal biopsy open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEC1","description":"ICD-OFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46744","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt biliary drainage cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47533","description":"Plmt biliary drainage cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDME0","description":"ICD-KDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glucose test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82950","description":"Glucose test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBA1","description":"ICD-CDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA151","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiopulmonary exercise testing_ including measurements of minute ventilation_ CO2 production_ O2 uptake_ and electrocardiographic recordings","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94621","description":"Cardiopulmonary exercise testing_ including measurements of minute ventilation_ CO2 production_ O2 uptake_ and electrocardiographic recordings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA45","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1076","description":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligate/staple esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43405","description":"Ligate/staple esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pneumococcal Vaccine Was Not Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9990","description":"Pneumococcal Vaccine Was Not Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJB1","description":"ICD-NKJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12D","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNB1","description":"ICD-GCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUE0","description":"ICD-IAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8G","description":"High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA160","description":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M.avium-intra dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87560","description":"M.avium-intra dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOE1","description":"ICD-HDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo-myomectomy complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58546","description":"Laparo-myomectomy complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMB0","description":"ICD-IFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWA0","description":"ICD-DIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJA1","description":"ICD-JCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQB0","description":"ICD-HCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX05","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv3 vaccine 3 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90658","description":"Iiv3 vaccine 3 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUC0","description":"ICD-EIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Musc test done w/n test comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95886","description":"Musc test done w/n test comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pmkr_ dual_ non rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2619","description":"Pmkr_ dual_ non rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFF0","description":"ICD-JBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of myoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83874","description":"Assay of myoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ atezolizumab_ 10 mg (Tecentriq)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9483","description":"Injection_ atezolizumab_ 10 mg (Tecentriq)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stainless steel any wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6630","description":"Stainless steel any wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0903","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0903","description":"CDT-D0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anastrozole 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0170","description":"Anastrozole 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSD1","description":"ICD-PDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTD0","description":"ICD-MFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (mild cognitive impairment)_ analysis of B-amyloid 1-42 and 1-40_ chemiluminescence enzyme immunoassay_ cerebral spinal fluid_ reported as positive_ likely positive_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0358U","description":"Neurology (mild cognitive impairment)_ analysis of B-amyloid 1-42 and 1-40_ chemiluminescence enzyme immunoassay_ cerebral spinal fluid_ reported as positive_ likely positive_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44360","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDD0","description":"ICD-MKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upright gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8001","description":"Upright gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1020T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","description":"CPT-1020T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANA0","description":"ICD-NANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pos clin depres scrn f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8431","description":"Pos clin depres scrn f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGE0","description":"ICD-GFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICD1","description":"ICD-AICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shdr fair lead cable molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6588","description":"Shdr fair lead cable molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDE0","description":"ICD-CIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63280","description":"Bx/exc idrl spine lesn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRE1","description":"ICD-PKRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXA1","description":"ICD-GAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDC0","description":"ICD-FCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSF1","description":"ICD-GBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intracardiac ecg (ice)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93662","description":"Intracardiac ecg (ice)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rib gusset (elastic) each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1280","description":"Rib gusset (elastic) each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAA0","description":"ICD-ABAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYB1","description":"ICD-PAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC40","description":"Very High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCC0","description":"ICD-AFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elective surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9643","description":"Elective surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAA0","description":"ICD-IGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comprehensive hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92557","description":"Comprehensive hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBE0","description":"ICD-BHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hm postpar hyper per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9212","description":"Hm postpar hyper per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYD0","description":"ICD-HIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADC1","description":"ICD-AADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPF1","description":"ICD-BHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Cystoscopy/Transurethral Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0615","description":"Hospital Special Treatment Room Support Component (Hstrsc) Cystoscopy/Transurethral Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASF0","description":"ICD-OASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEF0","description":"ICD-GEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0506","description":"Non-traumatic spinal cord injury with Motor <23.75._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0582U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","description":"CPT-0582U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTB1","description":"ICD-MLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAE1","description":"ICD-JIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCA1","description":"ICD-BBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ cemiplimab-rwlc_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9044","description":"Injection_ cemiplimab-rwlc_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETE1","description":"ICD-GETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2955","description":"Post removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retreat root canal bicuspid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3347","description":"Retreat root canal bicuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPF1","description":"ICD-OIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Determine refractive state","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92015","description":"Determine refractive state","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove kidney open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50220","description":"Remove kidney open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKE0","description":"ICD-GAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUF0","description":"ICD-GCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBB0","description":"ICD-CFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIF1","description":"ICD-MFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUD1","description":"ICD-GHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28D","description":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVE1","description":"ICD-JAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collagen gel/paste wound fil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6011","description":"Collagen gel/paste wound fil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTF0","description":"ICD-CFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINB1","description":"ICD-GINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revita_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4180","description":"Revita_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Common Variants (Eg_ W515A_ W515K_ W515L_ W515R)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81338","description":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Common Variants (Eg_ W515A_ W515K_ W515L_ W515R)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUC1","description":"ICD-NCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB21","description":"ICD-1IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHB1","description":"ICD-AFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIC0","description":"ICD-CDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEC0","description":"ICD-BAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5162","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","description":"HCPCS-Q5162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52234","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUE1","description":"ICD-CFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPC0","description":"ICD-JDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEA0","description":"ICD-CHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal Nativ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93596","description":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal Nativ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education_ include microprocessor_ all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0738","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education_ include microprocessor_ all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Angioscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35400","description":"Angioscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx brst stg1-2b hr_nopro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9071","description":"Onc dx brst stg1-2b hr_nopro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPE0","description":"ICD-NLPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47125","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAA1","description":"ICD-GBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLC1","description":"ICD-BBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHD0","description":"ICD-ACHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBF0","description":"ICD-BHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dx bronchoscope/lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31624","description":"Dx bronchoscope/lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEC1","description":"ICD-MFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHD0","description":"ICD-OKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISE0","description":"ICD-HISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photosensitivity tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95056","description":"Photosensitivity tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTC0","description":"ICD-MBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4A","description":"Default_ /PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFE1","description":"ICD-CGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clot factor ii prothrom spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85210","description":"Clot factor ii prothrom spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove mesh from abd wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11008","description":"Remove mesh from abd wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXF0","description":"ICD-NLXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMD0","description":"ICD-MJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQF0","description":"ICD-GHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2789","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2789","description":"HCPCS-J2789","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAC0","description":"ICD-OLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22116","description":"Remove extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self-adher band w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6454","description":"Self-adher band w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sleep study attended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95807","description":"Sleep study attended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compounded drug_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7999","description":"Compounded drug_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGF1","description":"ICD-FCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ctlso a-p-l control molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0700","description":"Ctlso a-p-l control molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine/urea-n","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84540","description":"Assay of urine/urea-n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Large size footplate each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0041","description":"Large size footplate each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kyphosis pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1020","description":"Kyphosis pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITD1","description":"ICD-FITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHA0","description":"ICD-CFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pralidoxime chloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2730","description":"Pralidoxime chloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRD0","description":"ICD-LHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0582","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","description":"HCPCS-J0582","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialysate sol test kit_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4760","description":"Dialysate sol test kit_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical placement: zygomatic implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7994","description":"Surgical placement: zygomatic implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imaging study ordered (bkp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3330F","description":"Imaging study ordered (bkp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUA0","description":"ICD-NDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVE0","description":"ICD-CDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pdgfra gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81314","description":"Pdgfra gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACA1","description":"ICD-KACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNA0","description":"ICD-ODNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tonguemuscle_ controlled by hardware remote","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0490","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tonguemuscle_ controlled by hardware remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ins cath ren art 2nd+ unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36253","description":"Ins cath ren art 2nd+ unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00140","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","description":"CPT-00140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAB0","description":"ICD-MKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27197","description":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81426","description":"Genome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hereditary pan cancer (eg_ hereditary breast and ovarian cancer_ hereditary endometrial cancer_ hereditary colorectal cancer)_ genomic sequence analysis panel utilizing a comb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0104U","description":"Hereditary pan cancer (eg_ hereditary breast and ovarian cancer_ hereditary endometrial cancer_ hereditary colorectal cancer)_ genomic sequence analysis panel utilizing a comb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0666U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0666U","description":"CPT-0666U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPE1","description":"ICD-CBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHB0","description":"ICD-AIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECC0","description":"ICD-EECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOF1","description":"ICD-CGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHE0","description":"ICD-GAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lwr ext dynamic prosth pylon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5985","description":"Lwr ext dynamic prosth pylon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMA1","description":"ICD-IGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00952","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","description":"CPT-00952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYF0","description":"ICD-PAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE151","description":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMC1","description":"ICD-NFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43633","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20702","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC45","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt consid poss risk fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3572F","description":"Pt consid poss risk fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDB0","description":"ICD-MKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRB0","description":"ICD-LFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB151","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tracheostomy care kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4629","description":"Tracheostomy care kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI pelvis w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72196","description":"MRI pelvis w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOC0","description":"ICD-DBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30125","description":"Removal of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXB1","description":"ICD-JHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ldh enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83625","description":"Assay of ldh enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5135","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","description":"HCPCS-Q5135","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laminotomy (Hemilaminectomy)_ With Decompression Of Nerve Root(S)_ Including Partial Facetectomy_ Foraminotomy And Excision Of Herniated Intervertebral Disc_ And Repair Of Ann","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9757","description":"Laminotomy (Hemilaminectomy)_ With Decompression Of Nerve Root(S)_ Including Partial Facetectomy_ Foraminotomy And Excision Of Herniated Intervertebral Disc_ And Repair Of Ann","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIE0","description":"ICD-OKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHA1","description":"ICD-MBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tte w/doppler complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93306","description":"Tte w/doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSC1","description":"ICD-OKSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCE0","description":"ICD-NHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ travoprost_ intracameral implant_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7355","description":"Injection_ travoprost_ intracameral implant_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHD0","description":"ICD-AIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKC1","description":"ICD-KCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUB1","description":"ICD-MKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBC0","description":"ICD-NJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVC1","description":"ICD-JAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEF0","description":"ICD-MHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQA1","description":"ICD-LFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC36","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal surg pulmon sequest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2403","description":"Fetal surg pulmon sequest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKB0","description":"ICD-JHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVE0","description":"ICD-FIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ifosfamide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9208","description":"Ifosfamide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVE0","description":"ICD-JCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brucella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86622","description":"Brucella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAA0","description":"ICD-GFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXB0","description":"ICD-BEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQA0","description":"ICD-KIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKB0","description":"ICD-ODKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFB1","description":"ICD-CDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFC0","description":"ICD-OHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIE1","description":"ICD-JAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHF0","description":"ICD-BCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone graft peri per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3428","description":"Bone graft peri per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22B","description":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Computer-aided detection_ including computer algorithm analysis of MRI image data for lesion detection/characterization_ pharmacokinetic analysis_ with further physician revie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0159T","description":"Computer-aided detection_ including computer algorithm analysis of MRI image data for lesion detection/characterization_ pharmacokinetic analysis_ with further physician revie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ArdeoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4333","description":"ArdeoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUC0","description":"ICD-CEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nras gene variants exon 2&3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81311","description":"Nras gene variants exon 2&3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemophilus influenza b vaccine (hib)_ prp-d conjugate_ for booster use only_ intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90646","description":"Hemophilus influenza b vaccine (hib)_ prp-d conjugate_ for booster use only_ intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXA1","description":"ICD-JAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sag-co shell pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0651","description":"Lso sag-co shell pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD241","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDE1","description":"ICD-BBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"E-Graft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4318","description":"E-Graft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDF0","description":"ICD-OHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34001","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1438","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","description":"HCPCS-M1438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHID1","description":"ICD-OHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRE1","description":"ICD-OGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNE1","description":"ICD-FDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA11","description":"ICD-2CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGA0","description":"ICD-JCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKE0","description":"ICD-KFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSB1","description":"ICD-PGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1501","description":"HCPCS-A1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJC1","description":"ICD-CGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient transfer system <300","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1035","description":"Patient transfer system <300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHE1","description":"ICD-FDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC251","description":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVD1","description":"ICD-FFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIF0","description":"ICD-FAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIF0","description":"ICD-KCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Device Supply With Initial Set-Up And Patient Education On Use Of Equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0704T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Device Supply With Initial Set-Up And Patient Education On Use Of Equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLC1","description":"ICD-GCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automatic ext defibrillator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0617","description":"Automatic ext defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antidepressants class 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80333","description":"Antidepressants class 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"M.tuberculo dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87557","description":"M.tuberculo dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE141","description":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Traction frame attach pelvic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0890","description":"Traction frame attach pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAB1","description":"ICD-IIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAA1","description":"ICD-MJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1308","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","description":"HCPCS-J1308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVD1","description":"ICD-FHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBA1","description":"ICD-FBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKA1","description":"ICD-OJKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","description":"CPT-00882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLE1","description":"ICD-ABLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXF1","description":"ICD-NJXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of galactose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82760","description":"Assay of galactose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB104","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJC1","description":"ICD-CFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lumbar artif diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22857","description":"Lumbar artif diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUA1","description":"ICD-AEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEID1","description":"ICD-MEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDED1","description":"ICD-MDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen one/mult class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80303","description":"Drug screen one/mult class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC31","description":"ICD-1HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPE0","description":"ICD-OLPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of brow nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64732","description":"Incision of brow nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFME1","description":"ICD-OFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJD1","description":"ICD-JIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYF0","description":"ICD-GBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert hepatic shunt (tips)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37182","description":"Insert hepatic shunt (tips)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEC1","description":"ICD-MHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFA1","description":"ICD-JEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0B","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Audiometry for hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0618","description":"Audiometry for hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser inc for pkp/lkp recip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0290T","description":"Laser inc for pkp/lkp recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stationary o2 contents_ gas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0441","description":"Stationary o2 contents_ gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMC1","description":"ICD-MKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA11","description":"ICD-3FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCB1","description":"ICD-JGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEF1","description":"ICD-BFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEC1","description":"ICD-FBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc cardiac modulj sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0408T","description":"Insj/rplc cardiac modulj sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No statin/no order statin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9665","description":"No statin/no order statin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspirate/inj ganglion cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20612","description":"Aspirate/inj ganglion cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot longitudinal arch suppo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3010","description":"Foot longitudinal arch suppo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRA0","description":"ICD-PKRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWA0","description":"ICD-ODWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTE1","description":"ICD-GGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special anesthesia service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99100","description":"Special anesthesia service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"teledentistry - asynchronous; information stored and forwarded to dentist for subse","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9996","description":"teledentistry - asynchronous; information stored and forwarded to dentist for subse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMD0","description":"ICD-JAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67880","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKC0","description":"ICD-BCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2087","description":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1031T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1031T","description":"CPT-1031T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove wrist joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25105","description":"Remove wrist joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNE1","description":"ICD-KFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB24","description":"Medium Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables_ patient lift_ and adjustabl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0501","description":"Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables_ patient lift_ and adjustabl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCA1","description":"ICD-NHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q0520","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0520","description":"HCPCS-Q0520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJB1","description":"ICD-FHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn cervl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63285","description":"Bx/exc idrl imed lesn cervl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADB0","description":"ICD-OADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plasma volume single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78110","description":"Plasma volume single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13D","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18X","description":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYC1","description":"ICD-OCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0043U","description":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assessment of and care planning for a patient with cognitive impairment_ requiring an independent historian_ in the office or other outpatient_ home or domiciliary or rest hom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99483","description":"Assessment of and care planning for a patient with cognitive impairment_ requiring an independent historian_ in the office or other outpatient_ home or domiciliary or rest hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Omnicardiogram/cardiointegra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9025","description":"Omnicardiogram/cardiointegra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tenoglide tendon prot_ cm2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9356","description":"Tenoglide tendon prot_ cm2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Platelet pheresis irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9036","description":"Platelet pheresis irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFA1","description":"ICD-FIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDC1","description":"ICD-OEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBB1","description":"ICD-MCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOF1","description":"ICD-CBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0533U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","description":"CPT-0533U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shldr disar prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6550","description":"Shldr disar prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTA0","description":"ICD-KFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA117","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLD1","description":"ICD-CBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAD0","description":"ICD-MFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIC0","description":"ICD-ABIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair lumbar hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49540","description":"Repair lumbar hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score le < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8656","description":"Fun stat score le < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt support & positioning sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0636","description":"Pt support & positioning sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8G","description":"High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQC1","description":"ICD-LGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKE0","description":"ICD-NDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMA0","description":"ICD-IHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISA0","description":"ICD-LISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUC1","description":"ICD-JFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5244","description":"Hearing aid_ prog_ mon_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOD0","description":"ICD-HIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ subsequent_ same hospital stay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31646","description":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ subsequent_ same hospital stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMF1","description":"ICD-OAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC31","description":"ICD-2GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHB0","description":"ICD-IHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sunglass frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0518","description":"Sunglass frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBC1","description":"ICD-BIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEB0","description":"ICD-KAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oversize lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2780","description":"Oversize lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLC0","description":"ICD-MHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15A","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMD0","description":"ICD-FEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADF1","description":"ICD-KADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Embedded ip cath exit-site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49436","description":"Embedded ip cath exit-site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Custom sleep apnea appliance fabrication and placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9947","description":"Custom sleep apnea appliance fabrication and placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVE0","description":"ICD-FCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMF1","description":"ICD-GFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fresh frozen plasma_ high titer COVID-19 convalescent_ frozen within 8 hours of collection_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9507","description":"Fresh frozen plasma_ high titer COVID-19 convalescent_ frozen within 8 hours of collection_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTC1","description":"ICD-KGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVB1","description":"ICD-OGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIE1","description":"ICD-FEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCF0","description":"ICD-FFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc face tum deep < 2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21013","description":"Exc face tum deep < 2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BCG live intravesical instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9030","description":"BCG live intravesical instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESF0","description":"ICD-CESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRE0","description":"ICD-PJRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCD1","description":"ICD-ECCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alpha 1 proteinase inhibitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0256","description":"Alpha 1 proteinase inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHA1","description":"ICD-NAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLF1","description":"ICD-KCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUF0","description":"ICD-NJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXB1","description":"ICD-OGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIE1","description":"ICD-EFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67850","description":"Treat eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLED1","description":"ICD-NLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSD1","description":"ICD-KGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIB0","description":"ICD-BGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsyin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9785","description":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsyin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Singl visn sphere 7.12-20.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2102","description":"Singl visn sphere 7.12-20.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGED1","description":"ICD-EGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation patient unable to communicate and informant not available","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2183","description":"Documentation patient unable to communicate and informant not available","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCA0","description":"ICD-BCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr umbil hern reduc > 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49585","description":"Rpr umbil hern reduc > 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIC1","description":"ICD-BFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRE1","description":"ICD-GIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTF1","description":"ICD-NJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKD0","description":"ICD-BDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSF1","description":"ICD-PJSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOE0","description":"ICD-DBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home sleep test/type 3 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0399","description":"Home sleep test/type 3 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWF0","description":"ICD-KIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thromboplastin time partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85732","description":"Thromboplastin time partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILA1","description":"ICD-EILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other counselor at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9475","description":"Other counselor at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADC1","description":"ICD-GADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1241","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB03","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24A","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC31","description":"ICD-4LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient was a permanent nursing home resident at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1058","description":"Patient was a permanent nursing home resident at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYD0","description":"ICD-OGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Px sup fee anti-can sub pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0512","description":"Px sup fee anti-can sub pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBE0","description":"ICD-MEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1803","description":"HCPCS-A1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of bladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51960","description":"Revision of bladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXE1","description":"ICD-KGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJC0","description":"ICD-NAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJC0","description":"ICD-BHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABED1","description":"ICD-ABED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bethanechol chloride inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0520","description":"Bethanechol chloride inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKE1","description":"ICD-OJKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGF1","description":"ICD-FGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ivig demo_ services/supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2052","description":"Ivig demo_ services/supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPF0","description":"ICD-FDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fixed appliance therapy habt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8220","description":"Fixed appliance therapy habt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No rec cortico>60d 1rx 600mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9470","description":"No rec cortico>60d 1rx 600mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammogram both breasts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77056","description":"Mammogram both breasts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/tr/ext >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12037","description":"Intmd rpr s/tr/ext >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA22","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWE0","description":"ICD-LAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUE0","description":"ICD-JFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILF1","description":"ICD-OILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJC0","description":"ICD-OBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-bmez_ biosimilar_ (ziextenzo)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5120","description":"Injection_ pegfilgrastim-bmez_ biosimilar_ (ziextenzo)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX10","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC255","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1pc ost pch drain hgh output","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4435","description":"1pc ost pch drain hgh output","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBE1","description":"ICD-BGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coronectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7251","description":"Coronectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No order for ceph no reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9198","description":"No order for ceph no reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL33","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesthe <60 min as docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4256F","description":"Anesthe <60 min as docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA111","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTA1","description":"ICD-NDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMF1","description":"ICD-MCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25265","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIE1","description":"ICD-NAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86451","description":"Anesth removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB255","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMA0","description":"ICD-EEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI pelvis w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72195","description":"MRI pelvis w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65280","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suction pump portab hom modl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0600","description":"Suction pump portab hom modl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp spenorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35636","description":"Art byp spenorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"L colectomy/coloproctostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44208","description":"L colectomy/coloproctostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"J-cell batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4234","description":"J-cell batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42509","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASE1","description":"ICD-GASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDC1","description":"ICD-EFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Graftjacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4107","description":"Graftjacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPD1","description":"ICD-NFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Allowrap ds or dry 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4150","description":"Allowrap ds or dry 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/3+ post-op nausea&vom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4556F","description":"Pt w/3+ post-op nausea&vom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skills train and dev_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2014","description":"Skills train and dev_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC112","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHA1","description":"ICD-GIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPE0","description":"ICD-GFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78432","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTF1","description":"ICD-BBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage mouth roof lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42000","description":"Drainage mouth roof lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-97008","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","description":"CPT-97008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tilt table locking hip sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5270","description":"Tilt table locking hip sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiology (heart transplant)_ mRNA gene expression profiling by microarray of 1283 genes_  transplant biopsy tissue_ allograft rejection and injury algorithm reported as a pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0087U","description":"Cardiology (heart transplant)_ mRNA gene expression profiling by microarray of 1283 genes_  transplant biopsy tissue_ allograft rejection and injury algorithm reported as a pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBID1","description":"ICD-JBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAB1","description":"ICD-IDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADF1","description":"ICD-BADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCD1","description":"ICD-IGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANE1","description":"ICD-NANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of fb reaction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7540","description":"Removal of fb reaction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0302T","description":"Icar ischm mntrng sys compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADF1","description":"ICD-OADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUF1","description":"ICD-OEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/mediast exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32662","description":"Thoracoscopy w/mediast exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERA0","description":"ICD-DERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay caffeine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80155","description":"Drug assay caffeine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other power whlchr base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0014","description":"Other power whlchr base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remov/replc ur sphinctr comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53448","description":"Remov/replc ur sphinctr comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLF0","description":"ICD-NFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64561","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ enfortumab vedotin-ejfv_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9177","description":"Injection_ enfortumab vedotin-ejfv_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fusion of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27580","description":"Fusion of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDF1","description":"ICD-OIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11A","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIA1","description":"ICD-FHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 6 central carbon metabolites (ie_ a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ and succ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0139U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 6 central carbon metabolites (ie_ a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ and succ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEE0","description":"ICD-NDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9310","description":"Injection_ rituximab_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES121","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWF1","description":"ICD-KGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vaginal endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95051","description":"Anesth vaginal endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXD1","description":"ICD-CDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSD1","description":"ICD-DGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEC1","description":"ICD-IDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5A","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA220","description":"Reduced Physical Function _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Change gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43888","description":"Change gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLB1","description":"ICD-BBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPA1","description":"ICD-BEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Med reminder serv per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5185","description":"Med reminder serv per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prostate saturation sampling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55706","description":"Prostate saturation sampling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPA1","description":"ICD-GDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHF1","description":"ICD-MFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGC1","description":"ICD-FCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pericard exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32661","description":"Thoracoscopy w/pericard exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYD0","description":"ICD-GGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITB1","description":"ICD-EITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHA0","description":"ICD-NLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise inner ear window","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69840","description":"Revise inner ear window","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYF0","description":"ICD-OJYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQD0","description":"ICD-GDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENE1","description":"ICD-OENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9817","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9817","description":"HCPCS-C9817","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXF1","description":"ICD-NBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKF0","description":"ICD-OGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0C","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mucormycosis antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86732","description":"Mucormycosis antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLB0","description":"ICD-GCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEE1","description":"ICD-OHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis_ c.472G>A (rs4680) variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0032U","description":"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis_ c.472G>A (rs4680) variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epstein-barr nuclear antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86664","description":"Epstein-barr nuclear antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28A","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0547","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","description":"HCPCS-G0547","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYC1","description":"ICD-HHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urine incon characterized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1091F","description":"Urine incon characterized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXE1","description":"ICD-NFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQB0","description":"ICD-DGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPA1","description":"ICD-CDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHC0","description":"ICD-MHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23A","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTC0","description":"ICD-CGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant spinal canal cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62351","description":"Implant spinal canal cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mccd_maintenance rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9002","description":"Mccd_maintenance rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVA0","description":"ICD-JBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCD0","description":"ICD-ABCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAA0","description":"ICD-EEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL46","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thorabd diaphr hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43337","description":"Thorabd diaphr hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDC1","description":"ICD-EIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWA0","description":"ICD-DBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Legg perthes orth scottish r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1730","description":"Legg perthes orth scottish r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpt implant pros dev_no cov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9899","description":"Inpt implant pros dev_no cov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSD1","description":"ICD-OFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGD0","description":"ICD-CBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB11","description":"ICD-4JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peristomal hernia supprt blt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4396","description":"Peristomal hernia supprt blt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD214","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX46","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRF0","description":"ICD-KFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGA1","description":"ICD-BDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9805","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6560","description":"Gradient compression stocking_ full length/chap style_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQE1","description":"ICD-OIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAE1","description":"ICD-GDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair single ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33617","description":"Repair single ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Screening performed and negative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9920","description":"Screening performed and negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYD0","description":"ICD-DFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult70","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0427","description":"Inpt/ed teleconsult70","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKB1","description":"ICD-NEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATB0","description":"ICD-CATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLA0","description":"ICD-FDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES236","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Menacwy vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90734","description":"Menacwy vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pcv13 vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90670","description":"Pcv13 vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATA0","description":"ICD-MATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair nasal septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30630","description":"Repair nasal septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18E","description":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYF0","description":"ICD-GAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insitu hybridization auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88367","description":"Insitu hybridization auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24B","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUC1","description":"ICD-ADUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSD1","description":"ICD-ODSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tc99m exametazime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9521","description":"Tc99m exametazime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of floor of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41108","description":"Biopsy of floor of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Open_ Performed At The Time Of Other Sternotomy Or Thoracotomy Procedure(S)_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33268","description":"Exclusion Of Left Atrial Appendage_ Open_ Performed At The Time Of Other Sternotomy Or Thoracotomy Procedure(S)_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin hydral swg ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5814","description":"Endo knee-shin hydral swg ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIED0","description":"ICD-JIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVF1","description":"ICD-CHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWB1","description":"ICD-HCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35351","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of femur epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27185","description":"Revision of femur epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTC1","description":"ICD-JGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLF0","description":"ICD-IBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERE0","description":"ICD-CERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy fundoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43280","description":"Laparoscopy fundoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21433","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJD0","description":"ICD-JIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIE0","description":"ICD-JFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ hydroxyprogesterone caproate_ (Makena)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1726","description":"Injection_ hydroxyprogesterone caproate_ (Makena)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fc receptor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86243","description":"Fc receptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQF0","description":"ICD-KFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAD1","description":"ICD-IGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAB0","description":"ICD-BDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKF0","description":"ICD-CBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30400","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJD1","description":"ICD-OHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABD1","description":"ICD-EABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supports brokerage_ self-directed_ waiver; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2051","description":"Supports brokerage_ self-directed_ waiver; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tenecteplase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3101","description":"Tenecteplase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epoetin beta non esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0888","description":"Epoetin beta non esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth major vein ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88251","description":"Anesth major vein ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation toe & metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28810","description":"Amputation toe & metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of clot in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35876","description":"Removal of clot in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC134","description":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQB1","description":"ICD-LBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEF1","description":"ICD-JIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tigecycline (accord) not therapeutically equivalent to j3243_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3244","description":"Injection_ tigecycline (accord) not therapeutically equivalent to j3243_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPB0","description":"ICD-OJPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX34","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEF1","description":"ICD-CEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSF0","description":"ICD-KBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22A","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMF1","description":"ICD-JFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay three catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82384","description":"Assay three catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJA1","description":"ICD-JFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Caster wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2395","description":"Caster wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUE0","description":"ICD-EGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bupivicaine_ not otherwise specified_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0665","description":"Injection_ bupivicaine_ not otherwise specified_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEB0","description":"ICD-OJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53520","description":"Repair of urethra defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93644","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5277","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ spheroid cell culture_ 4-drug panel (carboplatin_ doxorubicin_ gemcitabine_ paclitaxel)_ tumor chemotherapy response prediction for each drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0324U","description":"Oncology (ovarian)_ spheroid cell culture_ 4-drug panel (carboplatin_ doxorubicin_ gemcitabine_ paclitaxel)_ tumor chemotherapy response prediction for each drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGC0","description":"ICD-JEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTC0","description":"ICD-CBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAC0","description":"ICD-FGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone replacement graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7953","description":"Bone replacement graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUC1","description":"ICD-GHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aquatic therapy/exercises","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97113","description":"Aquatic therapy/exercises","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Certolizumab pegol inj 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0717","description":"Certolizumab pegol inj 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHC0","description":"ICD-MIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGA0","description":"ICD-NDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0984T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","description":"CPT-0984T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWA0","description":"ICD-KHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOD1","description":"ICD-DIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVC1","description":"ICD-OIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPF0","description":"ICD-NBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTB1","description":"ICD-BHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAE0","description":"ICD-CIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplj hematopoietic boost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38243","description":"Transplj hematopoietic boost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHE1","description":"ICD-NJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVA1","description":"ICD-CBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug scrn quant oxcarbazepin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80183","description":"Drug scrn quant oxcarbazepin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69120","description":"Removal of external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQC1","description":"ICD-PGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWF0","description":"ICD-HAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTB1","description":"ICD-NCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFF1","description":"ICD-KFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJC1","description":"ICD-NFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA156","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27784","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACC1","description":"ICD-EACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDE0","description":"ICD-MHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHD0","description":"ICD-AGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLE1","description":"ICD-ODLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMB0","description":"ICD-CHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWB0","description":"ICD-HCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of ammonia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82140","description":"Assay of ammonia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJD1","description":"ICD-FAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ob us >/= 14 wks sngl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76805","description":"Ob us >/= 14 wks sngl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLC1","description":"ICD-MCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHF0","description":"ICD-GFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23450","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD156","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr ing hernia baby blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49496","description":"Rpr ing hernia baby blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUD1","description":"ICD-OHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGB0","description":"ICD-OBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGA1","description":"ICD-KBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQF1","description":"ICD-LHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laser surgery of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57513","description":"Laser surgery of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1403","description":"HCPCS-C1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0B","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAB1","description":"ICD-CBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0006","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXC0","description":"ICD-CCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLA0","description":"ICD-FHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainable pch w ex wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4388","description":"Drainable pch w ex wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auditor evoke potent compre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92585","description":"Auditor evoke potent compre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAA1","description":"ICD-MKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBC0","description":"ICD-OLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental sedative filling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2940","description":"Dental sedative filling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJB1","description":"ICD-FEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29820","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42410","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE105","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1095","description":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy eyelid & lid margin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67810","description":"Biopsy eyelid & lid margin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explr/decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67414","description":"Explr/decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC150","description":"Reduced Physical Function _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAC0","description":"ICD-CEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncoprotein dcp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83951","description":"Oncoprotein dcp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTB1","description":"ICD-OJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTC0","description":"ICD-OKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE124","description":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bleeding time test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85002","description":"Bleeding time test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antiemetic drug oral nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8597","description":"Antiemetic drug oral nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amniotic fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82143","description":"Amniotic fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGC1","description":"ICD-GGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAF1","description":"ICD-KFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21010","description":"Incision of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIA1","description":"ICD-IDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plumb/elec wk hm hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4870","description":"Plumb/elec wk hm hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSA0","description":"ICD-KDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBB1","description":"ICD-GIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oximeter device for measuring bloodk osygen levels noninvasively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0445","description":"Oximeter device for measuring bloodk osygen levels noninvasively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAF1","description":"ICD-EIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUC0","description":"ICD-MCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IAAD IA CYTOMEGALOVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87332","description":"IAAD IA CYTOMEGALOVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 7-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4176","description":"Parenteral sol amino acid 7-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Influenza imm rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4035F","description":"Influenza imm rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; first 20 sq cm or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0491T","description":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; first 20 sq cm or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB31","description":"ICD-1AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11450","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch w/o barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5052","description":"Clsd ostomy pouch w/o barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBF0","description":"ICD-GDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECF1","description":"ICD-JECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18E","description":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTF1","description":"ICD-OLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLC1","description":"ICD-OFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"H pylori (c-13) blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83009","description":"H pylori (c-13) blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGB0","description":"ICD-BBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSE1","description":"ICD-DFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61530","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUA1","description":"ICD-AHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ob us limited fetus(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76815","description":"Ob us limited fetus(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAF0","description":"ICD-FFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOA0","description":"ICD-GAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5878","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5878","description":"CDT-D5878","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA26","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68500","description":"Removal of tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAB1","description":"ICD-BBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVA0","description":"ICD-JFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD135","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amino acids quant 2-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82136","description":"Amino acids quant 2-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Specimen handling office-lab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99000","description":"Specimen handling office-lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78831","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAA1","description":"ICD-OHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73020","description":"X-ray exam of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQE1","description":"ICD-OGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periph field stimul trial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0282T","description":"Periph field stimul trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA11","description":"ICD-2EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESC1","description":"ICD-PESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-E1814","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","description":"HCPCS-E1814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKC0","description":"ICD-FEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAE0","description":"ICD-KBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc compl inf antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9301","description":"Doc compl inf antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection Sulfur Hexafouride Lipid Microsphere Per Ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9457","description":"Injection Sulfur Hexafouride Lipid Microsphere Per Ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57500","description":"Biopsy of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40654","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42831","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscopy balloon <30mm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43220","description":"Esophagoscopy balloon <30mm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Io anal gast n-stim init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95980","description":"Io anal gast n-stim init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61582","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUC0","description":"ICD-MJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45111","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSC1","description":"ICD-HGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRD0","description":"ICD-PBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHME1","description":"ICD-OHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALE0","description":"ICD-FALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRC1","description":"ICD-LHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhcp-svs of s/l path_ea 15mn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0153","description":"Hhcp-svs of s/l path_ea 15mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0487U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","description":"CPT-0487U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56632","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0777T","description":"Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"C motor evoked lwr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95929","description":"C motor evoked lwr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61512","description":"Remove brain lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMA0","description":"ICD-ACMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tubular dressing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6457","description":"Tubular dressing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11C","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOC0","description":"ICD-HCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Healthcare Professional Online Assessment_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 5-10 Minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2061","description":"Qualified Nonphysician Healthcare Professional Online Assessment_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 5-10 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOE0","description":"ICD-CAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mastectomy form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8020","description":"Mastectomy form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occlusal orthotic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7880","description":"Occlusal orthotic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cr51 chromate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9553","description":"Cr51 chromate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trg gene rearrangement anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81342","description":"Trg gene rearrangement anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHD0","description":"ICD-NGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRF0","description":"ICD-HIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conn tiss_ non-human","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1763","description":"Conn tiss_ non-human","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; aspiration(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38220","description":"Diagnostic bone marrow; aspiration(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA150","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable pack w/bowel syst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0352","description":"Disposable pack w/bowel syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPB0","description":"ICD-BBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp pop-tibl-prl-other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35671","description":"Art byp pop-tibl-prl-other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01654","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","description":"CPT-01654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRA1","description":"ICD-OCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove skin nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64774","description":"Remove skin nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERD1","description":"ICD-LERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPF1","description":"ICD-GBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay ass","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX17","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay ass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHA0","description":"ICD-MIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPF1","description":"ICD-JFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYA1","description":"ICD-HGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVB0","description":"ICD-OLVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0403","description":"HCPCS-C0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXC0","description":"ICD-GEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIF1","description":"ICD-IDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB21","description":"ICD-1CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBC1","description":"ICD-NGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMC0","description":"ICD-KAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIF0","description":"ICD-FFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phospholipid pltlt neutraliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85597","description":"Phospholipid pltlt neutraliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLF0","description":"ICD-MDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73503","description":"X-ray exam hip uni 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDB0","description":"ICD-CCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLE1","description":"ICD-IGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagoscop stent placement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43212","description":"Esophagoscop stent placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUC1","description":"ICD-EIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19271","description":"Revision of chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALA1","description":"ICD-MALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88029","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ambulatory eeg monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95950","description":"Ambulatory eeg monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj ilio-ing/hypogi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64425","description":"N block inj ilio-ing/hypogi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below elbow prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6400","description":"Below elbow prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration behind abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49010","description":"Exploration behind abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dactinomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9120","description":"Dactinomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0604","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0604","description":"CDT-D0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ko elastic w/joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1812","description":"Ko elastic w/joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ conforming gauze_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6596","description":"Gradient compression bandaging supply_ conforming gauze_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGF0","description":"ICD-OAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNE1","description":"ICD-NCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCE0","description":"ICD-NGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYB0","description":"ICD-KCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53502","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93151","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0628U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","description":"CPT-0628U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0484U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","description":"CPT-0484U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Felbamate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80167","description":"Felbamate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCB1","description":"ICD-NFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81174","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJB1","description":"ICD-GFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53854","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB105","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9946","description":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMB1","description":"ICD-JIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMC1","description":"ICD-FAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27792","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQA0","description":"ICD-KBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPC0","description":"ICD-OBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOD0","description":"ICD-HEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove iris and lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66600","description":"Remove iris and lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB205","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBA1","description":"ICD-BBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDC1","description":"ICD-KFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACD1","description":"ICD-BACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBD1","description":"ICD-EFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD105","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esoph scope w/sclerosis inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43204","description":"Esoph scope w/sclerosis inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromosome analysis 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88261","description":"Chromosome analysis 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22843","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mra w/o cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8919","description":"Mra w/o cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cervical collar molded to pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0170","description":"Cervical collar molded to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-82234","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","description":"CPT-82234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A2029","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","description":"HCPCS-A2029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6010","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29892","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0925T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","description":"CPT-0925T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add ue prost s/d acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7405","description":"Add ue prost s/d acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMF1","description":"ICD-NEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34151","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB36","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLE1","description":"ICD-BGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBD1","description":"ICD-GFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOF1","description":"ICD-OFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak open end sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5321","description":"Ak open end sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUE1","description":"ICD-KIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35472","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinalysis nonauto w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81002","description":"Urinalysis nonauto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5299","description":"Hearing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complement/function activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86161","description":"Complement/function activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Image std nomenclature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9318","description":"Image std nomenclature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC11","description":"ICD-2IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHC1","description":"ICD-KAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oral device/appliance cusfab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0486","description":"Oral device/appliance cusfab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flebogamma injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1572","description":"Flebogamma injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUC1","description":"ICD-OGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 14 targets (adenovirus_ coronavirus_ human metapneum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0098U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 14 targets (adenovirus_ coronavirus_ human metapneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ranibizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2778","description":"Ranibizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rep dev_ urinary_ w/sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1771","description":"Rep dev_ urinary_ w/sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vehicle mod waiver/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2039","description":"Vehicle mod waiver/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0C","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGND1","description":"ICD-FGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILF0","description":"ICD-GILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tbo-filgrastim_ 5 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1446","description":"Injection_ tbo-filgrastim_ 5 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 22 Or Functional Status M","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2142","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 22 Or Functional Status M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esano a_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4272","description":"Esano a_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMB1","description":"ICD-BIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCA0","description":"ICD-NLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB115","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIB1","description":"ICD-GEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE206","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Silicone gel insert or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6692","description":"Silicone gel insert or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0586U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","description":"CPT-0586U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTD1","description":"ICD-BFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ meropenem (WG Critical Care)_ not therapeutically equivalent to J2185_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2183","description":"Injection_ meropenem (WG Critical Care)_ not therapeutically equivalent to J2185_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27030","description":"Drainage of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thorabd diaphr hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43336","description":"Thorabd diaphr hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMD1","description":"ICD-AIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1109","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL02","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA53","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBF1","description":"ICD-IDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWD0","description":"ICD-CFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSC0","description":"ICD-CFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNE1","description":"ICD-NDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noner transport meals escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0210","description":"Noner transport meals escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Candida dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87482","description":"Candida dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC240","description":"Special Care High _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coordinated specialty care_ team-based_ for first episode psychosis_ per encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2041","description":"Coordinated specialty care_ team-based_ for first episode psychosis_ per encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Part hand little/ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6010","description":"Part hand little/ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69540","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11C","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLE0","description":"ICD-KBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC210","description":"Special Care High _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reptilase test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85635","description":"Reptilase test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUE0","description":"ICD-NKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFA0","description":"ICD-JAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wnd prep f/n/hf/g addl cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15005","description":"Wnd prep f/n/hf/g addl cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBA1","description":"ICD-IBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 3 (HIPPS rate code)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 3 (HIPPS rate code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLF1","description":"ICD-MCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUB0","description":"ICD-MKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIE1","description":"ICD-KIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentistry Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0067","description":"Dentistry Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Below knee total contact","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5637","description":"Below knee total contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53431","description":"Reconstruct urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lo sag rig pnl stays pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0626","description":"Lo sag rig pnl stays pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRC1","description":"ICD-LDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIF1","description":"ICD-OLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWD1","description":"ICD-KIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; aortic counterpulsation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0461T","description":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; aortic counterpulsation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peridontal medicament","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5994","description":"Peridontal medicament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMD1","description":"ICD-JGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAD1","description":"ICD-JIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYF1","description":"ICD-PBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00902","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","description":"CPT-00902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA225","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTF0","description":"ICD-CGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3C","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esophagectomy_ total or near total_ with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43286","description":"Esophagectomy_ total or near total_ with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mdd in remission","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3092F","description":"Mdd in remission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27676","description":"Repair lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of nose polyp(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30115","description":"Removal of nose polyp(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECB0","description":"ICD-EECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBD0","description":"ICD-BBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOD0","description":"ICD-HCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Health Safety)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7336","description":"Community Transition Svcs (Health Safety)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNC0","description":"ICD-NBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJB1","description":"ICD-KBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPD0","description":"ICD-BEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Hot Entrée","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1759","description":"Home Delivered Meals-Hot Entrée","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"TPMT (thiopurine S-methyltransferase)_ NUDT15 (nudix hydroxylase 15)(eg_ thiopurine metabolism)_ gene analysis_ common variants (ie_ TPMT *2_ *3A_ *3B_ *3C_ *4_ *5_ *6_ *8_ *1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0034U","description":"TPMT (thiopurine S-methyltransferase)_ NUDT15 (nudix hydroxylase 15)(eg_ thiopurine metabolism)_ gene analysis_ common variants (ie_ TPMT *2_ *3A_ *3B_ *3C_ *4_ *5_ *6_ *8_ *1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVA0","description":"ICD-GBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vancomycin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3370","description":"Vancomycin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIF0","description":"ICD-MEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMD1","description":"ICD-JCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient is undergoing palliative dialysis with a catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9749","description":"Patient is undergoing palliative dialysis with a catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGB1","description":"ICD-CGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAF1","description":"ICD-OBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ sutimlimab-jome_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9094","description":"Injection_ sutimlimab-jome_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKC0","description":"ICD-KDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ low density flat foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6604","description":"Gradient compression bandaging supply_ low density flat foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33776","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEF1","description":"ICD-IEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXB0","description":"ICD-BBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEE1","description":"ICD-NLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDC0","description":"ICD-CIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMD1","description":"ICD-OGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39540","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFD0","description":"ICD-OJFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUC1","description":"ICD-GBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repos nstim apnea stimj ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0432T","description":"Repos nstim apnea stimj ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFB0","description":"ICD-KIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excursion amplifier pulley t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6641","description":"Excursion amplifier pulley t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHB0","description":"ICD-IEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOA0","description":"ICD-LDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of gum flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41821","description":"Excision of gum flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rmvl car modulj tranvns elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0413T","description":"Rmvl car modulj tranvns elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEF0","description":"ICD-CIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGC0","description":"ICD-BBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPD1","description":"ICD-BDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"XCellerate_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4234","description":"XCellerate_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vagina tissue compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57111","description":"Remove vagina tissue compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHC0","description":"ICD-FBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt w/dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3760F","description":"Pt w/dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUE1","description":"ICD-IHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKC1","description":"ICD-JAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult size brief/diaper xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4524","description":"Adult size brief/diaper xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLE0","description":"ICD-BBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTA0","description":"ICD-GHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYC0","description":"ICD-GAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXC1","description":"ICD-BAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECB1","description":"ICD-NECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revis reconst shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23474","description":"Revis reconst shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFF1","description":"ICD-GFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABD0","description":"ICD-MABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLD1","description":"ICD-IDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCB0","description":"ICD-AGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXD0","description":"ICD-OHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aorsubcl/carot/innom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35626","description":"Art byp aorsubcl/carot/innom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHE1","description":"ICD-MGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9611","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","description":"HCPCS-A9611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42844","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52310","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHA0","description":"ICD-OCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB25","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of vancomycin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80202","description":"Assay of vancomycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0540U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","description":"CPT-0540U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHB1","description":"ICD-IEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reattach tooth fragment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2921","description":"Reattach tooth fragment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMA0","description":"ICD-JEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKD0","description":"ICD-NLKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lso sagittal rigid panel cus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0636","description":"Lso sagittal rigid panel cus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspa gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81200","description":"Aspa gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAC0","description":"ICD-AGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOC0","description":"ICD-KGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVC1","description":"ICD-CGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap revise gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43771","description":"Lap revise gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE144","description":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYE0","description":"ICD-CBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIA1","description":"ICD-FAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61892","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap place gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43770","description":"Lap place gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31603","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ht inj anticoag diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9372","description":"Ht inj anticoag diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOE0","description":"ICD-PKOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUD0","description":"ICD-BEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosis Of Seizure Disorders_ Rapid Eye Movement Sleep Behavior Disorder_ Benzodiazepine Withdrawal_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0033","description":"Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosis Of Seizure Disorders_ Rapid Eye Movement Sleep Behavior Disorder_ Benzodiazepine Withdrawal_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLA1","description":"ICD-BHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRA1","description":"ICD-CHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"L hrt art/grft angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93459","description":"L hrt art/grft angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJB0","description":"ICD-KEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXC0","description":"ICD-GBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22634","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue culture bone marrow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88237","description":"Tissue culture bone marrow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72149","description":"MRI lumbar spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ppps_ initial visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0438","description":"Ppps_ initial visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLA0","description":"ICD-MLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFD1","description":"ICD-OKFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28052","description":"Biopsy of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26418","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ Trichomonas vaginalis_ Mycoplasma genitalium_ multiplex amplified probe techni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0402U","description":"Infectious agent (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ Trichomonas vaginalis_ Mycoplasma genitalium_ multiplex amplified probe techni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A4288","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","description":"HCPCS-A4288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAME0","description":"ICD-KAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ IV_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5138","description":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ IV_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXD1","description":"ICD-OFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Close tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68760","description":"Close tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA23","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHF1","description":"ICD-KCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd srv 4 visits p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90960","description":"Esrd srv 4 visits p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGE0","description":"ICD-FEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chikungunya virus vaccine_ live attenuated_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90589","description":"Chikungunya virus vaccine_ live attenuated_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of epiglottis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31420","description":"Removal of epiglottis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Monitor cable elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0485","description":"Monitor cable elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCF1","description":"ICD-FFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIA0","description":"ICD-FHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINC0","description":"ICD-FINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIB1","description":"ICD-BCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert balloon device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33973","description":"Insert balloon device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILA1","description":"ICD-KILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDB1","description":"ICD-MEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACC0","description":"ICD-GACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","description":"HCPCS-J1737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAC0","description":"ICD-GFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2A","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture reln part maxil lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5760","description":"Denture reln part maxil lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTE0","description":"ICD-NDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye muscle evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92265","description":"Eye muscle evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENC1","description":"ICD-CENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Absorp drg >48 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0746","description":"Absorp drg >48 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICC0","description":"ICD-AICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18G","description":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEF0","description":"ICD-IHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHF1","description":"ICD-KAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPC1","description":"ICD-ODPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth stone removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91851","description":"Anesth stone removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dna/rna amplified probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87150","description":"Dna/rna amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOC1","description":"ICD-DHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMB0","description":"ICD-KBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Miscellaneous component_ supply or accessory for use with total artificial heart system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8698","description":"Miscellaneous component_ supply or accessory for use with total artificial heart system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC02","description":"Medium Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total hip resurfacing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2118","description":"Total hip resurfacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC151","description":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dengue vaccine_ quadrivalent_ live_ 2 dose schedule_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90584","description":"Dengue vaccine_ quadrivalent_ live_ 2 dose schedule_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEA1","description":"ICD-KIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDD1","description":"ICD-EFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB130","description":"Special Care Low _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUA0","description":"ICD-EIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15C","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVE1","description":"ICD-BCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVA1","description":"ICD-BCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90477","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo ak/hip alignable system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5920","description":"Endo ak/hip alignable system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl bifocal 4.00d/.1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2203","description":"Lens sphcyl bifocal 4.00d/.1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIA1","description":"ICD-NEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skeletal muscle relaxant 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80369","description":"Skeletal muscle relaxant 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ini phq9 >9 not assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9396","description":"Ini phq9 >9 not assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00450","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","description":"CPT-00450","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35207","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28645","description":"Repair toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAE1","description":"ICD-NCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Arm pad each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0019","description":"Arm pad each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKB1","description":"ICD-BFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUF0","description":"ICD-NBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTC1","description":"ICD-FGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJE0","description":"ICD-CGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84144","description":"Assay of progesterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tocilizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3262","description":"Tocilizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUA1","description":"ICD-OEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOB1","description":"ICD-CBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64630","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; simple (ie_ valvotomy_ debridement_ debulking_ and/or simple commissural resuspension)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33390","description":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; simple (ie_ valvotomy_ debridement_ debulking_ and/or simple commissural resuspension)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5615","description":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of pilonidal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10081","description":"Drainage of pilonidal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMD0","description":"ICD-MDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBME0","description":"ICD-FBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPE1","description":"ICD-NJPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIA1","description":"ICD-MIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA41","description":"Default_ /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHC0","description":"ICD-BFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUC1","description":"ICD-CEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBE1","description":"ICD-NFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPA1","description":"ICD-CBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHF0","description":"ICD-NBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNC1","description":"ICD-GGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHB0","description":"ICD-EBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUF0","description":"ICD-JCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBE1","description":"ICD-NBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Combination bilateral ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1690","description":"Combination bilateral ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Paclitaxel protein bound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9264","description":"Paclitaxel protein bound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA21","description":"ICD-1FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excision of skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61558","description":"Excision of skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADD0","description":"ICD-KADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ bone-substitute material for bone and/or soft tissue hardware fixation augmentation_ including intraoperative imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0869T","description":"Injection(s)_ bone-substitute material for bone and/or soft tissue hardware fixation augmentation_ including intraoperative imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replantation arm complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20802","description":"Replantation arm complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 2 xtra hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0828","description":"Pwc gp 2 xtra hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plast socket jts/thgh lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5105","description":"Plast socket jts/thgh lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHA0","description":"ICD-MDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8B","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBID0","description":"ICD-JBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2174","description":"Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq card stent/ath/angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92933","description":"Prq card stent/ath/angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELD0","description":"ICD-IELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of lithium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80178","description":"Assay of lithium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUF0","description":"ICD-FEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8G","description":"Medium Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACC0","description":"ICD-AACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDME0","description":"ICD-CDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILE1","description":"ICD-OILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB213","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEC0","description":"ICD-FGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27886","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTE0","description":"ICD-MCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDA1","description":"ICD-IHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUC1","description":"ICD-MCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open wedge/bx lung infiltr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32096","description":"Open wedge/bx lung infiltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45020","description":"Drainage of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Imuglucerase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1786","description":"Imuglucerase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methocarbamol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2800","description":"Methocarbamol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay prostate phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84066","description":"Assay prostate phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEB0","description":"ICD-NFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0502T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGB0","description":"ICD-KCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy nerve of eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67345","description":"Destroy nerve of eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0401","description":"HCPCS-B0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDF1","description":"ICD-NCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I&d abscess p-spine l/s/ls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22015","description":"I&d abscess p-spine l/s/ls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKF1","description":"ICD-NKKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"O2 saturation</=88%/pao</=55","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3035F","description":"O2 saturation</=88%/pao</=55","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCB1","description":"ICD-CDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQA1","description":"ICD-HDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinary pouch w/o barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5072","description":"Urinary pouch w/o barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17264","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVB0","description":"ICD-JHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRF1","description":"ICD-DDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scrn hcv infec not recd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9386","description":"Scrn hcv infec not recd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMD0","description":"ICD-EDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1075","description":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inflammatory bowel dis mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8899","description":"Inflammatory bowel dis mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGF1","description":"ICD-GBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTA1","description":"ICD-CDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20D","description":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Attempted vbac after care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59622","description":"Attempted vbac after care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Macul result phy/qhp mng dm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5010F","description":"Macul result phy/qhp mng dm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRB0","description":"ICD-DDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Retinal polarization scan_ ocular screening with on-site automated results_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0469T","description":"Retinal polarization scan_ ocular screening with on-site automated results_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRB0","description":"ICD-HGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHD0","description":"ICD-IIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJB0","description":"ICD-JCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37288","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","description":"CPT-37288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contrcp talk b/4 antiv txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4159F","description":"Contrcp talk b/4 antiv txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUF1","description":"ICD-NCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSE1","description":"ICD-PHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSD1","description":"ICD-DBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMB0","description":"ICD-AAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating at or above the he","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93587","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating at or above the he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEE1","description":"ICD-CCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCA1","description":"ICD-MCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD110","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bowel surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44899","description":"Bowel surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBA0","description":"ICD-NKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Succinycholine chloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0330","description":"Succinycholine chloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shoulder cast fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4004","description":"Cast sup shoulder cast fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg_ myotonic dystrophy type 2) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81187","description":"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg_ myotonic dystrophy type 2) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microsurg epi sperm asp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4028","description":"Microsurg epi sperm asp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELC0","description":"ICD-FELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjust max prost appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5992","description":"Adjust max prost appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBF1","description":"ICD-OGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78265","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVC0","description":"ICD-JIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD255","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIC1","description":"ICD-NLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14C","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGB0","description":"ICD-JDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJC0","description":"ICD-ODJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Irrigation sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31002","description":"Irrigation sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVF1","description":"ICD-JBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJD1","description":"ICD-BBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRB0","description":"ICD-OHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of ankle/heel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28100","description":"Removal of ankle/heel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg <= 16 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6245","description":"Hydrogel drg <= 16 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGE0","description":"ICD-KDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1503","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1503","description":"CDT-D1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01832","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","description":"CPT-01832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99284","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27591","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Igg 1 2 3 or 4 each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82787","description":"Igg 1 2 3 or 4 each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLA0","description":"ICD-KGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSA1","description":"ICD-CFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"C motor evoked upr&lwr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95939","description":"C motor evoked upr&lwr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Zneuroendoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62163","description":"Zneuroendoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWB0","description":"ICD-KGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens_ intraocular (new tech)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1780","description":"Lens_ intraocular (new tech)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ rituximab-pvvr_ biosimilar_ (ruxience)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5119","description":"Injection_ rituximab-pvvr_ biosimilar_ (ruxience)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHB1","description":"ICD-FGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPA1","description":"ICD-FGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat shoulder blade fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23575","description":"Treat shoulder blade fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA31","description":"ICD-2DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVA1","description":"ICD-OIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Instll rx agnt into rnal tub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50391","description":"Instll rx agnt into rnal tub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95726","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation applicator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5983","description":"Radiation applicator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFE0","description":"ICD-FGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX32","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Kafo fem fx cast semi-rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2134","description":"Kafo fem fx cast semi-rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sewho airplane w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3967","description":"Sewho airplane w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replcmnt breast pump bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4285","description":"Replcmnt breast pump bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXF0","description":"ICD-FBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSB0","description":"ICD-OKSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINA0","description":"ICD-GINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chest x-ray frnt lat oblique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71022","description":"Chest x-ray frnt lat oblique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0014","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ inelastic short stretch_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6599","description":"Gradient compression bandage roll_ inelastic short stretch_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMB0","description":"ICD-BFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cath_ hemodialysis_long-term","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1750","description":"Cath_ hemodialysis_long-term","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVF0","description":"ICD-FHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAF1","description":"ICD-BEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drain bl w/cath insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51102","description":"Drain bl w/cath insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSA0","description":"ICD-CFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSC0","description":"ICD-DGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWA0","description":"ICD-CIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL31","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRC1","description":"ICD-LIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEA0","description":"ICD-KDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKF0","description":"ICD-FAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86849","description":"Immunology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contraceptive pills for bc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4993","description":"Contraceptive pills for bc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPA0","description":"ICD-KAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTC1","description":"ICD-MCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVE0","description":"ICD-BGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bladder irrigation tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4355","description":"Bladder irrigation tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENA0","description":"ICD-NENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neurorraphy w/vein autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64911","description":"Neurorraphy w/vein autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC115","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDE1","description":"ICD-AIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABME0","description":"ICD-ABME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWE0","description":"ICD-CGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No antihist/decong rx/recom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4134F","description":"No antihist/decong rx/recom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spine & skull spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22590","description":"Spine & skull spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A5103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5103","description":"HCPCS-A5103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKC0","description":"ICD-BDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVC0","description":"ICD-KIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cysto w/renal stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52343","description":"Cysto w/renal stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFA1","description":"ICD-NJFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Liver allotransplantation; heterotopic_ partial or whole_ from cadaver or living donor_ any age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47136","description":"Liver allotransplantation; heterotopic_ partial or whole_ from cadaver or living donor_ any age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSD1","description":"ICD-HFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCA0","description":"ICD-GHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Grad comp non-elastic bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6545","description":"Grad comp non-elastic bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB53","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGA0","description":"ICD-OGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHA1","description":"ICD-EDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14D","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1432","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","description":"HCPCS-M1432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSC1","description":"ICD-HHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-linked intellectual dblt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81471","description":"X-linked intellectual dblt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFD1","description":"ICD-JDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUE0","description":"ICD-NHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of hemorrhoid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46221","description":"Ligation of hemorrhoid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNF1","description":"ICD-FBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVC0","description":"ICD-CDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETD0","description":"ICD-IETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPD0","description":"ICD-CHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Create tear duct drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68750","description":"Create tear duct drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEE1","description":"ICD-FFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLA0","description":"ICD-MHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection Hpc Nos 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9985","description":"Injection Hpc Nos 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQE0","description":"ICD-CBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 13_ 18_ and 21)_ DNA sequence analysis of selected regions using maternal plasma_ algorithm reported as a risk score for each trisomy_ includes sex r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0327U","description":"Fetal aneuploidy (trisomy 13_ 18_ and 21)_ DNA sequence analysis of selected regions using maternal plasma_ algorithm reported as a risk score for each trisomy_ includes sex r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84580","description":"Assay of urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31400","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQE1","description":"ICD-HGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma)_ patients who are h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1018","description":"Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma)_ patients who are h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ibd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8758","description":"Ibd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ak univ multiplex sys frict","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5616","description":"Ak univ multiplex sys frict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eyeglasses delux frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2025","description":"Eyeglasses delux frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00630","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","description":"CPT-00630","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"History cd4+ cell count <350","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3492F","description":"History cd4+ cell count <350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pancreatic elastase fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82656","description":"Pancreatic elastase fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDC0","description":"ICD-BHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sig w/tndsc balloon dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45340","description":"Sig w/tndsc balloon dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54435","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dna analysis ret-oncogene","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3840","description":"Dna analysis ret-oncogene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFA0","description":"ICD-NBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cytopath c/v thin layer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88142","description":"Cytopath c/v thin layer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHF1","description":"ICD-EFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQE1","description":"ICD-CIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15C","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50290","description":"Removal of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-70471","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","description":"CPT-70471","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXA0","description":"ICD-GIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound exam aaa screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0389","description":"Ultrasound exam aaa screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWB1","description":"ICD-DAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDE1","description":"ICD-NHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELB1","description":"ICD-NELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDB1","description":"ICD-IEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microscopic exam of urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81015","description":"Microscopic exam of urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amikacin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0278","description":"Amikacin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQA1","description":"ICD-LHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo guide for transfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76941","description":"Echo guide for transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACB0","description":"ICD-NACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78830","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTB0","description":"ICD-GCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVF1","description":"ICD-OGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJF0","description":"ICD-ODJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFB0","description":"ICD-NCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc abd tum over 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49204","description":"Exc abd tum over 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQE0","description":"ICD-OLQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparoscopy vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43651","description":"Laparoscopy vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post 1 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2391","description":"Post 1 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31075","description":"Exploration of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2113","description":"Spherocylindr 7.25d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10D","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES241","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEC0","description":"ICD-AHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBA0","description":"ICD-MJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29885","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBF1","description":"ICD-IFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNE0","description":"ICD-GBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYA0","description":"ICD-LCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHC1","description":"ICD-IFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery bifurcation (eg_ aneurysm_ pseudoaneurysm_ arteriovenous malformation_ trauma_ dissection) using bifurcated endograft from the common iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0254T","description":"Endovascular repair of iliac artery bifurcation (eg_ aneurysm_ pseudoaneurysm_ arteriovenous malformation_ trauma_ dissection) using bifurcated endograft from the common iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autochondrocyte implant knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27412","description":"Autochondrocyte implant knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21C","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26445","description":"Release hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAE1","description":"ICD-MDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amniotic membrane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2790","description":"Amniotic membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peritoneal lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49084","description":"Peritoneal lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Manual therapy 1/> regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97140","description":"Manual therapy 1/> regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77605","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D2005","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2005","description":"CDT-D2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEE0","description":"ICD-KEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemipelvectomy canadian sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5341","description":"Hemipelvectomy canadian sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEA1","description":"ICD-ODEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHA1","description":"ICD-IFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWC1","description":"ICD-HGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHE0","description":"ICD-MHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYF1","description":"ICD-CHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYA1","description":"ICD-CFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth removal of nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63251","description":"Anesth removal of nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXA0","description":"ICD-CDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28200","description":"Repair of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWD1","description":"ICD-DGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lung transplant double","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32853","description":"Lung transplant double","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECE0","description":"ICD-FECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMC0","description":"ICD-MEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0969T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","description":"CPT-0969T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBA1","description":"ICD-FEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elevat legrst low extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0046","description":"Elevat legrst low extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathologist(s)/dermatopathologist(s) is the same clinician who performed the biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9939","description":"Pathologist(s)/dermatopathologist(s) is the same clinician who performed the biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSC1","description":"ICD-CCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC31","description":"ICD-2KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Not nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9291","description":"Not nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61760","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA_ gene expression profiling by real-time quantit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0119U","description":"Oncology (urothelial)_ mRNA_ gene expression profiling by real-time quantit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Number of patients screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1207","description":"Number of patients screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Specialized Medical Equipment and Supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0137","description":"Specialized Medical Equipment and Supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant neuroelectrde addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61864","description":"Implant neuroelectrde addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99155","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reposition pacing-defib lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33215","description":"Reposition pacing-defib lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle-specific kinase (MuSK) antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86366","description":"Muscle-specific kinase (MuSK) antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0C","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYB0","description":"ICD-LAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMC0","description":"ICD-NKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUE1","description":"ICD-MIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC254","description":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body fluid specific gravity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84315","description":"Body fluid specific gravity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg3/4 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9115","description":"Onc dx ovarian stg3/4 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFC1","description":"ICD-KIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIA0","description":"ICD-BFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHA0","description":"ICD-GBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHA1","description":"ICD-ECHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28290","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coch implant headset replace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8615","description":"Coch implant headset replace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Overdenture partial max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5864","description":"Overdenture partial max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"K flow/funct image w/o drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78707","description":"K flow/funct image w/o drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0B","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETC0","description":"ICD-EETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBA0","description":"ICD-NJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASB0","description":"ICD-GASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen sng rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8685","description":"Implt nrostm pls gen sng rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWB0","description":"ICD-HBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGF0","description":"ICD-KAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Methadone; Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Addition To Code F","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2078","description":"Take-Home Supply Of Methadone; Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Addition To Code F","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25332","description":"Revise wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDA1","description":"ICD-GHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onco (ovar) five proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81503","description":"Onco (ovar) five proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDC0","description":"ICD-JEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Single Study_ At Re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78430","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Single Study_ At Re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXB0","description":"ICD-OHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVF1","description":"ICD-JIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Team conf w/pat by hc prof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99366","description":"Team conf w/pat by hc prof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-2 quant&revrse trnscripj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87539","description":"Hiv-2 quant&revrse trnscripj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATF0","description":"ICD-CATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASC1","description":"ICD-CASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHD1","description":"ICD-JGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTF0","description":"ICD-KFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ diclofenac sodium_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1130","description":"Injection_ diclofenac sodium_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAD0","description":"ICD-JBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ disp_ binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5263","description":"Hearing aid_ disp_ binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnio quad-core_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4294","description":"Amnio quad-core_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1292","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc breast risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0008M","description":"Onc breast risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASB1","description":"ICD-GASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture tiss conditn maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5850","description":"Denture tiss conditn maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0801","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0801","description":"CDT-D0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ with blue-violet filter_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2526","description":"Contact lens_ hydrophilic_ with blue-violet filter_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMB1","description":"ICD-ACMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95926","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of an implantable_ patient-activated cardiac event recorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33284","description":"Removal of an implantable_ patient-activated cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGD1","description":"ICD-ODGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAF1","description":"ICD-CBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISB1","description":"ICD-LISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 1 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72081","description":"X-ray exam entire spi 1 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSF0","description":"ICD-CBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amnio or biodmatrix_ inj 1cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4139","description":"Amnio or biodmatrix_ inj 1cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hf assessment tool completed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3117F","description":"Hf assessment tool completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Moderna Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 50mcg/0.25mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1711","description":"Moderna Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 50mcg/0.25mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PLYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYB1","description":"ICD-PLYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKB1","description":"ICD-NGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient not screened for tobacco use_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9905","description":"Patient not screened for tobacco use_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSD0","description":"ICD-KGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone/skin graft metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20972","description":"Bone/skin graft metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQB0","description":"ICD-HBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIED1","description":"ICD-CIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0D","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test 3 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95863","description":"Muscle test 3 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore treat shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23107","description":"Explore treat shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWB1","description":"ICD-KHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMB0","description":"ICD-NBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDE1","description":"ICD-CHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE135","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEF0","description":"ICD-MDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 25MCG/0.25ML2ND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0112A","description":"ADM SARSCOV2 25MCG/0.25ML2ND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antisperm antibodies test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3655","description":"Antisperm antibodies test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEE1","description":"ICD-FBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTB0","description":"ICD-MKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Screening For Tobacco Use (E.G._ Limited Life Expectancy_ Other Medical Reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0028","description":"Documentation Of Medical Reason(S) For Not Screening For Tobacco Use (E.G._ Limited Life Expectancy_ Other Medical Reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ udenyca 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5111","description":"Injection_ udenyca 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXE1","description":"ICD-GHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supply allowance for non-adjunctive_ non-implanted continuous glucose monitor (cgm)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4239","description":"Supply allowance for non-adjunctive_ non-implanted continuous glucose monitor (cgm)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEC0","description":"ICD-NCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDND1","description":"ICD-BDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGB0","description":"ICD-CIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heat lamp with stand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0205","description":"Heat lamp with stand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27137","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQB1","description":"ICD-LGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJF1","description":"ICD-OKJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTE1","description":"ICD-MDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bp scrn no perf at interval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8785","description":"Bp scrn no perf at interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy accessory convex inse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5093","description":"Ostomy accessory convex inse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUA0","description":"ICD-AFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWA1","description":"ICD-HGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score knee pt noelg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8649","description":"Fun stat score knee pt noelg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUA1","description":"ICD-MDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYF0","description":"ICD-GGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLD1","description":"ICD-JGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVA1","description":"ICD-OHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of imipramine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6036","description":"Assay of imipramine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXD0","description":"ICD-NAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGED1","description":"ICD-CGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQF1","description":"ICD-CFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEE1","description":"ICD-CIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxford w/ supinat/pronator c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3202","description":"Oxford w/ supinat/pronator c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flutamide 125 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0175","description":"Flutamide 125 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJD1","description":"ICD-GDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMB1","description":"ICD-NFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVF1","description":"ICD-BBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAE1","description":"ICD-JHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABE0","description":"ICD-CABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FlowerAmnioFlo_ 0.1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4177","description":"FlowerAmnioFlo_ 0.1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fit spectacles compound lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92355","description":"Fit spectacles compound lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hit hydra 2 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9375","description":"Hit hydra 2 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31780","description":"Reconstruct windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g._ inadequate time for follow-up_ patients who received a prior intravitreal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1325","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g._ inadequate time for follow-up_ patients who received a prior intravitreal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMB0","description":"ICD-MLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAA1","description":"ICD-IBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correct skin color ea 20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11922","description":"Correct skin color ea 20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAE0","description":"ICD-FFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPC1","description":"ICD-OCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infusion supplies w/o pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4223","description":"Infusion supplies w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-rays for bone age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77072","description":"X-rays for bone age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXB1","description":"ICD-KHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67218","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bld typing serologic rh phnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86906","description":"Bld typing serologic rh phnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0879T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fistulization of sclera for glaucoma_ through ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0123T","description":"Fistulization of sclera for glaucoma_ through ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65273","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTA0","description":"ICD-JBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGC1","description":"ICD-NIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAND0","description":"ICD-KAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97154","description":"Group adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWD0","description":"ICD-HDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKD0","description":"ICD-NHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral 50% dextrose solu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4164","description":"Parenteral 50% dextrose solu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGD1","description":"ICD-JAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLC0","description":"ICD-IGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDA0","description":"ICD-OKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWA1","description":"ICD-DCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXF1","description":"ICD-FGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUD1","description":"ICD-AGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB11","description":"ICD-2GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCA1","description":"ICD-CCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peritoneal dialysis clamp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1634","description":"Peritoneal dialysis clamp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sgd w multi methods msg/accs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2510","description":"Sgd w multi methods msg/accs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15D","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRA1","description":"ICD-KGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Cell-Based Immunofluorescence Assay (Cba)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86362","description":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Cell-Based Immunofluorescence Assay (Cba)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heart symp image plnr spect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0332T","description":"Heart symp image plnr spect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shock absorber for man w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1015","description":"Shock absorber for man w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRA0","description":"ICD-LGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIB1","description":"ICD-OHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hm gest dm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9214","description":"Hm gest dm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A9613","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9613","description":"HCPCS-A9613","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMD1","description":"ICD-GCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAA0","description":"ICD-MFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMB0","description":"ICD-GIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPA0","description":"ICD-OIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA104","description":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQB1","description":"ICD-PEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHB1","description":"ICD-GBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEF1","description":"ICD-EEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dent sutur recent wnd to 5cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7910","description":"Dent sutur recent wnd to 5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMD0","description":"ICD-KAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heredtry nurondcrn tum dsrdr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81437","description":"Heredtry nurondcrn tum dsrdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stent placemt retro carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37217","description":"Stent placemt retro carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJB0","description":"ICD-GFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTB1","description":"ICD-JCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJB0","description":"ICD-FDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); device supply with automated report generation_ up to 10 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0812T","description":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); device supply with automated report generation_ up to 10 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAA0","description":"ICD-KGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYB1","description":"ICD-LGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Complement antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86160","description":"Complement antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKF1","description":"ICD-GHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVE1","description":"ICD-BDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj_ pasireotide long acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2502","description":"Inj_ pasireotide long acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp multiplane ext fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20696","description":"Comp multiplane ext fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMF0","description":"ICD-KAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLE0","description":"ICD-ECLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pet image w/ct skull-thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78815","description":"Pet image w/ct skull-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDE1","description":"ICD-NGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drill skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61108","description":"Drill skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr hern preemie reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49491","description":"Rpr hern preemie reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1050T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1050T","description":"CPT-1050T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWD1","description":"ICD-HBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Opto-acoustic imaging_ breast (including axilla when performed)_ unilateral_ with image documentation_ analysis and report_obtained with ultrasound examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9788","description":"Opto-acoustic imaging_ breast (including axilla when performed)_ unilateral_ with image documentation_ analysis and report_obtained with ultrasound examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial hip replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27125","description":"Partial hip replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44376","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLA0","description":"ICD-CGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA105","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7528","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","description":"HCPCS-J7528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYF1","description":"ICD-GHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI abdomen w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74181","description":"MRI abdomen w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj anesthetic per 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4737","description":"Inj anesthetic per 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHE1","description":"ICD-OCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHE1","description":"ICD-EEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50060","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOA0","description":"ICD-OFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28E","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental connector bar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6920","description":"Dental connector bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext wear ost skn barr <=4sqin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4407","description":"Ext wear ost skn barr <=4sqin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOC0","description":"ICD-DDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQB1","description":"ICD-CCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCE0","description":"ICD-AFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4A","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIID1","description":"ICD-CIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHC0","description":"ICD-BGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External urinary catheters; disposable_ with wicking material_ for use with suction pump_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6590","description":"External urinary catheters; disposable_ with wicking material_ for use with suction pump_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lyme dis dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87475","description":"Lyme dis dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYE0","description":"ICD-DIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect forarm/wrist tum 3cm>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25078","description":"Resect forarm/wrist tum 3cm>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRE0","description":"ICD-OJRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prosthetic device repair rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7510","description":"Prosthetic device repair rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRE0","description":"ICD-CCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWA0","description":"ICD-DAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA34","description":"Default_ /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNA0","description":"ICD-FGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCD0","description":"ICD-OBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Breast Diagnostic Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0619","description":"Hospital Special Treatment Room Support Component (Hstrsc) Breast Diagnostic Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46700","description":"Repair of anal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21193","description":"Reconst lwr jaw w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33780","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB11","description":"ICD-3EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Guardant360 CDX_ Guardant Health Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0242U","description":"Guardant360 CDX_ Guardant Health Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPE0","description":"ICD-KHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20B","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ conivaptan hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9488","description":"Injection_ conivaptan hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELF0","description":"ICD-AELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWB1","description":"ICD-OHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVF0","description":"ICD-FIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHA0","description":"ICD-EHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37298","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","description":"CPT-37298","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAID0","description":"ICD-NAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Unspecified periodontal proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4999","description":"Unspecified periodontal proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTA0","description":"ICD-MKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pulm funct test oscillometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94728","description":"Pulm funct test oscillometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQF1","description":"ICD-GAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCF0","description":"ICD-OCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWF0","description":"ICD-OEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67005","description":"Partial removal of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mr angiograph neck w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70549","description":"Mr angiograph neck w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNC0","description":"ICD-GCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hosp bed fx ht w/o rails w/m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0290","description":"Hosp bed fx ht w/o rails w/m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22C","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald for cochlear implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5273","description":"Ald for cochlear implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frozen ivf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4016","description":"Frozen ivf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVD0","description":"ICD-BGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBF1","description":"ICD-GGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oxytetracycline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2460","description":"Oxytetracycline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWE1","description":"ICD-HFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMA0","description":"ICD-FAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28294","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aripiprazole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0400","description":"Aripiprazole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOB0","description":"ICD-PIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Excis uppr jaw cyst w/repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21049","description":"Excis uppr jaw cyst w/repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLF1","description":"ICD-OBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-16374","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16374","description":"CPT-16374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJD0","description":"ICD-GCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ common and select rare variants (ie_ *2_ *3_ *4_ *4N_ *5_ *6_ *7_ *8_ *9_ *","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0070U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ common and select rare variants (ie_ *2_ *3_ *4_ *4N_ *5_ *6_ *7_ *8_ *9_ *","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLF0","description":"ICD-EGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIA1","description":"ICD-GHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQA1","description":"ICD-GEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of rbc pg6d enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84085","description":"Assay of rbc pg6d enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8C","description":"Medium Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15D","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUF0","description":"ICD-EBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23485","description":"Revision of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKA1","description":"ICD-KGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc stocking garter belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6544","description":"Gc stocking garter belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Novafix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4208","description":"Novafix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D5941","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5941","description":"CDT-D5941","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPD0","description":"ICD-KCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITD0","description":"ICD-IITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove radius head implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24164","description":"Remove radius head implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCB0","description":"ICD-KCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCF0","description":"ICD-IGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUD0","description":"ICD-NFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESE0","description":"ICD-GESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Superimposed prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5954","description":"Superimposed prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score ls >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8659","description":"Fun stat score ls >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pm device progr eval dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93280","description":"Pm device progr eval dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suction lipectomy head&neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15876","description":"Suction lipectomy head&neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PKRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRE0","description":"ICD-PKRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 5.1-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12014","description":"Rpr f/e/e/n/l/m 5.1-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0389T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown resin w/ high noble me","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2720","description":"Crown resin w/ high noble me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGA1","description":"ICD-JEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98971","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18X","description":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMC0","description":"ICD-KIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23B","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx nose/jaw fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21345","description":"Closed tx nose/jaw fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHE1","description":"ICD-IDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62322","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dalteparin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1645","description":"Dalteparin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB210","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise spine&cord 2 trx crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63196","description":"Incise spine&cord 2 trx crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHE0","description":"ICD-EIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp tibial-tib/peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35570","description":"Art byp tibial-tib/peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHC0","description":"ICD-IEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFE0","description":"ICD-GCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECB0","description":"ICD-KECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ampicillin sodium per 1.5 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0295","description":"Ampicillin sodium per 1.5 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACID0","description":"ICD-ACID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBID0","description":"ICD-KBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6752","description":"Crown porcelain noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57700","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB235","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy & ureter catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52005","description":"Cystoscopy & ureter catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aor ane 5.5-5.9 cm max diam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9598","description":"Aor ane 5.5-5.9 cm max diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D0805","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0805","description":"CDT-D0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66505","description":"Incision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Known Familial Variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81308","description":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Known Familial Variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospital observation per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0378","description":"Hospital observation per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0891","description":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB56","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99342","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEB0","description":"ICD-JBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDID0","description":"ICD-MDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTE0","description":"ICD-OFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPE0","description":"ICD-GBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Generator_ neuro non-recharg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1767","description":"Generator_ neuro non-recharg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glass/plastic slab off prism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2710","description":"Glass/plastic slab off prism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 2 genotyping (HPA-2)_ GP1BA (glycoprotein Ib [platelet]_ alpha polypeptide [GPIba]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81106","description":"Human Platelet Antigen 2 genotyping (HPA-2)_ GP1BA (glycoprotein Ib [platelet]_ alpha polypeptide [GPIba]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTB0","description":"ICD-MDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj foramen epidural add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64484","description":"Inj foramen epidural add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRE1","description":"ICD-DHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSA0","description":"ICD-PGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIB0","description":"ICD-JCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special teletx port plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77321","description":"Special teletx port plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVE1","description":"ICD-CAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUE0","description":"ICD-OGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise inner ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69950","description":"Incise inner ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mecasermin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2170","description":"Mecasermin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJF0","description":"ICD-FCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem odontogen cyst to 1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7450","description":"Rem odontogen cyst to 1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no follow imag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9549","description":"Doc med reas no follow imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAD1","description":"ICD-MLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE136","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXA1","description":"ICD-OHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spectrophotometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84311","description":"Spectrophotometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCA0","description":"ICD-FBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCA0","description":"ICD-KCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTE0","description":"ICD-ICTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18H","description":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGB1","description":"ICD-NHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33684","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUF1","description":"ICD-OAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRE1","description":"ICD-DFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Echo exam of head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76506","description":"Echo exam of head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","description":"HCPCS-M1407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSB1","description":"ICD-PHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOB0","description":"ICD-PAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIA1","description":"ICD-CCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUC1","description":"ICD-NLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHA1","description":"ICD-CIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNC1","description":"ICD-NKNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITB1","description":"ICD-OITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAB0","description":"ICD-EIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8I","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laparo cholecystectomy/graph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47563","description":"Laparo cholecystectomy/graph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5B","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting_ isolation and preparation of harvested cells including incubation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0489T","description":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting_ isolation and preparation of harvested cells including incubation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETD1","description":"ICD-GETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical conference_ 60 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0221","description":"Medical conference_ 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDA0","description":"ICD-BDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUE1","description":"ICD-EAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; HIV-1 antigen(s)_ with HIV-1 and HIV-2 antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87806","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; HIV-1 antigen(s)_ with HIV-1 and HIV-2 antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0D","description":"Very High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp aortobifemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35646","description":"Art byp aortobifemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDB0","description":"ICD-NFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ faricimab-svoa_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2777","description":"Injection_ faricimab-svoa_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone marrow aspiration for bone grafting_ spine surgery only_ through separate skin or fascial incision (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20939","description":"Bone marrow aspiration for bone grafting_ spine surgery only_ through separate skin or fascial incision (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx done w/colposcopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58110","description":"Bx done w/colposcopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy remove fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58562","description":"Hysteroscopy remove fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJA1","description":"ICD-NEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab-eqrn (cimerli)_ biosimilar_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5128","description":"Injection_ ranibizumab-eqrn (cimerli)_ biosimilar_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fungus nes antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86671","description":"Fungus nes antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVD0","description":"ICD-JFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTE1","description":"ICD-MGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srs multisource","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77371","description":"Srs multisource","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"B-amyloid (Abeta42) and total tau (tTau)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0459U","description":"B-amyloid (Abeta42) and total tau (tTau)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eye allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95060","description":"Eye allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDB0","description":"ICD-FBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dilation of cervical canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57800","description":"Dilation of cervical canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLE0","description":"ICD-KFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plasma 1 donor frz w/in 8 hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9017","description":"Plasma 1 donor frz w/in 8 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin pedicle flap trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15570","description":"Skin pedicle flap trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICD0","description":"ICD-FICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANA1","description":"ICD-GANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1551","description":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Satisfy with care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0916","description":"Satisfy with care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTB1","description":"ICD-OHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCB0","description":"ICD-NGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHF1","description":"ICD-GFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destroy nerve face muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64612","description":"Destroy nerve face muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICB0","description":"ICD-CICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXC1","description":"ICD-CHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1013","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE134","description":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRE1","description":"ICD-PDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures mand part resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5212","description":"Dentures mand part resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wireless pressure sensor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2624","description":"Wireless pressure sensor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLB0","description":"ICD-BDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOB0","description":"ICD-KDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Using Multimodal Pain Management (E.G._ Allergy To Multiple Classes Of Analgesics_ Intubated Patient_ Hepatic Failure_ Patient Repor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2149","description":"Documentation Of Medical Reason(S) For Not Using Multimodal Pain Management (E.G._ Allergy To Multiple Classes Of Analgesics_ Intubated Patient_ Hepatic Failure_ Patient Repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40500","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc hand les sc < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26115","description":"Exc hand les sc < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWC0","description":"ICD-OLWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Edetate calcium disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0600","description":"Edetate calcium disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIF0","description":"ICD-EHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Fixed Bilateral Space Maintainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1557","description":"Removal Of Fixed Bilateral Space Maintainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amputation of midfoot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28800","description":"Amputation of midfoot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXF1","description":"ICD-FIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Detect agent nos dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87799","description":"Detect agent nos dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole (abilify asimtufii)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0402","description":"Injection_ aripiprazole (abilify asimtufii)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pin hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26676","description":"Pin hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low risk for retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3072F","description":"Low risk for retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apically positioned flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4245","description":"Apically positioned flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9993","description":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDF0","description":"ICD-MIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXC0","description":"ICD-CIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMF0","description":"ICD-NFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAD1","description":"ICD-FFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBME0","description":"ICD-KBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of transcortin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84449","description":"Assay of transcortin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0A","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dextran 40 infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7100","description":"Dextran 40 infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add mech leg elevation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1009","description":"Add mech leg elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUF1","description":"ICD-JAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHB0","description":"ICD-EEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJE1","description":"ICD-NKJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62326","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXE0","description":"ICD-NGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA44","description":"Very High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVB0","description":"ICD-NKVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ has hcv treatment initiated within 3 months of the reactive hcv an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1228","description":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ has hcv treatment initiated within 3 months of the reactive hcv an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQD1","description":"ICD-PCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJD0","description":"ICD-NDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stool collection pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4330","description":"Stool collection pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Not ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8858","description":"Not ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLD1","description":"ICD-OKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEE0","description":"ICD-ADEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJC1","description":"ICD-GDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28X","description":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMB0","description":"ICD-OBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14A","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical boot each child","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3209","description":"Surgical boot each child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLE1","description":"ICD-OKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","description":"HCPCS-Q4401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plastic surgery neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15819","description":"Plastic surgery neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABA1","description":"ICD-BABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPC1","description":"ICD-FGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Face bone graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21210","description":"Face bone graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE236","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQB1","description":"ICD-GEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJB1","description":"ICD-KDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTD1","description":"ICD-IDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dem severity class severe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1493F","description":"Dem severity class severe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDA0","description":"ICD-EBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical path gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88300","description":"Surgical path gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exemestane_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0156","description":"Exemestane_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL31","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49593","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEB0","description":"ICD-FIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ progressive myoclonic epilepsy type 1A_ Unverricht-Lundborg disease)_ full gene analysis_ including small sequence changes in exonic and intronic region","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0232U","description":"CSTB (cystatin B) (eg_ progressive myoclonic epilepsy type 1A_ Unverricht-Lundborg disease)_ full gene analysis_ including small sequence changes in exonic and intronic region","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCE1","description":"ICD-OKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTC1","description":"ICD-NLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNE1","description":"ICD-GBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","description":"CPT-01474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPD0","description":"ICD-OKPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILC0","description":"ICD-JILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip flexible cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5966","description":"Hip flexible cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No rev_ comm_ track biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8885","description":"No rev_ comm_ track biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost pch w bar/bltinconv/fltr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4417","description":"Ost pch w bar/bltinconv/fltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18C","description":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53000","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; parenchyma (eg_ organ)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76981","description":"Ultrasound_ elastography; parenchyma (eg_ organ)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBA1","description":"ICD-AHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Symptom mgmnt plan care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0555F","description":"Symptom mgmnt plan care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJE1","description":"ICD-FAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-55714","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","description":"CPT-55714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam si joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72200","description":"X-ray exam si joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient had encephalitis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1162","description":"Patient had encephalitis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIE1","description":"ICD-KAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Admin pneumococcal vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0009","description":"Admin pneumococcal vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFF1","description":"ICD-NHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Slp stdy unattended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95800","description":"Slp stdy unattended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Perq lamot/lam lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0275T","description":"Perq lamot/lam lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flu vacc iiv3 no preserv id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90654","description":"Flu vacc iiv3 no preserv id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0600U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","description":"CPT-0600U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63052","description":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFE0","description":"ICD-OBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"I&d abscess extraoral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7520","description":"I&d abscess extraoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0C","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFB0","description":"ICD-NGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTE1","description":"ICD-CFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEC0","description":"ICD-KAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0567","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","description":"HCPCS-G0567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDF1","description":"ICD-OCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA244","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAE1","description":"ICD-MGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of rectocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45560","description":"Repair of rectocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwr standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2301","description":"Pwr standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo knee-shin frct swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5812","description":"Endo knee-shin frct swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECF1","description":"ICD-EECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBA1","description":"ICD-NIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18H","description":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC231","description":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4335","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","description":"HCPCS-Q4335","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ny heart assoc class docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3118F","description":"Ny heart assoc class docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frame typ socket bel elbow/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6687","description":"Frame typ socket bel elbow/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microbe susceptible enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87185","description":"Microbe susceptible enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPB0","description":"ICD-KEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKD0","description":"ICD-NBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intrvl 3/>yr pts clnscp docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0529F","description":"Intrvl 3/>yr pts clnscp docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Automated Analysis Of An Existing Computed Tomography Study For Vertebral Fracture(S)_ Including Assessment Of Bone Density When Performed_ Data Preparation_ Interpretation_ A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0691T","description":"Automated Analysis Of An Existing Computed Tomography Study For Vertebral Fracture(S)_ Including Assessment Of Bone Density When Performed_ Data Preparation_ Interpretation_ A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXD1","description":"ICD-GCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX41","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERE0","description":"ICD-HERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAF1","description":"ICD-NCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLA0","description":"ICD-BDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lo flex l1-below l5 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0625","description":"Lo flex l1-below l5 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITC/ITC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5214","description":"Hearing aid_ contralateral routing system_ binaural_ ITC/ITC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Presbyopia-correct function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2788","description":"Presbyopia-correct function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRB0","description":"ICD-GBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQC0","description":"ICD-PJQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMB0","description":"ICD-MFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVA0","description":"ICD-FHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXC1","description":"ICD-GDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lat retinacular release open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27425","description":"Lat retinacular release open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lever-activated wheel drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0988","description":"Lever-activated wheel drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coagulation time otr method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85348","description":"Coagulation time otr method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid skin barrier 8x8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5122","description":"Solid skin barrier 8x8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVD0","description":"ICD-JAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUA1","description":"ICD-BBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYF1","description":"ICD-PGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGF0","description":"ICD-GBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPE1","description":"ICD-GEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRA0","description":"ICD-KCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystatin c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82610","description":"Cystatin c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus (SARS-CoV-2) (coronavirus disease [COVID-19]) mutation identification in targeted region(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87913","description":"Severe acute respiratory syndrome coronavirus (SARS-CoV-2) (coronavirus disease [COVID-19]) mutation identification in targeted region(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mnpj of tmj w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21073","description":"Mnpj of tmj w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOD1","description":"ICD-HIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHD1","description":"ICD-FEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNE0","description":"ICD-JCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBA1","description":"ICD-AEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB245","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPB1","description":"ICD-FIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay for infectious agent antibody(ies)_ qualitative or semi-quantitative_ single step method (eg. reagent strip); severe acute respiratory system coronavirus 2 (SARS C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86328","description":"Immunoassay for infectious agent antibody(ies)_ qualitative or semi-quantitative_ single step method (eg. reagent strip); severe acute respiratory system coronavirus 2 (SARS C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUC1","description":"ICD-EFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSE0","description":"ICD-LDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period_ (e.g._ patient declined_ other patient reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1202","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period_ (e.g._ patient declined_ other patient reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Soft protect helmet custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8002","description":"Soft protect helmet custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMB1","description":"ICD-CBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEB1","description":"ICD-FCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBC0","description":"ICD-IHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPC0","description":"ICD-BGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1A","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Employment - Job Finding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1735","description":"Employment - Job Finding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATC1","description":"ICD-AATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bmi not calculated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8421","description":"Bmi not calculated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDB0","description":"ICD-OGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair windpipe opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31614","description":"Repair windpipe opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56637","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree_ derived from coronary angiogram data_ for re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0523T","description":"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree_ derived from coronary angiogram data_ for re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Splint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4570","description":"Splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABF1","description":"ICD-FABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUE1","description":"ICD-AIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFA0","description":"ICD-BHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ leadless pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0391T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ leadless pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00352","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","description":"CPT-00352","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNE1","description":"ICD-CGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60540","description":"Explore adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Io radiation tx management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77469","description":"Io radiation tx management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXC1","description":"ICD-BHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen III b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0279U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen III b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63277","description":"Bx/exc xdrl spine lesn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit fecal/enema mgmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99511","description":"Home visit fecal/enema mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg_ mapping) of sentinel lymph node(s) including injection of non-radioactive dye when per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7503","description":"Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg_ mapping) of sentinel lymph node(s) including injection of non-radioactive dye when per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise external hemorrhoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46083","description":"Incise external hemorrhoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMB0","description":"ICD-MKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flowcytometry/tc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88185","description":"Flowcytometry/tc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDND1","description":"ICD-FDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJF1","description":"ICD-NKJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBD0","description":"ICD-MDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHC0","description":"ICD-BBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHB0","description":"ICD-BBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKB0","description":"ICD-OAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVC1","description":"ICD-KEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0973T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","description":"CPT-0973T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28107","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLE0","description":"ICD-GGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARD1","description":"ICD-HARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE240","description":"Special Care Low _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00540","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","description":"CPT-00540","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQB0","description":"ICD-KCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14D","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTB0","description":"ICD-MHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPA0","description":"ICD-JBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise additional leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27692","description":"Revise additional leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Use of speech device service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92609","description":"Use of speech device service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level IV_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0753T","description":"Digitization of glass microscope slides for level IV_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antiviral not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9244","description":"Antiviral not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elastic garment/covering","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4466","description":"Elastic garment/covering","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUF0","description":"ICD-GHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYD0","description":"ICD-OFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMC1","description":"ICD-MIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPD1","description":"ICD-NDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antibody; Zika virus_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86794","description":"Antibody; Zika virus_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDD1","description":"ICD-NCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45390","description":"Colonoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSE1","description":"ICD-PBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIA1","description":"ICD-FGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEB0","description":"ICD-KDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc forearm tum deep 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25073","description":"Exc forearm tum deep 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee disart expand wall sock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5653","description":"Knee disart expand wall sock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJC1","description":"ICD-FIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Md service required for pmd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0372","description":"Md service required for pmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEB0","description":"ICD-OKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVD0","description":"ICD-NKVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD241","description":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIE1","description":"ICD-GBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIC1","description":"ICD-EAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cervical laminoplsty 2/> seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63050","description":"Cervical laminoplsty 2/> seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00750","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","description":"CPT-00750","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDB1","description":"ICD-OHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSC1","description":"ICD-LDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUA0","description":"ICD-JDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDD1","description":"ICD-ABDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMA0","description":"ICD-GGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDE1","description":"ICD-IIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cptr ophth dx img post segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92134","description":"Cptr ophth dx img post segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Had smoke b/4 anes day surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9645","description":"Had smoke b/4 anes day surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNF1","description":"ICD-NBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth neck vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35051","description":"Anesth neck vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mlh1 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81293","description":"Mlh1 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01462","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","description":"CPT-01462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plating chrome/nickel pr bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2750","description":"Plating chrome/nickel pr bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEID1","description":"ICD-NEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cervic collar w air bladders","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0856","description":"Cervic collar w air bladders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA60","description":"High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nebulizer administration set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7003","description":"Nebulizer administration set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVB1","description":"ICD-NFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC34","description":"High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Histotripsy (Ie_ Non-Thermal Ablation Via Acoustic Energy Delivery) Of Malignant Hepatocellular Tissue_ Including Image Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0686T","description":"Histotripsy (Ie_ Non-Thermal Ablation Via Acoustic Energy Delivery) Of Malignant Hepatocellular Tissue_ Including Image Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28B","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1437","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","description":"HCPCS-M1437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDD1","description":"ICD-NGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hep b core antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86705","description":"Hep b core antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plt_ aph/pher_ l/r_ cmv-neg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9055","description":"Plt_ aph/pher_ l/r_ cmv-neg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hand restoration no fingers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6910","description":"Hand restoration no fingers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGE0","description":"ICD-NJGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB140","description":"Clinically Complex _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplantation Medicine (Allograft Rejection_ Pediatric Liver And Small Bowel)_ Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells_ Utilizing Whole P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81560","description":"Transplantation Medicine (Allograft Rejection_ Pediatric Liver And Small Bowel)_ Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells_ Utilizing Whole P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMC1","description":"ICD-IFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBD1","description":"ICD-CDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEA0","description":"ICD-CEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9728","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hib prp-t vaccine 4 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90648","description":"Hib prp-t vaccine 4 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTE0","description":"ICD-BCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMF1","description":"ICD-MEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ef adult fluids and electro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4102","description":"Ef adult fluids and electro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWC0","description":"ICD-DGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Human epididymis protein 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86305","description":"Human epididymis protein 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPF0","description":"ICD-JHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4338","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","description":"HCPCS-Q4338","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHB1","description":"ICD-OKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUD1","description":"ICD-FCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA24","description":"Default_ /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bortezomib_ (dr. reddy_s)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9046","description":"Injection_ bortezomib_ (dr. reddy_s)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transposition of vein valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34510","description":"Transposition of vein valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1206","description":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with pregnancy during adjuvant treatment course","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2205","description":"Patients with pregnancy during adjuvant treatment course","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACB0","description":"ICD-MACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tetanus toxoid adsorbed_ for intramuscular or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90703","description":"Tetanus toxoid adsorbed_ for intramuscular or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J0167","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","description":"HCPCS-J0167","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA21","description":"ICD-2FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special base curve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2730","description":"Special base curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65101","description":"Removal of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tmj diagnostic arthroscopy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7872","description":"Tmj diagnostic arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNC0","description":"ICD-NFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hpv high-risk types","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87624","description":"Hpv high-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEID1","description":"ICD-OEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8856","description":"Ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACF0","description":"ICD-MACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ chloroprocaine hydrochloride (clorotekal)_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2402","description":"Injection_ chloroprocaine hydrochloride (clorotekal)_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHF1","description":"ICD-NLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1138","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microsurgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69990","description":"Microsurgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARE0","description":"ICD-DARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJD0","description":"ICD-CFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0105","description":"HCPCS-C0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQA1","description":"ICD-PAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 90-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0518","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 90-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDE0","description":"ICD-ACDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGED0","description":"ICD-FGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0009","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRC1","description":"ICD-DCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 3999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4724","description":"Dialys sol fld vol > 3999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28X","description":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYF1","description":"ICD-PDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJB1","description":"ICD-JAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXB1","description":"ICD-FGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUD0","description":"ICD-FDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prq card revasc mi 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92941","description":"Prq card revasc mi 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A7021","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","description":"HCPCS-A7021","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSE1","description":"ICD-CBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRC0","description":"ICD-HDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKC1","description":"ICD-FIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEA0","description":"ICD-GGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEF0","description":"ICD-JDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laminotomy addl lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63044","description":"Laminotomy addl lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00632","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","description":"CPT-00632","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parvovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86747","description":"Parvovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skin sub graft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15272","description":"Skin sub graft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove brain tumor w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62164","description":"Remove brain tumor w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGC0","description":"ICD-GGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13C","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPC0","description":"ICD-OHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQE0","description":"ICD-GCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHE1","description":"ICD-KAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg3a no progre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9065","description":"Onc dx nsclc stg3a no progre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who did not have a follow-up assessment within 120 days of the index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1363","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rem odontogen cyst > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7451","description":"Rem odontogen cyst > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVF0","description":"ICD-GGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWE1","description":"ICD-HAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEC1","description":"ICD-MLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHB0","description":"ICD-MDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWE1","description":"ICD-DCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLF1","description":"ICD-MGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1129","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITA1","description":"ICD-FITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exploration of middle ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69440","description":"Exploration of middle ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEB0","description":"ICD-OIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHD1","description":"ICD-FFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Compre dental tx adolescent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8080","description":"Compre dental tx adolescent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBB0","description":"ICD-KCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDC1","description":"ICD-OLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair degenerated kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27418","description":"Repair degenerated kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0801T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Routine ophthalmological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0621","description":"Routine ophthalmological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disposable compressor filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7013","description":"Disposable compressor filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/o manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21310","description":"Closed tx nose fx w/o manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01844","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","description":"CPT-01844","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Art byp grft axill/fem/fem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35533","description":"Art byp grft axill/fem/fem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove spinal canal catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62355","description":"Remove spinal canal catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0104","description":"HCPCS-B0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Uvl pnl 2 sq ft or less","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0691","description":"Uvl pnl 2 sq ft or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flexible metal hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6610","description":"Flexible metal hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASC1","description":"ICD-KASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAC0","description":"ICD-IEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ingest challenge ini 120 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95076","description":"Ingest challenge ini 120 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15853","description":"Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIC0","description":"ICD-CBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Triptorelin pamoate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3315","description":"Triptorelin pamoate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLF0","description":"ICD-KDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDC0","description":"ICD-BIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWC0","description":"ICD-GHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indic for head ct not valid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9533","description":"Indic for head ct not valid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTF0","description":"ICD-EGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ efbemalenograstim alfa-vuxw_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9361","description":"Injection_ efbemalenograstim alfa-vuxw_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHE0","description":"ICD-BBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert bladder catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51701","description":"Insert bladder catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 6 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP06","description":"Auto.test pane pricing code_ 6 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGB0","description":"ICD-BCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICC0","description":"ICD-FICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth cleft palate repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17251","description":"Anesth cleft palate repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA43","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUB1","description":"ICD-JFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRE1","description":"ICD-LHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ini phq9 >9 no remiss >=5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9395","description":"Ini phq9 >9 no remiss >=5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITC1","description":"ICD-CITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWE0","description":"ICD-PEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4429","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","description":"HCPCS-Q4429","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Surgical opening of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42955","description":"Surgical opening of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial amputation of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28825","description":"Partial amputation of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD111","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCID0","description":"ICD-JCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTE0","description":"ICD-OJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKC1","description":"ICD-GGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUA1","description":"ICD-BAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXD1","description":"ICD-GEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOF1","description":"ICD-GIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGF0","description":"ICD-BDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Correction of astigmatism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65772","description":"Correction of astigmatism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy wbx sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32604","description":"Thoracoscopy wbx sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTD1","description":"ICD-ODTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPB0","description":"ICD-NBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI neck spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72142","description":"MRI neck spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Egd cautery tumor polyp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43250","description":"Egd cautery tumor polyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOE1","description":"ICD-CFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical services after hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99050","description":"Medical services after hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01820","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","description":"CPT-01820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00220","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","description":"CPT-00220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCA0","description":"ICD-ADCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Post op service lvrs min 6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0305","description":"Post op service lvrs min 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tympanostomy (Requiring Insertion Of Ventilating Tube)_ Using An Automated Tube Delivery System_ Iontophoresis Local Anesthesia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0583T","description":"Tympanostomy (Requiring Insertion Of Ventilating Tube)_ Using An Automated Tube Delivery System_ Iontophoresis Local Anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-G0560","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","description":"HCPCS-G0560","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1004","description":"HCPCS-A1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUD0","description":"ICD-GEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAE0","description":"ICD-FDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIA0","description":"ICD-GEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVD1","description":"ICD-GDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTC0","description":"ICD-FCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIE0","description":"ICD-OFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug assay cyclosporine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80158","description":"Drug assay cyclosporine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIID0","description":"ICD-AIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ixabepilone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9207","description":"Ixabepilone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWA1","description":"ICD-HEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPD1","description":"ICD-ODPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKA0","description":"ICD-CAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALC1","description":"ICD-NALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYA1","description":"ICD-LGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exercise w/hemodynamic meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93464","description":"Exercise w/hemodynamic meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDD0","description":"ICD-MIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of head brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20661","description":"Application of head brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERD1","description":"ICD-PERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCB0","description":"ICD-NBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55801","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGE1","description":"ICD-BAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score neck/ts < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8672","description":"Fun stat score neck/ts < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWE1","description":"ICD-OHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSC0","description":"ICD-OBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBA1","description":"ICD-JFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay phosphatidylglycerol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84081","description":"Assay phosphatidylglycerol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBE1","description":"ICD-BHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUF1","description":"ICD-CAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe sole wedge between sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3370","description":"Shoe sole wedge between sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEF0","description":"ICD-MBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBF1","description":"ICD-NDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAF0","description":"ICD-FAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETB1","description":"ICD-EETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUA0","description":"ICD-IHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFF0","description":"ICD-GBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBF1","description":"ICD-GIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hast w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94452","description":"Hast w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHE0","description":"ICD-BHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBE0","description":"ICD-GIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSD1","description":"ICD-PCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 2.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12031","description":"Intmd rpr s/a/t/ext 2.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRF0","description":"ICD-OCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSC1","description":"ICD-HCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC151","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ex arm/elbow tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24076","description":"Ex arm/elbow tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKA0","description":"ICD-BDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCB0","description":"ICD-EGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ic inf pbw 2501-5000 g subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99480","description":"Ic inf pbw 2501-5000 g subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFB1","description":"ICD-NHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue culture skin/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88233","description":"Tissue culture skin/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKF1","description":"ICD-JBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA26","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ ha_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2635","description":"Brachytx_ non-str_ ha_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ alfentanil hydrochloride_ 500 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0216","description":"Injection_ alfentanil hydrochloride_ 500 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHD1","description":"ICD-IAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75451","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Islet cell tissue transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2102","description":"Islet cell tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9750","description":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHB1","description":"ICD-BGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAB1","description":"ICD-GDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTA1","description":"ICD-FFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25000","description":"Incision of tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOF1","description":"ICD-HEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"AmchoPlast_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4316","description":"AmchoPlast_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","description":"HCPCS-M1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVF1","description":"ICD-FIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 22 And Functional Status Measure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2145","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 22 And Functional Status Measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove infected skull bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61501","description":"Remove infected skull bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Collect sweat for test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89230","description":"Collect sweat for test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADA1","description":"ICD-KADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLE0","description":"ICD-NDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4360","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","description":"HCPCS-Q4360","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQF0","description":"ICD-GCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKC1","description":"ICD-GBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat kneecap fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27524","description":"Treat kneecap fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL55","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARE0","description":"ICD-HARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1C","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHF0","description":"ICD-CIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHME1","description":"ICD-BHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLC0","description":"ICD-BBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTA0","description":"ICD-KGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWA1","description":"ICD-OAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAD0","description":"ICD-MCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove pharynx foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42809","description":"Remove pharynx foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBA1","description":"ICD-NDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of 5-hiaa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83497","description":"Assay of 5-hiaa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NEURO INH ATAXIA DNA 51 GENE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0217U","description":"NEURO INH ATAXIA DNA 51 GENE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt couns 4 txmnt opt prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4163F","description":"Pt couns 4 txmnt opt prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation of wheezing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94070","description":"Evaluation of wheezing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext pwrd shlder lock/unlock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6648","description":"Ext pwrd shlder lock/unlock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Eeg awake and asleep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95819","description":"Eeg awake and asleep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; removal_ each balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0550T","description":"Transperineal periurethral balloon continence device; removal_ each balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occ orthotic device adjust","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7881","description":"Occ orthotic device adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"SurFactor or NuDyn_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4233","description":"SurFactor or NuDyn_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of head injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62010","description":"Treatment of head injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTD1","description":"ICD-IBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSE1","description":"ICD-CGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSA1","description":"ICD-DCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTB0","description":"ICD-MJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crown porcelain fused base m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2751","description":"Crown porcelain fused base m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGE1","description":"ICD-KGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDB1","description":"ICD-BHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interim labor facility globa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4005","description":"Interim labor facility globa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCD1","description":"ICD-GDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSC1","description":"ICD-KHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD256","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPB1","description":"ICD-OIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lev 5 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0384","description":"Lev 5 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0B","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBID1","description":"ICD-EBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWC0","description":"ICD-DHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTB1","description":"ICD-IFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant cochlear device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69930","description":"Implant cochlear device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tumor imaging mult areas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78801","description":"Tumor imaging mult areas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFA1","description":"ICD-OFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIC1","description":"ICD-OIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRD0","description":"ICD-KHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJD1","description":"ICD-CBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immntx 4 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95133","description":"Immntx 4 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXC1","description":"ICD-GCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01650","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","description":"CPT-01650","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMB1","description":"ICD-KIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJD1","description":"ICD-CAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVD1","description":"ICD-JDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQB0","description":"ICD-KFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIED1","description":"ICD-OIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIB1","description":"ICD-NKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANE1","description":"ICD-KANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMD1","description":"ICD-GGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap insert tunnel ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49324","description":"Lap insert tunnel ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDA1","description":"ICD-BGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMD0","description":"ICD-JEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (xembify)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1558","description":"Injection_ immune globulin (xembify)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEE0","description":"ICD-AEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Organic acids total quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83918","description":"Organic acids total quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair/svc dme non-oxygen eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0739","description":"Repair/svc dme non-oxygen eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUE0","description":"ICD-JIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Uppr gi scope w/submuc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43236","description":"Uppr gi scope w/submuc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67971","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBB0","description":"ICD-FCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHB1","description":"ICD-KDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22556","description":"Thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEE0","description":"ICD-BGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhc rn e&m plan svs_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0162","description":"Hhc rn e&m plan svs_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAE1","description":"ICD-OIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant spike protein nanoparticle_ saponin-based adjuvant_5mcg/0.5m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91304","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant spike protein nanoparticle_ saponin-based adjuvant_5mcg/0.5m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANE0","description":"ICD-FANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-aafi_ biosimilar_ (Nivestym)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5110","description":"Injection_ filgrastim-aafi_ biosimilar_ (Nivestym)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0716T","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHA0","description":"ICD-GEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTA1","description":"ICD-BHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIF0","description":"ICD-JAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGF1","description":"ICD-BFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6020","description":"Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHA0","description":"ICD-JIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHND1","description":"ICD-GHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Commissure splint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5987","description":"Commissure splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAA1","description":"ICD-BBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1078T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1078T","description":"CPT-1078T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ald fm/dm adapt/boot couplin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5289","description":"Ald fm/dm adapt/boot couplin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKB1","description":"ICD-OIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEC1","description":"ICD-OAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcv >=10mg daily predniso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4194F","description":"Pt rcv >=10mg daily predniso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCE1","description":"ICD-OCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hospice in inpatient psych","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5008","description":"Hospice in inpatient psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGD1","description":"ICD-NEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0704","description":"HCPCS-B0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Afo w/ankle joint_ prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1971","description":"Afo w/ankle joint_ prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFC0","description":"ICD-OEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pathogen reduced platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9072","description":"Pathogen reduced platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUA1","description":"ICD-CDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCD0","description":"ICD-GDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-92637","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","description":"CPT-92637","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Battery cables","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4612","description":"Battery cables","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ligation of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55450","description":"Ligation of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE155","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Com wrap-around sv_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2021","description":"Com wrap-around sv_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0665U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0665U","description":"CPT-0665U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSE0","description":"ICD-GDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTC1","description":"ICD-CDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYB1","description":"ICD-LIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJC1","description":"ICD-NJJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUD0","description":"ICD-ODUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSF0","description":"ICD-KFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMF0","description":"ICD-IHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Urinal female jug-type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0326","description":"Urinal female jug-type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAD0","description":"ICD-GCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93017","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGB0","description":"ICD-KIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc rsn no adeno/neopl detec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9496","description":"Doc rsn no adeno/neopl detec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6559","description":"Gradient compression stocking_ full length/chap style_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30150","description":"Partial removal of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVB0","description":"ICD-BCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAC1","description":"ICD-MLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESD1","description":"ICD-OESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skills training and development_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2038","description":"Skills training and development_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36481","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE154","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWD0","description":"ICD-KGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15946","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENA0","description":"ICD-BENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost clsd pouch w att st barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4387","description":"Ost clsd pouch w att st barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUC1","description":"ICD-AGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTE0","description":"ICD-FHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKB0","description":"ICD-JAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cd4+cell count <200cells/mm3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3494F","description":"Cd4+cell count <200cells/mm3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCD1","description":"ICD-MFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOE0","description":"ICD-CBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHE1","description":"ICD-JCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54120","description":"Partial removal of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6122","description":"Implant Supported Retainer For Metal Fpd - Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj foramen epidural c/t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64479","description":"Inj foramen epidural c/t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gjb2 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81252","description":"Gjb2 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4422","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","description":"HCPCS-Q4422","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0945T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","description":"CPT-0945T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endo poly hip_ pneu/hyd/rot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5961","description":"Endo poly hip_ pneu/hyd/rot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruct premalg lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17000","description":"Destruct premalg lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gallium ga-68_ dotatate_ diagnostic_ 0.1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9587","description":"Gallium ga-68_ dotatate_ diagnostic_ 0.1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect/debride pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48105","description":"Resect/debride pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBA0","description":"ICD-CCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJB0","description":"ICD-NBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYA1","description":"ICD-CCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Affinity1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4159","description":"Affinity1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADF0","description":"ICD-OADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Odontics transosteal implnt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6050","description":"Odontics transosteal implnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22D","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMD1","description":"ICD-EAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Phototherap keratect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0812","description":"Phototherap keratect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJA1","description":"ICD-NGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBA0","description":"ICD-KFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of sutures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0630","description":"Removal of sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0454T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJF1","description":"ICD-GHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rbc osmotic fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85555","description":"Rbc osmotic fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q5150","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","description":"HCPCS-Q5150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVF1","description":"ICD-CIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC31","description":"ICD-4KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLC1","description":"ICD-FGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muramidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85549","description":"Muramidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBA0","description":"ICD-OBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOF1","description":"ICD-PIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11772","description":"Remove pilonidal cyst compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA11","description":"ICD-1BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso r fram soft ant pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0466","description":"Tlso r fram soft ant pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTD0","description":"ICD-MDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSD0","description":"ICD-KCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQB0","description":"ICD-KGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4436","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","description":"HCPCS-Q4436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect talus/calcaneus tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27647","description":"Resect talus/calcaneus tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28320","description":"Repair of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDF0","description":"ICD-JBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBE1","description":"ICD-MHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFE1","description":"ICD-GDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ct lower extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73700","description":"Ct lower extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Diast bp <80 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3078F","description":"Diast bp <80 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl bifo 7.25-12/4.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2213","description":"Lens sphcyl bifo 7.25-12/4.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDND0","description":"ICD-KDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTA0","description":"ICD-NDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHD0","description":"ICD-NJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRC1","description":"ICD-HFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Contact layer > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6208","description":"Contact layer > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEF1","description":"ICD-IFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJA1","description":"ICD-BCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of anal tags","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46230","description":"Removal of anal tags","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endoscopic submucosal dissection (ESD)_ including endoscopyor colonoscopy_ mucosal closure_ when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9779","description":"Endoscopic submucosal dissection (ESD)_ including endoscopyor colonoscopy_ mucosal closure_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFD0","description":"ICD-FBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOE1","description":"ICD-PAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIF1","description":"ICD-CEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Frnt cstr cmpl sem-pneum tir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0072","description":"Frnt cstr cmpl sem-pneum tir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0D","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUB1","description":"ICD-OCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Visco-3_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7333","description":"Hyaluronan or derivative_ Visco-3_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPC0","description":"ICD-NIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove part lumbar vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22114","description":"Remove part lumbar vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit for hemodialysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99512","description":"Home visit for hemodialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIID1","description":"ICD-EIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periodontal scaling & root","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4341","description":"Periodontal scaling & root","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXE1","description":"ICD-NCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUF1","description":"ICD-ODUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCA1","description":"ICD-MKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove sutures same surgeon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15850","description":"Remove sutures same surgeon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKA0","description":"ICD-JFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pov group 1 std up to 300lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0800","description":"Pov group 1 std up to 300lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAD1","description":"ICD-KDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Venipuncture home/snf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9529","description":"Venipuncture home/snf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHF0","description":"ICD-EHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEC0","description":"ICD-CEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52240","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore chest vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35820","description":"Explore chest vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocolld drg filler paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6240","description":"Hydrocolld drg filler paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWC0","description":"ICD-OJWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEB1","description":"ICD-FBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFE0","description":"ICD-OKFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1903","description":"HCPCS-A1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPD1","description":"ICD-JEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Washed red blood cells unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9022","description":"Washed red blood cells unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVD1","description":"ICD-BDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J1271","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","description":"HCPCS-J1271","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8I","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEF1","description":"ICD-EBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9487","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXF1","description":"ICD-OJXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLA0","description":"ICD-CFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESB0","description":"ICD-GESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res W/Pne Billd Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9679","description":"Onsite Ac C Tx Nsg Fac Res W/Pne Billd Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Consult inc prep of slides","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0485","description":"Consult inc prep of slides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES250","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEA0","description":"ICD-OAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd serv 2-3 vsts p mo <2yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90952","description":"Esrd serv 2-3 vsts p mo <2yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGB0","description":"ICD-KAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj multihance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9577","description":"Inj multihance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIC0","description":"ICD-OGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1463","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","description":"HCPCS-M1463","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUF0","description":"ICD-CIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4356","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","description":"HCPCS-Q4356","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAB1","description":"ICD-FDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA106","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cep72 (Centrosomal Protein_ 72-Kda)_ Nudt15 (Nudix Hydrolase 15) And Tpmt (Thiopurine S-Methyltransferase) (Eg_ Drug Metabolism) Gene Analysis_ Common Variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0286U","description":"Cep72 (Centrosomal Protein_ 72-Kda)_ Nudt15 (Nudix Hydrolase 15) And Tpmt (Thiopurine S-Methyltransferase) (Eg_ Drug Metabolism) Gene Analysis_ Common Variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transplant of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27396","description":"Transplant of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAC0","description":"ICD-FEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconstruct windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31781","description":"Reconstruct windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIF0","description":"ICD-KFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD214","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inject spine lumbar/sacral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62311","description":"Inject spine lumbar/sacral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWA0","description":"ICD-OCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair clitoris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56805","description":"Repair clitoris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB11","description":"ICD-3BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWE0","description":"ICD-KIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chemo intralesional up to 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96405","description":"Chemo intralesional up to 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCD0","description":"ICD-NKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTB0","description":"ICD-IHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJE0","description":"ICD-BBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resect foot/toe tumor < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28046","description":"Resect foot/toe tumor < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCE1","description":"ICD-CBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDB1","description":"ICD-GCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25272","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Addition to lower extremity_ user adjustable_ mechanical_ residual limb volume management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5783","description":"Addition to lower extremity_ user adjustable_ mechanical_ residual limb volume management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rcmnd flw-up 10 yrs docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0528F","description":"Rcmnd flw-up 10 yrs docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23670","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJE1","description":"ICD-NEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFC0","description":"ICD-JEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cesarean delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59514","description":"Cesarean delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Services of skilled nurse in home health setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0154","description":"Services of skilled nurse in home health setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemoglobin a1c level >9.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3046F","description":"Hemoglobin a1c level >9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hemin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1640","description":"Hemin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Hymovis_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9471","description":"Hyaluronan or derivative_ Hymovis_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg1a-b or 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9114","description":"Onc dx ovarian stg1a-b or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVC1","description":"ICD-KHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8A","description":"Low Rehab_ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKC0","description":"ICD-CBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pin finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26776","description":"Pin finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9153","description":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth tympanotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12651","description":"Anesth tympanotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUF0","description":"ICD-AGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWF1","description":"ICD-LEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: low complexity_ requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97161","description":"Physical therapy evaluation: low complexity_ requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAC1","description":"ICD-ADAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Group psychotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90853","description":"Group psychotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11313","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCB0","description":"ICD-CHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBA0","description":"ICD-CHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXF1","description":"ICD-OIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVB1","description":"ICD-NHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHB1","description":"ICD-CGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace/revise brain shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62230","description":"Replace/revise brain shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (xellia) not therapeutically equivalent to j0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0873","description":"Injection_ daptomycin (xellia) not therapeutically equivalent to j0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69603","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Methylergonovin maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2210","description":"Methylergonovin maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTE1","description":"ICD-EBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKC0","description":"ICD-FDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE135","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27216","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARB0","description":"ICD-LARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98980","description":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYE0","description":"ICD-PDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47360","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures complete mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5120","description":"Dentures complete mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEE0","description":"ICD-IHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJA0","description":"ICD-GBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31255","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphcyl trifocal 4.00/>6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2306","description":"Lens sphcyl trifocal 4.00/>6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQA1","description":"ICD-CGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95724","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLF0","description":"ICD-KHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOC1","description":"ICD-OIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUC1","description":"ICD-CCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX52","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYB1","description":"ICD-HFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCD1","description":"ICD-CGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA25","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDF0","description":"ICD-FHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEC1","description":"ICD-GCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2126","description":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHB1","description":"ICD-GIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAF1","description":"ICD-JBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILD1","description":"ICD-OILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lymphocytotoxicity assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86805","description":"Lymphocytotoxicity assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKF0","description":"ICD-NIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDME1","description":"ICD-KDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBE0","description":"ICD-OJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Site not small cell lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9285","description":"Site not small cell lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNA0","description":"ICD-NDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63085","description":"Remove vert body dcmprn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWE0","description":"ICD-KAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC144","description":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lutetium Lu 177_ dotatate_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9031","description":"Lutetium Lu 177_ dotatate_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay glucose blood quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82947","description":"Assay glucose blood quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ levoleucovorin (khapzory)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0642","description":"Injection_ levoleucovorin (khapzory)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27707","description":"Incision of fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCED0","description":"ICD-GCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUF1","description":"ICD-EAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair biceps tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23430","description":"Repair biceps tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rv1 vacc 2 dose live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90681","description":"Rv1 vacc 2 dose live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVE0","description":"ICD-NGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Esrd demo bundle level i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9013","description":"Esrd demo bundle level i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Muscle test thor paraspinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95869","description":"Muscle test thor paraspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (asceniv)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9072","description":"Injection_ immune globulin (asceniv)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dental coronoidectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7991","description":"Dental coronoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQC1","description":"ICD-GGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Needle localization by xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77002","description":"Needle localization by xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXF1","description":"ICD-CEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQD0","description":"ICD-DBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0536U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","description":"CPT-0536U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHE0","description":"ICD-MLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQA0","description":"ICD-DCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAC1","description":"ICD-NBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUD1","description":"ICD-ICUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQC0","description":"ICD-LEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAE0","description":"ICD-FIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A6517","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","description":"HCPCS-A6517","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOD1","description":"ICD-DBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 45 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90836","description":"Psytx pt&/fam w/e&m 45 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigid plastic pre one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0490","description":"Tlso rigid plastic pre one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Molecular pathology interpr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0452","description":"Molecular pathology interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJC1","description":"ICD-OIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58920","description":"Partial removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2B","description":"Very High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tumor imaging limited area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78800","description":"Tumor imaging limited area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESD0","description":"ICD-KESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21260","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTF1","description":"ICD-JBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIA0","description":"ICD-FFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Portable 02 contents_ liquid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0444","description":"Portable 02 contents_ liquid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5D","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAE1","description":"ICD-CBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEB0","description":"ICD-AIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHF0","description":"ICD-CDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGF0","description":"ICD-FGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Multisys ther/juvenile 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2033","description":"Multisys ther/juvenile 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYD0","description":"ICD-GAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8D","description":"Low Rehab_ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of serum potassium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84132","description":"Assay of serum potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66762","description":"Revision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHF0","description":"ICD-MLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECC0","description":"ICD-OECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2A","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acoustic cardiography_ including automated analysis of combined acoustic and electrical intervals; single_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0223T","description":"Acoustic cardiography_ including automated analysis of combined acoustic and electrical intervals; single_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCC1","description":"ICD-FDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23630","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPD0","description":"ICD-CIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEB1","description":"ICD-MCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTB1","description":"ICD-NDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6006","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYE0","description":"ICD-CCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cabergoline_ oral 0.25mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8515","description":"Cabergoline_ oral 0.25mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDF1","description":"ICD-ABDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Scr c/v cyto_ autosys_ rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0148","description":"Scr c/v cyto_ autosys_ rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRC1","description":"ICD-CDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy trisom risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0009M","description":"Fetal aneuploidy trisom risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21A","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL23","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAA0","description":"ICD-CIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0026","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHE0","description":"ICD-CGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1119","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELB0","description":"ICD-JELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone scn b/4 txmnt/aftr dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3269F","description":"Bone scn b/4 txmnt/aftr dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28H","description":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-98003","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","description":"CPT-98003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHC1","description":"ICD-AGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTA1","description":"ICD-EHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAE1","description":"ICD-NAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA01","description":"Low Rehab_ ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1103T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1103T","description":"CPT-1103T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJC0","description":"ICD-GGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE125","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRE1","description":"ICD-CIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Elevate footrest articulate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0053","description":"Elevate footrest articulate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB116","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1395","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","description":"HCPCS-M1395","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) Pain At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (V","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2139","description":"Back Pain Measured By The Visual Analog Scale (Vas) Pain At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (V","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Relese_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4257","description":"Relese_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPF0","description":"ICD-BDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAA0","description":"ICD-MBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFB1","description":"ICD-KEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99345","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYF1","description":"ICD-CIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iiv3 vaccine 6-35 months im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90657","description":"Iiv3 vaccine 6-35 months im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Glaucoma scrn hgh risk direc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0118","description":"Glaucoma scrn hgh risk direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC225","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITC1","description":"ICD-AITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVD0","description":"ICD-KBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQF0","description":"ICD-GGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; subsequent vein(s) treated in a si","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36474","description":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; subsequent vein(s) treated in a si","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETE0","description":"ICD-GETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Non-sterile gloves","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4927","description":"Non-sterile gloves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVF1","description":"ICD-JHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIA1","description":"ICD-EBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0477","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUB1","description":"ICD-ECUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABF0","description":"ICD-AABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth lumbar puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63551","description":"Anesth lumbar puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPB0","description":"ICD-CAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGB0","description":"ICD-JCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0401","description":"HCPCS-C0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQE0","description":"ICD-CGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"FUT2 GNOTYP FUT2 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0186U","description":"FUT2 GNOTYP FUT2 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTF0","description":"ICD-NGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"C-1 esterase_ berinert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0597","description":"C-1 esterase_ berinert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Throat x-ray & fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70370","description":"Throat x-ray & fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWF0","description":"ICD-OJWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNA1","description":"ICD-NHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLA1","description":"ICD-CBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQE0","description":"ICD-OAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cntct lens pmma-toric/prism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2501","description":"Cntct lens pmma-toric/prism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMD1","description":"ICD-GDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cinacalcet_ oral_ 1 mg_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0604","description":"Cinacalcet_ oral_ 1 mg_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKB0","description":"ICD-FGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB33","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Microprocessor control uplmb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6882","description":"Microprocessor control uplmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMF0","description":"ICD-MLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMD0","description":"ICD-GBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Conization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57520","description":"Conization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Artery to vein shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36835","description":"Artery to vein shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISB0","description":"ICD-KISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAB0","description":"ICD-NAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEA1","description":"ICD-JGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIE1","description":"ICD-MFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDA0","description":"ICD-NGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No srch for ct in 12mo norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9342","description":"No srch for ct in 12mo norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXA1","description":"ICD-GHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHB1","description":"ICD-NDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Quantification Of The Structure And Composition O","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0712T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Quantification Of The Structure And Composition O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHB1","description":"ICD-NIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYB0","description":"ICD-KGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMA0","description":"ICD-IDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEF1","description":"ICD-MHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJD0","description":"ICD-NEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc dx colon t4_ n0 w/o prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9085","description":"Onc dx colon t4_ n0 w/o prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALA1","description":"ICD-GALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Calculation Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77091","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Calculation Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC155","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE116","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYB1","description":"ICD-KHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSB0","description":"ICD-OGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25150","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBB1","description":"ICD-KIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Home vent mgmt supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94005","description":"Home vent mgmt supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAF1","description":"ICD-NEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0517","description":"Removal of non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAC0","description":"ICD-OHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDD0","description":"ICD-GHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Open tx nose fx w/skele fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21330","description":"Open tx nose fx w/skele fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17282","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPA1","description":"ICD-JGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antiepileptics nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80341","description":"Antiepileptics nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Symptoms improved/consist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1450F","description":"Symptoms improved/consist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIF0","description":"ICD-NDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14C","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Buprenorphine (Oral); Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2079","description":"Take-Home Supply Of Buprenorphine (Oral); Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJA0","description":"ICD-OFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4440","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","description":"HCPCS-Q4440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADB1","description":"ICD-BADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Interferon beta-1b / .25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1830","description":"Interferon beta-1b / .25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHE1","description":"ICD-CGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rv5 vacc 3 dose live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90680","description":"Rv5 vacc 3 dose live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAE0","description":"ICD-NFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Antipsychotic rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4065F","description":"Antipsychotic rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQD1","description":"ICD-HHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEE0","description":"ICD-NJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Azithromycin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0456","description":"Azithromycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone/skin graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20969","description":"Bone/skin graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPF0","description":"ICD-BCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pt rcvng warf thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4300F","description":"Pt rcvng warf thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEA1","description":"ICD-NFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crutch underarm pair wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0112","description":"Crutch underarm pair wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRE1","description":"ICD-GFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-3GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB21","description":"ICD-3GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEA1","description":"ICD-BHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35355","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dentures rebase cmplt maxil","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5710","description":"Dentures rebase cmplt maxil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYD0","description":"ICD-DIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Solid caster tire_ integrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2392","description":"Solid caster tire_ integrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOB1","description":"ICD-OLOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHB0","description":"ICD-OBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIA1","description":"ICD-JDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUE1","description":"ICD-FHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Iris Prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1839","description":"Iris Prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBE1","description":"ICD-IBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bupren/nal 3.1 to 6mg bupren","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0573","description":"Bupren/nal 3.1 to 6mg bupren","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXE0","description":"ICD-JGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-2 probe&revrse trnscripj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87538","description":"Hiv-2 probe&revrse trnscripj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBB1","description":"ICD-EFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRF1","description":"ICD-KIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKC0","description":"ICD-JDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPA0","description":"ICD-NIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occlusal guard - soft appliance_ full arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9945","description":"Occlusal guard - soft appliance_ full arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ADMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMA0","description":"ICD-ADMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genotype dna hiv reverse t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87901","description":"Genotype dna hiv reverse t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTB1","description":"ICD-JHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lorazepam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2060","description":"Lorazepam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUC0","description":"ICD-NGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOC1","description":"ICD-DDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBA0","description":"ICD-CDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ eteplirsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1428","description":"Injection_ eteplirsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUA0","description":"ICD-JIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOF0","description":"ICD-GBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPB0","description":"ICD-FGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEC0","description":"ICD-JDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODND0","description":"ICD-ODND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVE1","description":"ICD-KBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEC1","description":"ICD-GGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0486U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","description":"CPT-0486U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUF0","description":"ICD-CDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGA0","description":"ICD-FAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIND0","description":"ICD-JIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pwc gp 1 std port seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0813","description":"Pwc gp 1 std port seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0584T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 1","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1781","description":"vaccine administration-human papillomavirus - Dose 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25415","description":"Repair radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adult size brief/diaper med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4522","description":"Adult size brief/diaper med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJME1","description":"ICD-OJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHC0","description":"ICD-OEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPB1","description":"ICD-FHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWE0","description":"ICD-CDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWE0","description":"ICD-LFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESE1","description":"ICD-HESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth vasectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92151","description":"Anesth vasectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nasal endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31231","description":"Nasal endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuropsychia sympts assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1181F","description":"Neuropsychia sympts assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology (pan-tumor)_ genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR)_ whole blood_ reported as a high or low proba","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0332U","description":"Oncology (pan-tumor)_ genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR)_ whole blood_ reported as a high or low proba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDC1","description":"ICD-OHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCD1","description":"ICD-OJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrocollator unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0225","description":"Hydrocollator unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUE0","description":"ICD-AEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5995","description":"Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYA0","description":"ICD-LGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUA0","description":"ICD-CCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Symphony_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2009","description":"Symphony_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert major vessel graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33330","description":"Insert major vessel graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0796T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stenger test speech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92577","description":"Stenger test speech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPD0","description":"ICD-JBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWC1","description":"ICD-OGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25A","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45388","description":"Colonoscopy w/ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCD1","description":"ICD-MLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUC1","description":"ICD-CHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCB1","description":"ICD-OCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHF1","description":"ICD-MCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMB1","description":"ICD-OBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bl smear w/diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85007","description":"Bl smear w/diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAF1","description":"ICD-OJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analysis tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88358","description":"Analysis tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCD0","description":"ICD-JDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTC0","description":"ICD-EBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEE0","description":"ICD-NGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foot drop splint pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4398","description":"Foot drop splint pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVC0","description":"ICD-NHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"U1 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2365","description":"U1 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albuterol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7610","description":"Albuterol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFA1","description":"ICD-NDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQE0","description":"ICD-LEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLB1","description":"ICD-NFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTB0","description":"ICD-MGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTF0","description":"ICD-NBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICF1","description":"ICD-CICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHE0","description":"ICD-KBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIE1","description":"ICD-EEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBF1","description":"ICD-NHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of knee ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27407","description":"Repair of knee ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ plazomicin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9039","description":"Injection_ plazomicin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cyclosporin parenteral 250mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7516","description":"Cyclosporin parenteral 250mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVE0","description":"ICD-NIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Speech lang d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9176","description":"Speech lang d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQA0","description":"ICD-HGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSF0","description":"ICD-GHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRA0","description":"ICD-HCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYF0","description":"ICD-KFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUB0","description":"ICD-MDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPF1","description":"ICD-BBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSD1","description":"ICD-GCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil (Aristada Initio)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9035","description":"Injection_ aripiprazole lauroxil (Aristada Initio)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx vert fx w/manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22315","description":"Closed tx vert fx w/manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISD1","description":"ICD-KISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRF0","description":"ICD-LFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOC0","description":"ICD-GBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWB1","description":"ICD-PFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of homovanillic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83150","description":"Assay of homovanillic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"MRI for tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77022","description":"MRI for tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intro/sheath_ fixed_non-peel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1893","description":"Intro/sheath_ fixed_non-peel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc plan hybrid/stage proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9640","description":"Doc plan hybrid/stage proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPC0","description":"ICD-GFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28D","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHD0","description":"ICD-JHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Oncology_ pharmacogenomic analysis of single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ whole blood or buccal swab_ with variant analysis_ includin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0461U","description":"Oncology_ pharmacogenomic analysis of single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ whole blood or buccal swab_ with variant analysis_ includin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUA1","description":"ICD-FFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBD1","description":"ICD-FDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABA1","description":"ICD-GABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIF0","description":"ICD-BEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PJRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRD1","description":"ICD-PJRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fetal aneuploidy DNA sequencing comparative analysis_ fetal DNA from products of conception_ reported as normal (euploidy)_ monosomy_ trisomy_ or partial deletion/duplication_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0341U","description":"Fetal aneuploidy DNA sequencing comparative analysis_ fetal DNA from products of conception_ reported as normal (euploidy)_ monosomy_ trisomy_ or partial deletion/duplication_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACF0","description":"ICD-CACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRB0","description":"ICD-GHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCC1","description":"ICD-MCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bronchial allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95070","description":"Bronchial allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSA1","description":"ICD-LCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Shoe molded plastazote cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3253","description":"Shoe molded plastazote cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replacement of precision att","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5867","description":"Replacement of precision att","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cerv artific diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22856","description":"Cerv artific diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Endosteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6012","description":"Endosteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC51","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC31","description":"ICD-1JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bx breast percut w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19100","description":"Bx breast percut w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1602","description":"HCPCS-C1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMA1","description":"ICD-CGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAND1","description":"ICD-CAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTC1","description":"ICD-OGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Annual gynecological examina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0612","description":"Annual gynecological examina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSE0","description":"ICD-HGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKE1","description":"ICD-KCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNE1","description":"ICD-OCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSB1","description":"ICD-DHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC21","description":"ICD-1DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0316","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wet-dry dressings rx recmd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4265F","description":"Wet-dry dressings rx recmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0692U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692U","description":"CPT-0692U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIA1","description":"ICD-OFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMD0","description":"ICD-GCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC221","description":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64584","description":"Removal Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJA0","description":"ICD-KGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gc chl syp documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9228","description":"Gc chl syp documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc med reas no ann srn hcv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9384","description":"Doc med reas no ann srn hcv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUC0","description":"ICD-BDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES105","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of ankle ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27698","description":"Repair of ankle ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRC1","description":"ICD-PFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEE1","description":"ICD-BDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone graft repair perimplant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6103","description":"Bone graft repair perimplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKND0","description":"ICD-NKND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-2HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA21","description":"ICD-2HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of knee 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73560","description":"X-ray exam of knee 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Anesth bleeding control","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91651","description":"Anesth bleeding control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tobramycin comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7685","description":"Tobramycin comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clsd reduct simpl maxilla fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7620","description":"Clsd reduct simpl maxilla fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQA0","description":"ICD-CCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAD0","description":"ICD-KIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inter active grp psych parti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0411","description":"Inter active grp psych parti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMF0","description":"ICD-BFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Safety equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0700","description":"Safety equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQE0","description":"ICD-LGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPD0","description":"ICD-CFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMF0","description":"ICD-NGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9700","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid >","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4178","description":"Parenteral sol amino acid >","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJF1","description":"ICD-FIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special supplies phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99070","description":"Special supplies phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIE1","description":"ICD-NLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXE1","description":"ICD-FIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40801","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA156","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFB1","description":"ICD-CHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMF1","description":"ICD-EIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documentation Of Patient Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Patient Declined_ Other Patient Reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2094","description":"Documentation Of Patient Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Patient Declined_ Other Patient Reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Composite drsg > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6205","description":"Composite drsg > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ped compr care pkg_ per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1026","description":"Ped compr care pkg_ per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Craniectomy_ suboccipital; for mesencephalic tractotomy or pedunculotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61480","description":"Craniectomy_ suboccipital; for mesencephalic tractotomy or pedunculotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUF1","description":"ICD-BBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQF0","description":"ICD-KDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYC0","description":"ICD-LFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUC1","description":"ICD-IHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Thoracoscopy pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32671","description":"Thoracoscopy pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC213","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHA1","description":"ICD-ABHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAA1","description":"ICD-NCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPC1","description":"ICD-CAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-37277","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","description":"CPT-37277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML17","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQA1","description":"ICD-HEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADC0","description":"ICD-AADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABA1","description":"ICD-IABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUE1","description":"ICD-NKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Place needle in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36000","description":"Place needle in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFD0","description":"ICD-FDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTA0","description":"ICD-ODTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC210","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure_ unless_ since","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9722","description":"Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure_ unless_ since","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEF0","description":"ICD-BBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECB1","description":"ICD-IECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Beremagene geperpavec-svdt for topical administration_ containing nominal 5 x 10^9 pfu/ml vector genomes_ per 0.1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3401","description":"Beremagene geperpavec-svdt for topical administration_ containing nominal 5 x 10^9 pfu/ml vector genomes_ per 0.1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPF1","description":"ICD-BFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBME0","description":"ICD-BBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVC1","description":"ICD-NFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCB1","description":"ICD-GFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPD1","description":"ICD-GEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIB0","description":"ICD-AGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTD0","description":"ICD-NDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWE1","description":"ICD-KHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXC1","description":"ICD-NHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUF0","description":"ICD-IDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAC0","description":"ICD-EHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of liver duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47400","description":"Incision of liver duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cast sup shrt leg ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4039","description":"Cast sup shrt leg ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc esrd dia trans preg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9231","description":"Doc esrd dia trans preg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILA1","description":"ICD-JILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tempr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0278T","description":"Tempr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73030","description":"X-ray exam of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Legion pneumo dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87542","description":"Legion pneumo dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC141","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sleep apnea assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8839","description":"Sleep apnea assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUF1","description":"ICD-ICUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0949T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","description":"CPT-0949T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intravertebral body fracture augmentation with implant (e.g._ metal_ polymer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1062","description":"Intravertebral body fracture augmentation with implant (e.g._ metal_ polymer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implantation of anterior segment intraocular nonbiodegradable drug-eluting system_ internal approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0660T","description":"Implantation of anterior segment intraocular nonbiodegradable drug-eluting system_ internal approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0687U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687U","description":"CPT-0687U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20B","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ pertuzumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9306","description":"Injection_ pertuzumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQE0","description":"ICD-LCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSD1","description":"ICD-OKSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert epicard eltrd open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33202","description":"Insert epicard eltrd open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDF1","description":"ICD-ACDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Crisis intervention per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9484","description":"Crisis intervention per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10A","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11C","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDF1","description":"ICD-FEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Micro w exam of surg margins","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0474","description":"Micro w exam of surg margins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIC1","description":"ICD-NJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTF0","description":"ICD-CBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXC1","description":"ICD-GGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCC1","description":"ICD-CFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTC1","description":"ICD-OKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJC1","description":"ICD-FHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14B","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fit spectacles monofocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92340","description":"Fit spectacles monofocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incision of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50065","description":"Incision of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCA0","description":"ICD-CGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transcochlear approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61596","description":"Transcochlear approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA31","description":"High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Personalized_ anterior and lateral interbody cage (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1831","description":"Personalized_ anterior and lateral interbody cage (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Day habil waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2020","description":"Day habil waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARC0","description":"ICD-GARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYD0","description":"ICD-DDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27501","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMC0","description":"ICD-KDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHD1","description":"ICD-BDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLF1","description":"ICD-NFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFF1","description":"ICD-FCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD121","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDD1","description":"ICD-BEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMD0","description":"ICD-NDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKB1","description":"ICD-OFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWA0","description":"ICD-CEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEB0","description":"ICD-GFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJD0","description":"ICD-GBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ bezlotoxumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0565","description":"Injection_ bezlotoxumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mammogram one breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77055","description":"Mammogram one breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"1 or no ct sinus w/in 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9354","description":"1 or no ct sinus w/in 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00880","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","description":"CPT-00880","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Xray control catheter change","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75984","description":"Xray control catheter change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAE1","description":"ICD-GIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhc occup therapy ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0160","description":"Hhc occup therapy ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMB0","description":"ICD-CIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Admin + supply_ tositumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3001","description":"Admin + supply_ tositumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCE1","description":"ICD-FFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPE0","description":"ICD-OEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1C","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Loxapine for inhalation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2062","description":"Loxapine for inhalation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHD1","description":"ICD-NBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACF1","description":"ICD-JACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIA0","description":"ICD-ICIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES340","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psytx crisis ea addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90840","description":"Psytx crisis ea addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAC1","description":"ICD-KEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBE1","description":"ICD-FGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSC0","description":"ICD-OHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE101","description":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYD0","description":"ICD-GCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Self care goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8988","description":"Self care goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38700","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWF0","description":"ICD-LCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic evaluation(s)_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0243T","description":"Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic evaluation(s)_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWD1","description":"ICD-OGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ost skn barr w/o conv >4 sqi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4415","description":"Ost skn barr w/o conv >4 sqi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunodiffusion ouchterlony","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86331","description":"Immunodiffusion ouchterlony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIC0","description":"ICD-JEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWC1","description":"ICD-HEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRF0","description":"ICD-PHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKC0","description":"ICD-KIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECF1","description":"ICD-FECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUC1","description":"ICD-MHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOE0","description":"ICD-KFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Norsn incomp inf antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9302","description":"Norsn incomp inf antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUE0","description":"ICD-AGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Neuroeltrd stim post tibial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64566","description":"Neuroeltrd stim post tibial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB150","description":"Special Care High _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBA1","description":"ICD-BGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; initial device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0449T","description":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; initial device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEE1","description":"ICD-KAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHED0","description":"ICD-OHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clearance of airways","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31720","description":"Clearance of airways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEE1","description":"ICD-NEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPB0","description":"ICD-FEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEE1","description":"ICD-MCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8H","description":"High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Apc gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81203","description":"Apc gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSF0","description":"ICD-DCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLB0","description":"ICD-GDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medical supplies and equipme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9061","description":"Medical supplies and equipme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mycophenolic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7518","description":"Mycophenolic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJD0","description":"ICD-FAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILB1","description":"ICD-GILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVA1","description":"ICD-BDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMD0","description":"ICD-NJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Disconnect insert locking wr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6616","description":"Disconnect insert locking wr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Polishing artifical eye","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2624","description":"Polishing artifical eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACA1","description":"ICD-FACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43886","description":"Revise gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair laminectomy defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63295","description":"Repair laminectomy defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCE1","description":"ICD-KBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVC1","description":"ICD-BGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCF1","description":"ICD-MFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWB1","description":"ICD-GIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"JK GNOTYP SLC14A1 EXON 9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0192U","description":"JK GNOTYP SLC14A1 EXON 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTE0","description":"ICD-IDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Epi etiol synd rvwd and docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1205F","description":"Epi etiol synd rvwd and docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPA0","description":"ICD-KEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External transmitter_ cgm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9277","description":"External transmitter_ cgm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLF1","description":"ICD-BGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ECEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEF1","description":"ICD-ECEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABA0","description":"ICD-NABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54220","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYC0","description":"ICD-CHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA131","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of acute vitreous hemorrhage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1328","description":"Patients with a diagnosis of acute vitreous hemorrhage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Onc nhlstg 1-2 no relap no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9134","description":"Onc nhlstg 1-2 no relap no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXB1","description":"ICD-OFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No tpa init w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8602","description":"No tpa init w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nuclear rx intra-articular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79440","description":"Nuclear rx intra-articular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDE1","description":"ICD-KCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Resin one surface-anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2330","description":"Resin one surface-anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ low density channel foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6603","description":"Gradient compression bandaging supply_ low density channel foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fuse esophagus & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43340","description":"Fuse esophagus & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA31","description":"ICD-4FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-4IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC31","description":"ICD-4IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove renal tube w/fluoro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50389","description":"Remove renal tube w/fluoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ tofersen_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1304","description":"Injection_ tofersen_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis (ie_ CYP1A2_ CYP2C19_ CYP2C9_ CYP2D6_ CYP3A4_ CYP3A5_ CYP4F2_ SLCO1B1_ VKORC1 and rs1277","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0029U","description":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis (ie_ CYP1A2_ CYP2C19_ CYP2C9_ CYP2D6_ CYP3A4_ CYP3A5_ CYP4F2_ SLCO1B1_ VKORC1 and rs1277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthr0 w/synovectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29863","description":"Hip arthr0 w/synovectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMC1","description":"ICD-CCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTA1","description":"ICD-FCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIB1","description":"ICD-GIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQE0","description":"ICD-PGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue culture placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88235","description":"Tissue culture placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC101","description":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16030","description":"Dress/debrid p-thick burn l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Test sock elbw disart/above","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6682","description":"Test sock elbw disart/above","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWB0","description":"ICD-PFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUC0","description":"ICD-KBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spinal fluid tap diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62270","description":"Spinal fluid tap diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Other carot sten 120 days/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9007F","description":"Other carot sten 120 days/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGB1","description":"ICD-ODGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6083","description":"Implant Supported Crown - Porcelain Fused To Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVA0","description":"ICD-BIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc neck tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21554","description":"Exc neck tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJB0","description":"ICD-OHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J2374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2374","description":"HCPCS-J2374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLA1","description":"ICD-FGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAME0","description":"ICD-EAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIC0","description":"ICD-MAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPC0","description":"ICD-OEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGC0","description":"ICD-KFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ younger than 12 years of age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31553","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ younger than 12 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASD1","description":"ICD-LASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 19-9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86301","description":"Immunoassay tumor ca 19-9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHF0","description":"ICD-OIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKB1","description":"ICD-GGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES335","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTF0","description":"ICD-BFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aoe intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9465","description":"Aoe intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electronic Analysis With Complex Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0590T","description":"Electronic Analysis With Complex Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psytx pt&/family 45 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90834","description":"Psytx pt&/family 45 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMA0","description":"ICD-NJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNF0","description":"ICD-FFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUF0","description":"ICD-NEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20520","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Amino acids mult qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82128","description":"Amino acids mult qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Albumin; other source_ quantitative_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82042","description":"Albumin; other source_ quantitative_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57410","description":"Pelvic examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18H","description":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1065T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1065T","description":"CPT-1065T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Decompress spinal cord lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63056","description":"Decompress spinal cord lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Acne surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10040","description":"Acne surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28525","description":"Treat toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVD0","description":"ICD-FDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fun stat score le not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8658","description":"Fun stat score le not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-1DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB31","description":"ICD-1DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA31","description":"Low Rehab_ ADL Index 0-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXA1","description":"ICD-KBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDE1","description":"ICD-OEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic ring fracture uni/bil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0413","description":"Pelvic ring fracture uni/bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Srs cranial lesion complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61798","description":"Srs cranial lesion complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fracture frame free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0930","description":"Fracture frame free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-M1443","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","description":"HCPCS-M1443","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Octagam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1568","description":"Octagam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bat clps elec/comb vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0497","description":"Bat clps elec/comb vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTD0","description":"ICD-NLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sbsq nb em per day hosp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99462","description":"Sbsq nb em per day hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body pos d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8983","description":"Body pos d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray guide intestinal tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74355","description":"X-ray guide intestinal tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXE0","description":"ICD-CHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Release of lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27681","description":"Release of lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J7514","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","description":"HCPCS-J7514","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria and fungi)_ gram-positive organism identification and drug resistance element detection_ DNA (20 gram-positive bacterial targets_ 4 resistance gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0141U","description":"Infectious disease (bacteria and fungi)_ gram-positive organism identification and drug resistance element detection_ DNA (20 gram-positive bacterial targets_ 4 resistance gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAC1","description":"ICD-AGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-1068T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1068T","description":"CPT-1068T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIE1","description":"ICD-BEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKA0","description":"ICD-OGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTA0","description":"ICD-OGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tlso rigidlined cust fab two","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0486","description":"Tlso rigidlined cust fab two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nortriptyline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6037","description":"Nortriptyline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Electron beam computed tomog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8092","description":"Electron beam computed tomog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFD1","description":"ICD-GCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRF0","description":"ICD-HDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ calaspargase pegol-mknl_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9118","description":"Injection_ calaspargase pegol-mknl_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLF1","description":"ICD-OHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQF1","description":"ICD-KBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJA1","description":"ICD-FBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adjust elbow ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1800","description":"Adjust elbow ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47605","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mitochondrial Antibody (Eg_ M2)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86381","description":"Mitochondrial Antibody (Eg_ M2)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing 1 antigen lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81374","description":"Hla i typing 1 antigen lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CDT-D1004","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1004","description":"CDT-D1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCC1","description":"ICD-BCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12D","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPC1","description":"ICD-OHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Brachy_non-str_ytterbium-169","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2637","description":"Brachy_non-str_ytterbium-169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOE0","description":"ICD-ODOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"B-amyloid (Abeta42) and phospho tau (181P) (pTau181)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0445U","description":"B-amyloid (Abeta42) and phospho tau (181P) (pTau181)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEF1","description":"ICD-IDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOC1","description":"ICD-PHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1124","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJC1","description":"ICD-FCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Protein e-phoresis/urine/csf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84166","description":"Protein e-phoresis/urine/csf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/o fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21195","description":"Reconst lwr jaw w/o fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 2.1-3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11443","description":"Exc face-mm b9+marg 2.1-3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1006","description":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"NFCT DS RNA 3 TARGETS UPPER RESPIRATORY SPECIMEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0240U","description":"NFCT DS RNA 3 TARGETS UPPER RESPIRATORY SPECIMEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABA0","description":"ICD-BABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hepatitis c rna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87520","description":"Hepatitis c rna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMB0","description":"ICD-OJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Colonoscopy w/ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44406","description":"Colonoscopy w/ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Flt3 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81245","description":"Flt3 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10C","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove in/ex hem grp & fiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46257","description":"Remove in/ex hem grp & fiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUC0","description":"ICD-GEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hydrogel drg >16<=48 in w/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6246","description":"Hydrogel drg >16<=48 in w/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLB0","description":"ICD-AFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rev artific disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0098T","description":"Rev artific disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA106","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUD1","description":"ICD-CBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICC1","description":"ICD-BICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIME1","description":"ICD-FIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMF1","description":"ICD-IAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"A finding of an incidental pulmonary nodule","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9754","description":"A finding of an incidental pulmonary nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCA1","description":"ICD-AHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIE0","description":"ICD-CHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Incise skull repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62121","description":"Incise skull repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Occlusal guard - hard appliance_ full arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9944","description":"Occlusal guard - hard appliance_ full arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWF0","description":"ICD-OIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Path consult introp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88329","description":"Path consult introp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8625","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drug screen quantalcohols","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80320","description":"Drug screen quantalcohols","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Exc back tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21933","description":"Exc back tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX32","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADE1","description":"ICD-MADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBD0","description":"ICD-IHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXB1","description":"ICD-CFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore chest free adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32124","description":"Explore chest free adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILA1","description":"ICD-CILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mis sup/ac imp vad nopay med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0509","description":"Mis sup/ac imp vad nopay med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of spinal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27105","description":"Transfer of spinal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Explore/treat finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26075","description":"Explore/treat finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILB0","description":"ICD-NILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDE1","description":"ICD-AEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRC1","description":"ICD-HBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJA1","description":"ICD-CIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKA1","description":"ICD-JFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove anal fist complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46280","description":"Remove anal fist complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40530","description":"Partial removal of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB16","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFND1","description":"ICD-NFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBME1","description":"ICD-CBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAB1","description":"ICD-AGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vasopneumatic device therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97016","description":"Vasopneumatic device therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8X","description":"High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29705","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-B0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0407","description":"HCPCS-B0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Air injection into abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49400","description":"Air injection into abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc count of ct in 12mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9322","description":"No doc count of ct in 12mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"External urinary catheter; non-disposable_ for use with suction pump_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6591","description":"External urinary catheter; non-disposable_ for use with suction pump_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rhythm ecg report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93042","description":"Rhythm ecg report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSA1","description":"ICD-PHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ICBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBB0","description":"ICD-ICBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65265","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYE0","description":"ICD-CFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1089","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICF0","description":"ICD-AICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ext ureth clmp or compr dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4356","description":"Ext ureth clmp or compr dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OLPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPC0","description":"ICD-OLPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Social work visit_ in the ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9127","description":"Social work visit_ in the ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIID0","description":"ICD-CIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ippb all types","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0500","description":"Ippb all types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Th/wght bear quad-lat brim c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2520","description":"Th/wght bear quad-lat brim c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fibrin degradation products","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85362","description":"Fibrin degradation products","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C9174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9174","description":"HCPCS-C9174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELB1","description":"ICD-CELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4341","description":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Patient education materials","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99071","description":"Patient education materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Sio panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0624","description":"Sio panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKB1","description":"ICD-NCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMB0","description":"ICD-FBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Adj skin pro/pos wc cus>=22","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2625","description":"Adj skin pro/pos wc cus>=22","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJF1","description":"ICD-NDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70328","description":"X-ray exam of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1209","description":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVD1","description":"ICD-KGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJB0","description":"ICD-BIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLF1","description":"ICD-EFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-DBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOD0","description":"ICD-DBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEC0","description":"ICD-BHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28E","description":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC136","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hhcp-serv of ot_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0152","description":"Hhcp-serv of ot_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLA1","description":"ICD-CGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHD0","description":"ICD-MBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15B","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOA0","description":"ICD-KDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUE1","description":"ICD-OKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFD0","description":"ICD-BCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cannabinoids natural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80349","description":"Cannabinoids natural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Evaluation of wheezing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94060","description":"Evaluation of wheezing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJB1","description":"ICD-KAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4347","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","description":"HCPCS-Q4347","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICD1","description":"ICD-EICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYE0","description":"ICD-LIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Combination oral/nasal mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7027","description":"Combination oral/nasal mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX17","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWB0","description":"ICD-CBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hiv-1/hiv-2 1 result antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86703","description":"Hiv-1/hiv-2 1 result antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPC1","description":"ICD-KHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Inj ferric pyrophosphate cit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1443","description":"Inj ferric pyrophosphate cit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cardiac MRI for morph w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75561","description":"Cardiac MRI for morph w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Power operated vehicle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1230","description":"Power operated vehicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIB1","description":"ICD-CHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUD0","description":"ICD-OFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBF0","description":"ICD-IFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIF1","description":"ICD-FBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHE0","description":"ICD-AHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Nrv cndj tst 3-4 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95908","description":"Nrv cndj tst 3-4 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam for fungi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87220","description":"Tissue exam for fungi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAD1","description":"ICD-FAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIA1","description":"ICD-AHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Rep perf anoper/vestib fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46716","description":"Rep perf anoper/vestib fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"No doc cur funct assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8541","description":"No doc cur funct assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0971T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","description":"CPT-0971T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic control band & belt u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2630","description":"Pelvic control band & belt u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLB0","description":"ICD-NJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYC0","description":"ICD-HAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA36","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59852","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTF1","description":"ICD-NGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWB1","description":"ICD-CEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Photodynmc tx 30 min add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96570","description":"Photodynmc tx 30 min add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Back upholstery_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0982","description":"Back upholstery_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA216","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Init pm e/m new pat infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99381","description":"Init pm e/m new pat infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Supplies for maintenance of insulin infusion catheter_ per week","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4224","description":"Supplies for maintenance of insulin infusion catheter_ per week","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hocm <=149 mg/ml iodine_ 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9958","description":"Hocm <=149 mg/ml iodine_ 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHED1","description":"ICD-OHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc order given vte prophylx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4044F","description":"Doc order given vte prophylx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Denture interm part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5820","description":"Denture interm part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFA0","description":"ICD-BBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKD0","description":"ICD-KCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hla i typing 1 allele hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81381","description":"Hla i typing 1 allele hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDB0","description":"ICD-KHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-METE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METE1","description":"ICD-METE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEB0","description":"ICD-MFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Genotype dna hepatitis b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87912","description":"Genotype dna hepatitis b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWC1","description":"ICD-OFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15A","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJF0","description":"ICD-GIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Consultation with family","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90887","description":"Consultation with family","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80330","description":"Analgesics non-opioid 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLB0","description":"ICD-CDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIF1","description":"ICD-EDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-A0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0405","description":"HCPCS-A0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Peng benzathine/procaine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0558","description":"Peng benzathine/procaine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lang express d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9164","description":"Lang express d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28A","description":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hip arthro w/femoroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29914","description":"Hip arthro w/femoroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQF1","description":"ICD-LEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD)_ with concurrent vertebral fracture assessment_ utilizing data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0743T","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD)_ with concurrent vertebral fracture assessment_ utilizing data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Immune globulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90399","description":"Immune globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Blood sulfhemoglobin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83060","description":"Blood sulfhemoglobin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Abduction bar jointed adjust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2300","description":"Abduction bar jointed adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI and WAIS)_ with qualified health","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96102","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI and WAIS)_ with qualified health","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXA0","description":"ICD-KAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3D","description":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Plmt nephroureteral catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50433","description":"Plmt nephroureteral catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEA0","description":"ICD-GHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNE0","description":"ICD-GHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQE0","description":"ICD-HBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHA1","description":"ICD-OHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRA1","description":"ICD-LHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Aspirin or another antiplatelet therapy not used_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1057","description":"Aspirin or another antiplatelet therapy not used_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELD0","description":"ICD-EELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUA0","description":"ICD-KCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Foam drg <=16 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6212","description":"Foam drg <=16 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0506U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","description":"CPT-0506U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCB0","description":"ICD-GDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pelvic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99459","description":"Pelvic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Dual layer impax membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4262","description":"Dual layer impax membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15A","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELB1","description":"ICD-KELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insert eye socket implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67550","description":"Insert eye socket implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Coch implant trans coil repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8617","description":"Coch implant trans coil repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Stress mgmt class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9454","description":"Stress mgmt class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXF1","description":"ICD-KEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pre-op service lvrs 10-15dos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0303","description":"Pre-op service lvrs 10-15dos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKED1","description":"ICD-OKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHF0","description":"ICD-KFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"X-ray exam of femur 2/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73552","description":"X-ray exam of femur 2/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINC0","description":"ICD-GINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Indwelling catheter latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4338","description":"Indwelling catheter latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25520","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVB1","description":"ICD-OFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lap esophagomyotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2079","description":"Lap esophagomyotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUA1","description":"ICD-NEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ABBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBE0","description":"ICD-ABBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSE0","description":"ICD-HFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Filter_ non disposable w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7039","description":"Filter_ non disposable w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Card MRI veloc flow mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75565","description":"Card MRI veloc flow mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of urine vma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84585","description":"Assay of urine vma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC236","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ suprachoroidal (Xipere)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9092","description":"Injection_ triamcinolone acetonide_ suprachoroidal (Xipere)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tube_ pneum wheel drive tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2382","description":"Tube_ pneum wheel drive tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Seg pneumatic appl full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0667","description":"Seg pneumatic appl full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"W/c dpth 22-25 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2343","description":"W/c dpth 22-25 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYE0","description":"ICD-OCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEB0","description":"ICD-FHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Prolong clincl staff svc add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99416","description":"Prolong clincl staff svc add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insj/rplc car modulj vnt elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0411T","description":"Insj/rplc car modulj vnt elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"BCR/ABL1 (t(9;22)) (eg_ chronic myelogenous leukemia) translocation analysis_ major breakpoint_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0040U","description":"BCR/ABL1 (t(9;22)) (eg_ chronic myelogenous leukemia) translocation analysis_ major breakpoint_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDD0","description":"ICD-FCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42340","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-00550","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","description":"CPT-00550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Mdd moderate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3089F","description":"Mdd moderate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Biopsy of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25100","description":"Biopsy of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Skilled services of a licensed practical nurse (LPN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0496","description":"Skilled services of a licensed practical nurse (LPN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Doc reas no statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8815","description":"Doc reas no statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAC1","description":"ICD-GBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUB1","description":"ICD-AHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fluoro exam of g/colon tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49465","description":"Fluoro exam of g/colon tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Hysteroscopy sterilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58565","description":"Hysteroscopy sterilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFF0","description":"ICD-CDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPA0","description":"ICD-OAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIC1","description":"ICD-GCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUA1","description":"ICD-NHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Closed tx orbit w/manipulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21401","description":"Closed tx orbit w/manipulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinical Follow-Up And Mrs Score Assessed At 90 Days Following Endovascular Stroke Intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0045","description":"Clinical Follow-Up And Mrs Score Assessed At 90 Days Following Endovascular Stroke Intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTC1","description":"ICD-MBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21470","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUF0","description":"ICD-BHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMA0","description":"ICD-MAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFC1","description":"ICD-OGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_  Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28E","description":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Spherocylinder 4.00d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2105","description":"Spherocylinder 4.00d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Implant breast silicone/eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8600","description":"Implant breast silicone/eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPA0","description":"ICD-GDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ACUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUF0","description":"ICD-ACUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAA1","description":"ICD-EAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Application of hip casts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29325","description":"Application of hip casts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFE0","description":"ICD-JHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC255","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; set-up_ patient training_ configuration of monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0534T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; set-up_ patient training_ configuration of monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQF1","description":"ICD-LFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB214","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBD0","description":"ICD-MKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Destruction rectal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45190","description":"Destruction rectal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-C0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0704","description":"HCPCS-C0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUC1","description":"ICD-OFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0478U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","description":"CPT-0478U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLD0","description":"ICD-OGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81274","description":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Gammagraft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4111","description":"Gammagraft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEF0","description":"ICD-GIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29883","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJD1","description":"ICD-GCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHD1","description":"ICD-NJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGB0","description":"ICD-FDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0453T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88307","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59121","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIA1","description":"ICD-CAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5276","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Splint digit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8450","description":"Splint digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIA0","description":"ICD-JIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clsd reduct compd mandble fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7740","description":"Clsd reduct compd mandble fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSF1","description":"ICD-LHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYB0","description":"ICD-OEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHF0","description":"ICD-CEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDE1","description":"ICD-IBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Drainage of tonsil abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42700","description":"Drainage of tonsil abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIB0","description":"ICD-OEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-PGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRF0","description":"ICD-PGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Comp ext fixate strut change","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20697","description":"Comp ext fixate strut change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNB1","description":"ICD-KGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-IFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHB1","description":"ICD-IFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-BBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGE0","description":"ICD-BBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHB0","description":"ICD-CAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKA0","description":"ICD-OHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Total hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58150","description":"Total hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHC1","description":"ICD-OEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML40","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Pharmacist at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9479","description":"Pharmacist at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; thin layer_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82489","description":"Chromatography_ qualitative; thin layer_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_  Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Laminate labial veneer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2960","description":"Laminate labial veneer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIB1","description":"ICD-GBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Overdenture complete mandib","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5865","description":"Overdenture complete mandib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-J3375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","description":"HCPCS-J3375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cysto/uretero w/lithotripsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52356","description":"Cysto/uretero w/lithotripsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGID1","description":"ICD-JGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Body jacket mold to patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1300","description":"Body jacket mold to patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"WoundEx Flow_ BioSkin Flow_ 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4162","description":"WoundEx Flow_ BioSkin Flow_ 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCE1","description":"ICD-EGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-AFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMC0","description":"ICD-AFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIB0","description":"ICD-FCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 3RD DOSE PFIZER","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 3RD DOSE PFIZER","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGB0","description":"ICD-NBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHD0","description":"ICD-NBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1098","description":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_  Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28540","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Add joint upper ext orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3956","description":"Add joint upper ext orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEC1","description":"ICD-NIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBE0","description":"ICD-MLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIA0","description":"ICD-MIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGC1","description":"ICD-OFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUC1","description":"ICD-KHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Repair of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27725","description":"Repair of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 7.12-20","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2302","description":"Lens sphere trifocal 7.12-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Cranial cervical orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0112","description":"Cranial cervical orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGD1","description":"ICD-FDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77299","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Replace vad intra w/o bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33982","description":"Replace vad intra w/o bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13A","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDA1","description":"ICD-MKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ostomy irrigation set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4400","description":"Ostomy irrigation set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBD0","description":"ICD-GDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8G","description":"Very High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQC1","description":"ICD-OAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Osteopath manj 7-8 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98928","description":"Osteopath manj 7-8 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICE1","description":"ICD-FICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA52","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-LCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYD1","description":"ICD-LCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Psychophysiological therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90876","description":"Psychophysiological therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Partial removal collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23120","description":"Partial removal collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHC1","description":"ICD-JBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWD1","description":"ICD-GBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAB1","description":"ICD-CEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12B","description":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28X","description":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBD1","description":"ICD-NJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-ODLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLC0","description":"ICD-ODLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-HESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESF0","description":"ICD-HESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18E","description":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD245","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-L6039","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","description":"HCPCS-L6039","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-EGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIE1","description":"ICD-EGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Fndngs mammo 2pt w/in 3 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5060F","description":"Fndngs mammo 2pt w/in 3 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71046","description":"Radiologic examination_ chest; 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Removal of bladder & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51575","description":"Removal of bladder & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX33","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDF0","description":"ICD-MEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX06","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"HCPCS-Q4425","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","description":"HCPCS-Q4425","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Vent mgmt inpat init day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94002","description":"Vent mgmt inpat init day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Assay of renin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84244","description":"Assay of renin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUD1","description":"ICD-MAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB244","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Heat lamp without stand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0200","description":"Heat lamp without stand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXB0","description":"ICD-JAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKE1","description":"ICD-JHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-OGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMA1","description":"ICD-OGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-JHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTF1","description":"ICD-JHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26755","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHND0","description":"ICD-GHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVA0","description":"ICD-FGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-NJKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKF1","description":"ICD-NJKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-CIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHC1","description":"ICD-CIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATA0","description":"ICD-FATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-KENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENE0","description":"ICD-KENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-MJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIC0","description":"ICD-MJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22A","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-01926","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","description":"CPT-01926","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-GGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEE0","description":"ICD-GGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65780","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC136","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"ICD-FIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAC1","description":"ICD-FIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Revise cerv artific disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22861","description":"Revise cerv artific disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"N block inj plantar digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64455","description":"N block inj plantar digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99241","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]},
{"negotiation_arrangement":"ffs","name":"CPT-0915T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","description":"CPT-0915T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[541545860]}]}]}